Influenza A/H1N1: DOH Interim Guidelines

Influenza A/H1N1
DOH Interim Guidelines
Department of Health
Technical Guidelines
1. Clinical Management and the Use of Anti-Virals for Influenza A H1N1
Virus Infection
2. Infection Control and Use of Personal Protective Equipment for
Influenza A H1N1 Virus Infection
3. Laboratory Diagnosis of Influenza A H1N1
4. On Public Gatherings in Response to Influenza A (H1N1) Virus Threat
I. Clinical Management and the

Use of Anti-Virals
Priority Group for Prophylaxis:
- Health workers
- First responders
- Workers providing essential services
- Household contacts of probable/confirmed
case
Clinical Management and the Use of Anti-Virals

Antiviral Treatment
- confirmed case, probable case, suspected case at
high risk of severe disease
-given w/in 1st 48 hours of illness, x5 days or 24 to 48
hrs after acute sx resolve
-Tx: Oseltamivir 75 mg BID x 5 days
Zanamivir 10 mg BID x 5 days
-Prophylaxis: 1 cap OD x 10 days
Clinical Management and the Use of Anti-Virals

Infection control precautions:
- For adults to remain in place 7 days after resolution
of fever; for children 21 days after onset of illness
- Educate family on personal hygiene and infection
control measures (handwashing, use of surgical mask
of px still coughing)
- Children should not attend school during this period
II. Infection Control and Use of

Personal Protective Equipment
A. Rational Use of PPE by Health Care Personnel
- Standard and droplet precaution for staff providing care
to suspects/confirmed case
- Use medical or surgical mask
- Emphasize hand hygiene and provide hand hygiene
facilities
- Infection control precautions : N95 mask, eye protection,
clean nonsterile long sleeved gown, sterile gloves
- If PPEs are limited, use medical or surgical mask for the
care of all A/H1N1 and practice hand hygiene
Personal
Protective
Equipment
Infection Control
and Use of
Personal
Protective
Equipment
(PPE)
Cap
Gown
N-95 Respirator Mask

Gloves
Goggles
Shoe covers
Infection Control and Use of Personal

Personal
Protective Equipment
Principles for Using PPE

PPE reduces, but does not completely eliminate
the possibility of infection.
PPE is only effective if used correctly.
The use of PPE does not replace basic hygiene
measures such as hand washing hand washing
is still essential to prevent transmission of
infection.

B. Infection Control for General Public
Well Individuals:
- Distance at least 1 m. fr individual w/ flu-like sx
- Avoid crowded situations
- Refrain from touching mouyh and nose
- Frequent hand hygiene
- Reduce close contact w/ people who might be ill
- Improve airflow in living spaces
- Self quarantine if in contact with influenza cases

B. Infection Control for General Public
Individuals w/ Flu-like Sx:
- Seek Consult if unwell; wear mask in going to health
facility
- Follow medical advice and public health
recommendations
- Keep distance from well individuals
- Cover mouth and nose when coughing;dispose of soiled
materials immediately and clean hands after contact with
respiratory secretions
- Improve airflow in living spaces

Guidelines on the Use of masks
- Place mask carefully to cover mouth and nose; tie
securely to minimize gaps between the face and mask
- Avoid touching the mask; clean hands with soap and
water or alcohol based handrub when touching used
mask
- Replace used mask w/ new, clean, dry mask as soon
humid/damp
- Do not reuse single use mask; dispose used mask
immediately upon removing

Personal Hygiene
- Frequent and proper handwashing
- Cough etiquette
III. Laboratory Diagnosis of H1N1
IV. On Public Gatherings

I. For Persons Attending a
Public Gathering
Dos:
- Proper cough manners
and wash hands after
- Maintain personal
hygiene (regular
handwashing with soap
and water, sanitizer )
- Defer attending
gatherings if w/ flu-like
sx; seek consult
On Public Gatherings
High Risk for complications:
- (+) chronic medical condition and/or
immunocompromised
- < 5 y/o or >60 y/o
- Pregnant women
II. For Event Organizers or Hosts:
- Determine time required for the purpose;
avoid extending
- Provide alternative options and venues (ie.
open spaces vs. outdoors)
- Adequately available basic facilities
(handwashing facilities, garbage bins, on-site
medical assessment teams
III. For Local Officials, Health Officers and other
officials
-Reinforce guidelines
-Provide key educational messages, health
alerts, advisories on prevention and control
of A/H1N1
-Complement preparations of event organizers
(adequate facilities and services)
III. For Local Officials, Health Officers and other
officials
- Plan for provision of on-site medical
assistance for possible medical emergencies
- Report ILI in the community where public
gatherings are planned
Republic Act No. 9271/Quarantine Act of 2004
-DOH authorized to investigate, recommend
and assist community to contain the
infection
The ff measures can be recommended to the
Secretary of Health:
- apprehension,detention/isolation or
surveillance of suspect/cases
- place under active or passive surveillance
individuals exposed to the infection
- declare an area under quarantine where
public health emergency occurs
Whats next?
Coordination with other concerned
agencies regarding national response
in the event of a pandemic
OP, DA, DILG, DFA, NDCC
National Center for Health Promotion, DOH
National Center for Health Promotion, DOH
Health Emergency Management Structure

CENTRAL
COMMAND
Secretariat
Safety Team
and Liaison
PLANNING
DOH Central
Office Directors
CHD Directors
DOH Hospitals
Expert Panel
OPERATIONS
Surveillanc
e
Quarantine
Hospital
Operations
Field
Operations
Public Info Ofc
Etc
LOGISTIC
S
Admin
Procureme
nt
CoBAC
MMD
Transport
FINANC
E
Budget
What to do with a suspect A/H1N1
Infection control in transport:

Driver and assist should wear PPE
Adequate barrier (plastic sheet or curtain)
b/w px and driver
Disinfect ambulance after transport of px;
clean surfaces w/ sodium hypochlorite and
spray vehicles interior w/ Lysol.
Referral Centers
I. National Referral Center
Research Institute for Tropical Medicine (RITM)
Alabang, Muntinlupa, Metro Manila
Tel No. 809-7599
II. Subnational Referral Center
A. Luzon and Metro Manila
San Lazaro Hospital
Quiricada St., Sta. Cruz, Manila
Tel No. (02) 732-3776 to 78
Lung Center of the Philippines
Quezon Avenue, QC
Tel No. (02) 924-6101/924-0707
Referral Centers
B. Visayas
Vicente Sotto Medical Center
Cebu City
Tel. No. (032)-253-9891/254-0057
C. Mindanao
Davao Medical Center
Bajada, Davao City
Tel No. (082) 221-6574
III. Satellite Referral Hospitals
Regional Hospitals/Medical Centers of 16 Regions

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Influenza A/H1N1

DOH Interim Guidelines

I. Clinical Management and the

Clinical Management and the Use of Anti-Virals

Clinical Management and the Use of Anti-Virals

II. Infection Control and Use of

N-95 Respirator Mask

Infection Control and Use of Personal

Principles for Using PPE

Infection Control and Use of Personal

Infection Control and Use of Personal

Infection Control and Use of Personal

Infection Control and Use of Personal

III. Laboratory Diagnosis of H1N1

IV. On Public Gatherings

Health Emergency Management Structure

What to do with a suspect A/H1N1

Infection control in transport:

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