MoHFW issues guidelines to manage seasonal epidemic infectio
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With co-infection cases increasingly being reported by doctors, the Union health ministry has issued guidelines for the management of co-infection of the coronavirus disease (Covid-19) with other seasonal epidemic-prone diseases such as Dengue, Malaria, Seasonal Influenza (H1N1), Leptospirosis, Chikungunya etc.

Approach to diagnosis of suspected co-infection

1. Malaria/Dengue

Confirmation of malaria or dengue infection does not rule out the possibility of the patient not suffering from Covid-19.

Similarly, a high index of suspicion of malaria or dengue must be there when a fever is diagnosed as a symptom of Covid-19, particularly during the rainy and post-rainy season.

2. Seasonal influenza

Both Covid-19 and seasonal influenza present symptoms influenza-like illness ((ILI/SARI), hence all ILI and SARI cases in areas reporting Covid-19 cases must be evaluated and tested for both Covid-19 and seasonal influenza.

3. Chikungunya

Chikungunya manifests itself with an acute onset of moderate to high-grade continuous fever and malaise followed by rash, myalgia (muscle pain) and arthralgia (joint pain).

Respiratory failure may ensue in the late stages. Co-infection with Covid-19 may be suspected in chikungunya-endemic areas during monsoon.

4. Leptospirosis (rat fever)

Leptospirosis, apart from the symptom of fever, also has a tendency to manifest as acute respiratory illness, leading to respiratory distress and shock.

In areas where leptospirosis is known to cause outbreaks during monsoon or post-monsoon, doctors need to keep in mind this co-infection while evaluating a patient.

5. Scrub typhus

Patients may develop complications that include interstitial pneumonia (30% to 65% of cases), meningoencephalitis (brain swelling) and myocarditis (swelling of heart muscles).

6. Bacterial infections

Few patients with Covid-19 experience a secondary bacterial infection. In such cases, empiric antibiotic therapy needs to be considered.

Refer below presentation for specific therapeutic considerations for each co-infections mentioned above.

Note: This list is a brief compilation of some of the key recommendations included in the Guideline and is not exhaustive and does not constitute medical advice. Kindly refer to the original publication attached with the post.

Source: https://www.mohfw.gov.in/
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