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Influenza Management Protocol (WHO 2024)

Respiratory

1. Assessment & Diagnosis

  • Clinical Presentation: Sudden onset of cough, headache, muscle/joint pain, severe malaise, sore throat, and rhinorrhea, with or without fever.
  • Diagnosis:
  • Gold Standard: RT-PCR is the preferred method for confirmation.
  • Rapid Tests: NAATs (molecular assays) or Digital Immunoassays (DIAs) are suggested for high-risk patients to guide treatment decisions.
  • Severity Classification:
  • Non-Severe: Uncomplicated illness where symptoms typically resolve within a week.
  • Severe: Presence of sepsis, severe pneumonia, ARDS, or exacerbation of chronic medical conditions requiring hospitalization.

    • 2. Management (Non-Severe)

  • Low-Risk Patients: Symptomatic care only. DO NOT administer Oseltamivir, Zanamivir, or Baloxavir for routine non-severe cases in healthy individuals.
  • High-Risk Patients (e.g., >65 years, chronic disease):
  • Baloxavir: Conditional recommendation for use in high-risk patients if given within 48 hours of onset.
  • Antibiotics: NOT RECOMMENDED for non-severe influenza unless there is a confirmed bacterial co-infection.

    • 3. Management (Severe)

  • Antiviral of Choice: Oseltamivir is suggested for all patients with confirmed or suspected severe influenza. Start treatment as early as possible (within 2 days).
  • Adjunctive Therapies:
  • Corticosteroids: NOT RECOMMENDED (Conditional recommendation against use).
  • Macrolides: NOT RECOMMENDED as immunomodulatory therapy.
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    Warning Signs

    RISK FACTORS & SEVERE SIGNS

  • High Risk Groups: Age ≥65 years, immunocompromised, cardiovascular disease, or chronic respiratory disease.
  • Severe Complications: Sepsis, septic shock, or multi-organ failure.
  • Respiratory Failure: Acute Respiratory Distress Syndrome (ARDS) or need for mechanical ventilation.

    • Reference

    1. World Health Organization (WHO) (2024). Clinical practice guidelines for influenza.
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