STUDY OF CLINICAL PROFILE AND ASSOCIATED RISK FACTORS OF H1N1 INFLUENZA PATIENTS IN A TERTIARY CARE CENTRE IN EASTERN RAJASTHAN

Dr Abdul Wahid, Dr Dheeraj Singh Shekhawat, Dr Girish Chandra Verma, Dr Arun Vinayagan

Abstract


BACKGROUND: Even though pandemic of Influenza A(H1N1) virus has settled, yet yearly epidemics continue to occur.
We describe the clinical profile of H1N1 positive patients admitted in Medical college Hospital, Kota, from August 2018 to
March 2019, all coming from eastern Rajasthan.
METHODS: We collected prospective data of 75 patients whose throat swabs were positive for novel influenza H1N1 by
RT-PCR assay (TAQ MAN real time PCR CDC protocol).
RESULTS: Majority (62.66%) of the cases were between 16-45 years of age group. Females (62.66%) were significantly
more affected than males (37.33%), p value=0.025. Most common symptoms were cough (100%), fever (85.33%) and
shortness of breath (57.33%). 40 cases (53.33%) out of 75 cases had one or more co-morbid condition. Hypertension
(24%), pregnancy (12%) and diabetes (8%) were the most common co-morbid conditions. The mean duration between
onset of symptoms and admission in hospital and start of oseltamivir was 4.61 days in patients who died in comparison to
3.62 days in patients who were cured, overall it was 3.8 days. Death of 13 cases (17.33%) occurred. Mortality was 15% in
cases with co-morbid conditions and 20% in cases with no co-morbid condition (not significant, p value=0.71). Mortality
was 19.14% among female patients as compared to 14.28% among men. 5 out of 9 pregnant patients had fetal loss during
their course of pregnancy.
CONCLUSIONS: Although the pandemic era of H1N1 has settled, epidemics occurring every year in different parts of
our country continuously reminds us of the danger ahead. H1N1 Influenza occurs in post monsoon period mainly,
thereafter incidence decreases due to attainment of immunity against spreading strains of virus. Vaccination should be
done in the month of August – September rather than in November to prevent epidemics. Early initiation of treatment
with oseltamivir may reduce mortality. Patients with risk factors require additional attention because of high morbidity.


Keywords


Influenza A(H1N1) virus, Co-morbid Condition, Pregnancy, Mortality

Full Text:

PDF

References


Baden LR, Drazen JM, Kritek PA, Curfman GD, Morrissey S, Campion EW, et al. H1N1 influenza a disease- Information for health professionals. N Engl J Med 2009;360:2666-7.

Belshe RB. Implications of the emergence of a novel H1 influenza virus. N Engl J Med 2009;360:2667-8.

Dhawale S, Jayant S. Clinical profile, morbidity and mortality among swine flu(H1N1) infected patients: 2015 Gwalior, Madhya Pradesh pandemic, India. Int J Adv Med 2016;3:324-7.

K. Sujatha, VasudevaMurali, B. BabuRao, AkhilKathi. A clinical and epidemiological study of H1N1 cases at a tertiary care hospital in Hyderabad, Telangana. International Journal of Contemporary Medical Research 2016;3(9):2732-2735.

Wright P F. Harrison’s Principles of Internal Medicine. 20th ed. Mc Graw Hill;2018. pp.1382-88.

Shah A N. Medicine Update. Vol. 28th. Evangel; 2018. Pp. 629-35.

Prasad S, Indhu AJ, Margos RA, Philip S. Clinical profile and outcome of H1N1 influenza patients in a tertiary care hospital in kochi, kerala. Indian J Respir Care 2018;7:97-101.

Ministry of Health and Family Welfare-Govt.of India seasonal influenza- Guidelines on Categorization of Influenza A H1N1 cases during screening for home isolation, testing, treatment and hospitalization(Revised on 18.10.2016) (http://mohfw.gov.in/swine-flu- h1n1-seasonal-influenza).

Ministry of Health and Family Welfare-Govt.of India seasonal influenza- Clinical Management Protocol for Seasonal Influenza (http://mohfw.gov.in/swine-flu- h1n1-seasonal-influenza).

Chaudhari AI, Zaveri JR, Thakor N. Profile of confirmed H1N1 virus infected patients admitted in the swine flu isolation ward of tertiary care hospitals of Baroda district, Gujarat, India. Int J Res Med Sci 2015;3(9):2174-80.

NL Varun Mai, MudumalaIssacAbhilash, Narasimhulu. Comparative study of morbidity and mortality of non H1N1 pneumonia with H1N1 pneumonia in Gandhi Hospital during the epidemic of H1N1 outbreak. International Journal of Contemporary Medical Research 2017;4(9):1921-1923.

Patel Bhavin D SVS, Patel Ameekumari B, ModiBhautik P. Clinico-epidemiological Correlates of Hospitalised H1N1 Pneumonitis cases in a Teaching Hospital of Western India During 2009-2010 Pandemic. NJMR.2012;2(2):218-22.

Chudasama RK, Patel UV, Verma PB et al. Clinico-epidemiological features of the hospitalized patients with 2009 pandemic influenza A (H1N1) virus infection in Saurashtra region, India (September, 2009 to February, 2010). Lung India. 2011 Jan- March; 28(1):11-16.

Mehta AA, Kumar VA, Nair SG, K Joseph F, Kumar G, Singh SK, et al. Clinical profile of patients admitted with swine-origin influenza A(H1N1) virus infection:An experience from a tertiary care hospital. J ClinDiagn Res 2013;7:2227-30.

Jain S, Schmitz AM, Louie J,DruckenmillerJK,Chugh R, Deutscher M, et al. Hospitalised patients with 2009 H1N1 influenza in the United States, April- June 2009. N Engl J Med 2009;361:1935-44.

Kalyani D, Bhatt SS, Chitralekha T et al. Comorbidities in H1N1 positive patients – Hospital based study. IOSR-JDMS. March 2016;15(3):52-55.

Bhatt KN, Jethwa SC, Bhadiyadara D et al. Study of clinical profile in patients with H1N1 influenza in Surat District, June 2009- March 2010. JAPI. May 2012;60:15-19.

Puvanalingam A, Rajendiran C, Sivasubramanian K, Raghunanthanan S, Suresh S, Gopalakrishnan S, et al. Case series study of the clinical profile of H1N1 swine flu influenza. J Assoc Physicians India 2011;59:14-6, 18.


Refbacks

  • There are currently no refbacks.