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GPs told to give Tamiflu to close contacts of swine flu suspects

By Lilian Anekwe

GPs should prescribe Tamiflu to close contacts of probable and confirmed cases of swine flu, the latest guidance from the Health Protection Agency advises.

In the latest treatment guidance for GPs, the HPA recommends post exposure prophylaxis for close contacts who were exposed to a probable or confirmed case of swine flu.

The new guidance came as the World Health Organisation (WHO) raised its alert level over swine flu from four to five, following confirmation of localised human to human transmission in at least two countries. The raised alert means there is a ‘strong signal that a pandemic is imminent', according to the WHO.

The HPA defines a probable case as a patient who has returned from an affected area, with fever and a flu-like illness and a positive influenza A test from a nose and throat swab.

Patients returning from affected areas who have had a fever in the last seven days but who have not tested positive for influenza A are not classified as probable cases.

The HPA defines a confirmed case as a patient who meets the clinical criteria who also has HPA-laboratory confirmation of influenza A/H1N1 on further analysis of swabs.

The guidance also recommends GPs arrange blood tests for contacts ‘as soon as possible and 14 days after last exposure to the case and sent to the centre for infection for serology testing'.

GPs may now face logistical differences arranging blood tests. The RCGP have already expressed concerns that practices will face difficulties accessing swabs for tests and Tamiflu for patients under investigation and their contacts.

GPs have been advised to give prophylactics to close contacts of confirmed and suspected swine flu patients Tamiflu Swine flu survey

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