CLINICAL SPECTRUM AND OUTCOME OF SUSPECTED AND PROVED H1N1 CASES IN A TERTIARY CARE HOSPITAL

Harish BV*, Vidyasagar C.R., Prabhakar K. and Uphar G.

ABSTRACT

Introduction: Swine-origin influenza virus is the strain of the influenza family of viruses that is endemic in pigs. The first pandemic of influenza occurred in 1918. It was attributed to human H1N1 virus & affected 500 million persons worldwide. The current virus is a remnant of the 1918 virus, first detected in 2009. Objective: To study the clinical spectrum and outcome of patients of suspected or confirmed H1N1 influenza. Materials and Methods: Detailed history & examination was done in patients aged above 18yrs with suspected H1N1 influenza (CDC criteria). They were divided into 4 categories (A, B1, B2 and C) as per Ministry of Health & Family Welfare Guidelines.[2] Patients belonging to B2 & C category were included in the study & throat swab examination was sent in Cat C patients & both the group patients were started on antiviral treatment (Oseltamivir). Results: Total of 75 cases were included in the study of which 36% were males & 64% were females. 90% (68) patients presented with fever, 76% (51) had cough, 60% (45) with breathlessness, 73% (55) had rhinorrhea, 59% (44) had sore throat, 18% (14) with diarrhoea, 74% (56) presented with headache. 76% (56) showed B/L pneumonia on CXR. 24% (18) had h/o exposure. 22% were positive for H1N1. 33 patients (44%) had 1 or more co-morbid condition. Diabetes was the most common risk factor. Mortality was seen in 13% (10 patients of which 6 patients tested positive for H1N1 and 4 were negative). The deaths were due to complications like B/L pneumonia with ARDS & MODS. Conclusion: Identifying the symptoms & co morbidities & early initiation of antiviral therapy reduces the mortality & morbidity. Hand hygiene, cough etiquette and maintain safe distance (minimum two feet) from infected patients reduces the transmission. Prevent overcrowding and Use of personal protective measures reduce easy spread of infection.

Keywords: Swine-origin influenza (Oseltamivir). rhinorrhea, criteria).