Swine flu : Questions Related to Isolation and Quarantine

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SWINE FLU - QUESTIONS RELATED TO ISOLATION AND QUARANTINE

Karishma Kulkarni, Nikhil Thatte, Rucha Shelgikar, Ira Shah
medical Sciences Department, Pediatric Oncall

Address for Correspondence:

1/B Saguna, 271/B St. Francis Road, Vile Parle (W), Mumbai 400056.
Email: info@pediatriconcall.com

Home isolation

Patients who develop flulike illness (i.e., fever with either cough or sore throat) should be strongly encouraged to self-isolate in their home for 7 days after the onset of illness or at least 24 hours after symptoms have resolved, whichever is longer. Centers for disease control and prevention(CDC), USA recommends that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]), or signs of a fever without the use of fever-reducing medications.

Isolation practices in hospitals

•	Place patients in a single-patient room with the door kept closed. An airborne-infection isolation room with negative-pressure air handling can be used, if available. Air can be exhausted directly outside or can be recirculated after filtration by a high efficiency particulate air (HEPA) filter.
•	If dedicated isolation room is not available then patients can be cohorted in a well ventilated isolation ward with beds kept one metre apart.
•	Aerosol-generating procedures such as endotracheal intubation, nebulized medication administration, induction and aspiration of sputum or other respiratory secretions, airway suction, chest physiotherapy and positive pressure ventilation should be performed by the treating physician/ nurse wearing full complement of PPE with N95 respirator on.
•	Hospitals with centralized air conditioning are not allowed by the Government to treat swine flu cases as the centralized AC may help in spread of infection within the hospital.
•	Until further evidence is available, infection control precautions should continue in an adult patient for 7 days after resolution of symptoms and 14 days after resolution of symptoms for children younger than 12 years because of longer period of viral shedding expected in children. If the patient insists on returning home, after resolution of fever, it may be considered, provided the patient and household members follow recommended infection control measures and the cases could be monitored by the health workers in the community.

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