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Hini2012 update

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Babak Jebelli
Babak Jebelli

The document provides guidelines for evaluating and managing patients with influenza-like illness (ILI) during pregnancy. It describes the symptoms of ILI and H1N1 flu. Patients with mild ILI symptoms and no risk factors can be treated as outpatients, while those with concerning signs, comorbidities, or symptom progression warrant further evaluation and treatment including Tamiflu and possible hospitalization.

Health & Medicine
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CDC WEB SITE 10/06 : What are the symptoms of seasonal and 2009 H1N1 flu? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CDC CASE DEFINITIONS ,[object Object],[object Object],[object Object],[object Object]
CDC DEFINITION OF Close Contacts   ,[object Object],[object Object],[object Object],[object Object]
CDC ADDITION TO “CLOSE CONTACT” 10/16 ,[object Object],[object Object]
INCUBATION PERIOD CDC 10/16 ,[object Object],[object Object],[object Object]
Co-Morbidities that predispose patients to Complications from Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object]
Complications from 2009 H1N1 causing Severe Maternal Disease ,[object Object],[object Object],[object Object]
Primary Viral Pneumonia Clinical Presentation   ,[object Object],[object Object],Lancet 2009; 374: 451–58 N Engl J Med 2009;361
INFLUENZA FACILTATES BACTERIAL PNEUMONIA INFECTION ,[object Object],[object Object],Clin Microbiol Rev. 2006 July; 19(3): 571 N Engl J Med 2009;361. Morb Mortal Wkly Rep. 2007 Apr 13;56(14):325-9
2009 H1N1 CASES ASSOCIATED WITH BACTERIAL PNEUMONIA ,[object Object],[object Object],MMWR 2009 ;58:749--52. September 29, 2009 BACETRIAL CO-INFECTION WITH H1N1 N Engl J Med 2009;361. Morb Mortal Wkly Rep. 2007 Apr 13;56(14):325-9
Secondary Bacterial Pneumonia CLINICAL PRESENTATION ,[object Object],[object Object]
Clinical features of severe cases of 2009 H1N1 ,[object Object],[object Object],[object Object],WHO 10/16/2009
RIVERSIDE OB INTERIM RECOMMENDATIONS 10/26 Triage Evaluation Clinical Management Outpatient Follow up
Co-Morbidities that predispose patients to Complications from Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object]
Asthma and Pregnancy confer a high risk for Severe Disease with Seasonal Influenza or H1N1 ,[object Object],[object Object],[object Object],[object Object],MMWR Morb Mortal Wkly Rep. 2009 May 15;58(18):497-500. N Engl J Med 2009;361
Mild ILI Symptoms SEVERE DISEASE NOT LIKELY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILD ILI SYMPTON ONSET > 72 HOURS No Treatment with Tamiflu , NO culture, No Observation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MILD ILI SYMPTON ONSET < 72 HOURS Treat with Tamiflu & Release NO culture No Observation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Concerning ILI Signs & Symptoms Warrant further Evaluation, Tamiflu Tx, Culture & Observation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluation for Concerning ILI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],N Engl J Med 2009;361 (10.1056/NEJMoa0906695) Obstet & Gynecol VOL. 114, NO. 4, 2009
Consider Viral Studies, Tamiflu, Observation WITH No FEVER HOWEVER CLINICALLY CONCERNING ILI Sx/Sx AND ,[object Object],[object Object],[object Object]
ILI of Concern Further Workup & Treatment Indicated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstet & Genecol VOL. 114, NO. 4, 2009
SEVERE ILI Stabilization & Consider Delivery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications & 2009 H1N1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT WITH TAMIFLU Requires Approval By (…..) in Comments Section ,[object Object],[object Object],[object Object]
PREGNANCY HI RISK ,[object Object],[object Object],[object Object],[object Object],[object Object]
SEVERE ILI Stabilization in the ICU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Who to treat CDPH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT VS PROPHYLAXIS ,[object Object],[object Object]
TAMIFLU INFORMATION ,[object Object],[object Object],[object Object]
IV THERAPY RECOMMENDED ,[object Object],[object Object],[object Object]
INHALATION THERAPY ,[object Object],[object Object],[object Object]
MEDICAL COMPLICATIONS ,[object Object],[object Object],[object Object]
MEDICAL COMPLICATIONS HIGH RISK FOR ADVERSE OUTCOME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Hini2012 update

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