Flu season has arrived, and we need to be thinking about who to test and who to treat. Full guide HERE But don’t forget MERS!!

Q1. Do you suspect Flu?

• Fever
• Coryza
• Arthralgia and/or Myalgia
• Malaise
• GI symptoms – with or without signs of respiratory/other involvement e.g. CN

Yes! – Respiratory precautions

• Isolated in a side room
• Surgical face mask worn on entry to room + gloves and apron
• FFP3 mask or hood worn for aerosol generating procedures
• Bare below the elbow / good quality hand hygiene
• Proceed to Q2

Q2. Do they require admission?

• No – Are they high risk and require Tamiflu? – Prescribe oseltamivir (Tamiflu) 75mg BD for 5 days if in an “at risk” group
  • >65 years old
  • obese
  • pregnant
  • chronic underlying condition
• Yes – Isolate and test. Testing can be POCT or Lab, POCT will be our standard choice , but remember we only have one machine on each site and it takes 20min so samples may be stacked.
  • Flu Negative – Usual care
    • Haem/Oncology patient – Continue precautions and send nasal PCR
  • Flu Positive
    • Arrange for patient to go to a side room AND maintain respiratory precautions
    • Prescribe antivirals as per PHE guidelines (pdf)
    • Assess for secondary bacterial infection: if present, prescribe as per CHFT antibiotic policy
    • Ensure +ve flu status is included in nursing and medical handover