Discharge Criteria for Adult Inpatients with Influenza-Like Illness
1) Afebrile for at least 24 hours
2) Tolerating PO
3) Normal mental status
4) Heart rate ≤ 100
5) Respiratory rate ≤ 24
6) Systolic blood pressure ≥ 90
7) Stable or decreasing oxygen requirement of 4 liters or less, with saturation ≥ 90% on
ambulation.
Treatment Criteria for Adult Inpatients with Influenza-Like Illness
1) Patients with influenza-like illness should receive 5 days of oseltamivir (any
remaining doses at time of discharge will be provided to patient by their nurse.)
2) Patients with influenza-like illness who remain febrile for more than 5 days may
continue to receive oseltamivir.
3) Patients with influenza-like illness and chest x-ray abnormalities should be treated
with antibiotics for community-acquired pneumonia as well as oseltamivir.
4) Patients with influenza-like illness who receive antibiotics for chest x-ray
abnormalities should have a follow-up x-ray and primary care appointment in 4-6
weeks following discharge.
5) If central venous access is required in patients with influenza-like illness, the right IJ
should be avoided (this site is reserved in case ECMO is required.)
Clarification of Issues Surrounding Inpatients with Influenza-Like Illness
1) Patients with influenza-like illness may be cohorted together regardless of IFA-PCR
results. Drapes between such patients should remain drawn, and beds should be
separated by at least 3 feet.
2) All cases of H1N1 in the United States have been of identical genotype, thus there is
no risk of influenza positive patients spreading different genotypes to one another.
3) Surgical masks are sufficient precautions for physicians entering the rooms of
patients with influenza-like illness.
4) N95 masks should not routinely be used by physicians or family members visiting
patients with influenza-like illness.
5) When direct contact with respiratory secretions (or any body fluid) of a patient with
influenza-like illness is anticipated, wearing surgical gloves is appropriate.