Get your pharmacist involved if a customer reports any of the following:

• A high temperature (above 38ºC or 100.4ºF) that does not respond to medication such as paracetamol
• Very severe pain
• Breathing problems
• Difficulty swallowing that means dehydration is a possibility
• A muffled voice
• A high pitched noise when breathing (this is known as stridor)
• Drooling
• A sore throat that has not improved after a week.

Certain patient groups should also always be referred because they are more at risk of complications:

• Anyone with HIV, AIDS, leukaemia, or aplastic anaemia
• Anyone with diabetes
• Individuals with a spleen that does not work properly or has been removed
• Any patient on chemotherapy, immunosuppressants (most commonly because of an organ transplant) or on a medicine that can cause blood disorders (e.g. neutropenia and agranulocytosis).