MUMBAI: The BMC has upgraded guidelines for paediatric patients testing positive for H1N1. The upgradation of guidelines becomes even more important as two infants had succumbed to swine flu on Saturday.

According to the new guidelines, now, not only children with respiratory distress but also those with high fever, poor diet, excessive vomiting and convulsions will be admitted and monitored. The patients will now be given oseltamivir for 10 days if the five-day course does not show improvement in their condition. Apart from these, Paracetamol instead of Aspirin will be used for treating fever in kids, the children will be admitted in paediatric ICU promptly in case their condition deteriorates and oxygen will be used for all patients with respiratory distress.

According to sources, the paediatric ICU at Jerbai Wadia Children's Hospital in Parel has been closed for fumigation, with parents being told to transfer their children to other hospitals because of a swine flu scare in the hospital. One more critically ill child, a two-and-half-year-old boy, was first shifted from Wadia hospital to Kasturba on Saturday evening. According to civic officials, he was later shifted to Nair Hospital on Sunday after he tested negative for H1N1.

Meanwhile, only 170 people turned up for swine-flu screening at the various municipal hospitals on Sunday, with 19 of them admitted to its various isolation wards. Nine patients__five in municipal hospitals and four in private hospitals__are critically ill and on ventilator support, said the daily BMC update.

The deaths of two infants on Saturday, soon after they were transferred out of Wadia hospital in Parel, once again highlights the need for quick diagnosis and treatment of patients who are at high risk of H1N1 infection. "The BMC has tried to increase the number of centres where screening and medication is available. We will in the following months add more centres,'' said Manisha Mhaiskar, additional municipal commissioner. As there are fears of the second wave of H1N1 infection in winter, the civic body is toying with the idea of having designated ICU beds at its Sion and KEM hospitals as well, said sources. Over 250 doctors have been given fresh training on H1N1 management in the past few weeks.

With the Union government likely to allow the sale of Tamiflu at special chemist shops that are licensed to sell Schedule X drugs (requiring two prescriptions from doctors, one which will be kept with patients and another that will be filed with chemists for maintaining records that have to be submitted to the FDA), senior BMC officials say that they are relieved. "Early dispensation of Tamiflu__within 24 hours of symptoms setting in__seems to produce the best results. If Tamiflu is available more easily, then people will be greatly assisted,'' said a civic doctor.