ENHANCED INFLUENZA-LIKE ILLNESS COMMUNITY SURVEILLANCE &

SEVERE ACURE RESPIRATORY INFECTION SURVEILLANCE

REFERAL FLOW AND RESPONSE
Department of Health Region 7

Version 04
04.04.2020

A. Enhanced COMMUNITY Influenza Like-Illness (ILI) Surveillance Flow:
Persons presenting with
Influenza-Like Illness (PPI)
at Health Centers, Hospital
OPD, Clinics, ILI Centers
(present in some LGUs)
ILI: Fever≥ 38°C AND Cough
OR Sore throat reported
within 72 hrs of onset of
fever
• ILI Surveillance Officers:
• Collects ILI CIF, check
• Sends data to RESU
• RHW and/or BHW and/or BHERT
• Ensure PPI follows
isolation protocol for 14
days
• Ensures regular intake of
• Health Center prescribed medications
ILI CATEGORY 1: PPI WITH NO CO-MORBIDITIES
Staff/Clinic • Daily monitors and
• Send home with advise b
Staff/OPD
• Endorsed to Local Health Unit for prompt records improvement or
Personnel fills out progression of symptoms
monitoring c
ILI CIF • Prompt referral to
• No swab
• Physician and other MHO/Area Physician once
health personnel symptom progression is
with PPE examine, noted
ILI CATEGORY 2: PPI WITH STABLE & CONTROLLED CO-
diagnose and treat
MORBIDITIES
PPI a
• Obtain swab
• Endorse to Local Health Unit for monitoring c
• If negative, give advice b
• If positive, continue to monitor at home (if • MHO/Area Physician/ILI Center
home has a suitable quarantine space) or refer Physician promptly reassess PPI’s
to an ILI Center for monitoring condition
• If symptom progression is
completeness of
noted, decides to admit
information, enters
ILI CATEGORY 3 (SARI): PPI WITH SHORTNESS OF patient to hospital as
data using the MS
BREATH/DIFFICULTY OF BREATHING; WITHOUT (3A) OR WITH CO- SARI
Form and PIDSR
• Request ambulance for
MORBIDITIES (3B) e
• Obtain swab prompt transport of PPI to
(MS Form daily and
• Admit to hospital hospital
PIDSR weekly)
• Health Center Staff/Clinic Staff/OPD Personnel Staff • Coordinate with hospital
coordinates the hospital admission staff of in-coming SARI
admission

a Examination, diagnosis and treatment may be done in a separate, dedicated area in the premises of the health establishment. For in-facility procedures, preventive measures must be in place to protect others
from being infected.
b Isolate patient in a separate room from other household members for 14 days; separate beddings, utensils; if possible separate toilet and bathroom
c Done by RHW, NHW, BHERT
d Comorbidities (medically diagnosed with: Hypertension, Diabetes, Renal Disorder, Lung Disorder, Malignancy, Autoimmune Diseases, etc.) MUST BE HOSPITALIZED for close observation and management
 B. Enhanced HOSPITAL Severe Acute Respiratory Infection (SARI) Surveillance Flow:

• Hospital staff activates Infection

Control Protocols (e.g. activate ICS,
inform ICC, etc.)
• Assess SARI patient at ER Hospital staff manages SARI patients
Isolation Room
according to latest guideline (DOH
• Prompt clinical management
Department Order 2020-0108: Guidelines
according to current clinical
Persons presenting guidelines of Management of Patients with Possible
with SARI at the ER • ICN fills out SARI or Confirmed COVID19)
Surveillance CIF
• Collects NPS/OS specimens
• Informs RESU of admission

• RESU Officer:
• Collects SARI CIF, check
completeness of ICS: Incident Command System
information ICC: Infection Control Committee
• Sends data to RESU7
NPS: Nasopharyngeal Swab
weekly
• Coordinates transport of OS: Oral Swab
specimens to central
laboratory (RITM

SARI: Fever and cough or sore throat + Shortness or difficulty of breathing; for persons ≤ 5 years old, follow IMCI Criteria for Pneumonia
C. Community Response Flow to Clustering of ILI cases:

ILI Surveillance Officer: ILI Surveillance Officer Local Health Officer

• Analyses ILI Surveillance Clustering of cases noted a • Promptly • Informs Local Executives
daily and takes note of informs Local (Brgy Captain and
clustering of cases Health Officer Mayor) of clustering
• Documentation • Facilitates quarantine
of individuals measures immediately b
affected by • Facilitate life line support
community of quarantined
quarantine who community c
did and did not
develop ILI

a
Clustering of cases (Proposed):
• 5 of more ILI cases in a day in a Purok, Sitio, dwelling (apartments rows, condominium, etc.): initiate quarantine measure of whole Barangay
• 5 or more ILI cases in a day in 3 or more Barangays,: initiate quarantine measure of whole Municipality or City

b
Quarantine measures: prompt community quarantine for 14 days
c
LGU Executives shall provide assistance to the community in terms of food, potable water, clothes, essential services, etc.