In the Emergency Room we are seeing many patients with upper respiratory illnesses and presumed H1N1 influenza. The great majority of these cases are mild and require nothing more than treatment for symptoms. If a patient is at risk for complications the Centers for Disease Control and Prevention(CDC) recommend healthcare providers use clinical judgment to start an antiviral treatment of Tamiflu (oseltamivir) or Relenza (zanamivir).
Groups at higher risk for complications include:
- Children younger than 2 years old
- Persons aged 65 years or older
- Pregnant women and women up to 2 weeks postpartum (including following
- Persons of any age with certain chronic medical or immunosuppressive conditions
- Persons younger than 19 years of age who are receiving long-term aspirin therapy
The CDC is tracking the number of cases of invasive pneumococcal disease (IPD) commonly known as pneumonia across the country. There is a spike in IPD with a higher prevalence in the Denver, Colorado area. Click here for CDC graph.
Early in the course of this illness IPD patients can appear non-toxic. Patients with H1N1 influenza may have decreased immune systems from the illness and they can quickly develop IPD. Identifying these patients is paramount since some will return to the Emergency Department with life threatening pneumonias and septic shock (see my blog on the Signs of Sepsis: Be on Guard).
It is recommended that all healthcare providers and patients with influenza symptoms have a heightened awareness for IPD. If you have a persistent increased heart rate (greater than 100), difficulty breathing, or feel like you want to faint see a doctor right away.