Monitoring
Outpatients
As resources permit, the local
health facility should follow up on non-hospitalized patients through home
visits and telephone contact. Follow-up should be done within 24 to 48 hours as
most avian influenza patients develop pneumonia on days 4 to 5 after the onset
of symptoms. Patients should seek medical treatment if their condition worsens.
Adult patients should observe social
contact restriction and infection control procedures for 7 days after the resolution
of fever and symptoms. Children under 12 years old should observe social
contact restriction and infection control procedures for 21 days after the resolution
of symptoms and fever.
Inpatients
Isolation precautions
should be continued for 14 days after the onset of symptoms until an
alternative diagnosis is established or until diagnostic test results indicate
that the patient is not infected with the influenza A virus. Serial respiratory
and blood specimens may be requested to check for possible bacterial infection.
For patients discharged before 14 days, it is recommended that they be isolated
in the home setting.
Close
Contacts
Close
contacts should be monitored for 10 days after the last known exposure to a
confirmed or probable case. Daily assessment should include measurement of
temperature and evaluation for respiratory symptoms such as cough, sore throat,
shortness of breath, or difficulty breathing.
Complications
Pneumonia
is the most common complication of influenza virus. Influenza may be followed
by viral pneumonia and secondary bacterial pneumonia especially in severely ill patients.
Other complications include otitis
media, parotitis, tracheobronchitis, acute sinusitis, rhabdomyolysis with renal
failure, myocarditis, hemophagocytic syndrome, multi-organ failure,
encephalitis, and worsening of underlying conditions.