Re: Tracking deaths in Kerala (total 90)
Re: Tracking deaths in Kerala (total 90)
Delay in treatment hampers A(H1N1) control
C. Maya
Doctors not prescribing anti-viral drug despite instructions
Doctors asked to prescribe drug at the earliest
People unwilling to take drug without diagnosis
Thiruvananthapuram: Delay in the treatment of flu-like illnesses and a strange reluctance on the part of doctors to prescribe the anti-viral drug, Oseltamivir, to all suspected flu cases is affecting measures to control A(H1N1) infection in the State.
Senior Health officials said that though the department had issued many communications to doctors that Oseltamivir should be prescribed for suspected flu cases without waiting for lab tests to confirm diagnosis, many doctors in the periphery and the private sector were not following these guidelines.
More than two days
?Now our instruction to doctors is that any case of fever which lasts over two days be treated as possible H1N1 infection, especially, if the throat or respiratory tract is involved and that Oseltamivir be started immediately.
However, many doctors continue to refer patients to testing centres instead of prescribing Oseltamivir. This is a dangerous trend and could lead to the unnecessary loss of lives,? H1N1 State Nodal Officer Amar Fettle said.
He said that the drug was now available in all government hospitals right from the primary health centres. The government had provided ample supplies to several private hospitals, he added. He pointed out that along with the doctors' reluctance to prescribe Oseltamivir there was also the problem of some people questioning the doctors' wisdom in prescribing the drug without confirming the diagnosis of H1N1.
No need for testing
Last year, the virus was new in the community and the national policy relied on testing first before starting treatment. ?
With widespread community-level infection, testing is no longer relevant for treatment. In a pandemic situation, the pandemic virus (in this case, the H1N1 virus) will naturally replace all other flu viruses. Hence it is best to start Oseltamivir immediately for any influenza-like illness,? Dr. Amar explained.
Current guidelines also say that pregnant women, however mild their cold or fever may be, be started on Oseltamivir immediately as pregnancy and post-natal state is a highly vulnerable condition for H1N1 infection.
But many doctors as well as pregnant women themselves continued to resist the use of this drug during the gestation period, officials said. In some cases where the doctor had prescribed the drug, the women were persuaded against taking it ?unnecessarily' by family members, reports from the field showed.
Health Secretary Manoj Joshi, in a statement here, appealed to the public and the medical community not to delay treatment of flu-like illnesses and that Oseltamivir be started immediately for patients.
http://www.hindu.com/2010/07/17/stories/2010071754020400.htm
