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Local officials plan to follow guidelines on when patients should see doc

WILLMAR -- If you think you might have influenza, should you see a doctor?

Behind the scenes, health officials are worried about the potential for widespread flu -- both the seasonal and the novel H1N1 types -- to swamp the medical system with patients who perhaps are better off staying home.

Officials at Affiliated Community Medical Centers said Wednesday that they're following national recommendations for who should be evaluated and treated for suspected H1N1 influenza, often referred to as swine flu.

People between the ages of 5 and 65 who are in generally good health and are not pregnant don't need to see a doctor unless they're severely ill and require hospitalization.

Those who should seek evaluation and potential treatment are patients with a fever higher than 100.5 degrees and who are younger than age 5, older than age 65, pregnant women, nursing home residents, people taking immune-suppressing medications, and people with underlying severe health conditions such as asthma, chronic obstructive pulmonary disease, diabetes, kidney failure, cirrhosis, heart disease, cancer or multiple sclerosis.

It's also recommended that high-risk individuals who've had close contact with someone with the H1N1 virus receive preventive treatment for H1N1.

High-risk individuals who need to seek medical treatment or evaluation are urged to wear a mask for their visit to the clinic.

These recommendations likely will continue to evolve. New or updated information will be issued to the public as it becomes available.

Symptoms of novel H1N1, an influenza A strain, typically include fever, cough, headache and body aches, with possible vomiting and diarrhea.

Don't expect routine testing for the H1N1 virus, cautioned Jo DeBruycker, manager of the Health Learning Center at ACMC.

Although a rapid test is commercially available for seasonal flu, there's no such test yet for the novel H1N1 strain, she said. "It's not a test on demand. It may become available over time, but it's not right now."

Testing has generally been limited to hospitalized patients for the purpose of surveillance and monitoring.

Health providers also are targeting antiviral flu medications, such as Tamiflu, to the highest-risk patient groups, such as people who are hospitalized, people at high risk from flu-related complications, pregnant women and people with chronic immune-system suppression.

Because some resistance to Tamiflu has already been reported, many providers are trying to use the medication as judiciously as possible, DeBruycker said. "Not everybody is a good candidate for antivirals."

To be most effective, the medication must be given within 48 hours after the onset of symptoms, she said. "It will reduce the length of symptoms. It will reduce some of the symptoms, but it will not take away the virus."

There has been some confusion about how long people should stay home from work or school if they've been sick. The recommendation is to stay home for at least 24 hours after the fever is gone -- but be aware that people can still be contagious for up to seven more days.

"Everybody should look and see if they have a thermometer in the house," DeBruycker said. "When people call the doctor, they should be able to describe what their temperature is. Digital thermometers are easy to use and are inexpensive."

Anne Polta

Anne Polta covers health care, business/economic development and general assignment. Her HealthBeat blog can be found at Follow her on Twitter at @AnnePolta.

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