Clinical Profile of Suspected and Confirmed H1N1 Influenza Infection in Patients admitted at a Tertiary Care Teaching Hospital

Document Type : Original Article

Authors

1 Pulmonologist., Department Of Pulmonary Medicine, Bangalore Medical College and Research Institute, Bangalore, India

2 Pulmonologist, Department Of Pulmonary Medicine ,Bangalore Medical College and Research Institute, Bangalore, India.

3 Internal Medicine, Department Of Internal Medicine , Bangalore Medical College and Research Institute, Bangalore, India.

4 Anesthesiologist, Department Of Anesthesiology , Bangalore Medical College and Research Institute, Bangalore, India.

5 Pulmonologist, Department Of Pulmonary Medicine, Bangalore Medical College and Research Institute, Bangalore, India

Abstract

Introduction: This study aimed to evaluate the clinical profile and outcomes of adult patients screened and diagnosed with H1N1 influenza infection at a tertiary care hospital in India.
Materials and Methods: This retrospective  study was conducted on all adult patients suspected of H1N1 influenza admitted at a teaching hospital during the epidemic period of January-March 2015. Patients were screened and classified into three categories of A, B, and C based on international guidelines. Home confinement was recommended for patients in category A, and subjects in category B received treatment with Oseltamivir capsules. In addition, patients in category C received inpatient treatment with oseltamivir capsules.
Results: In total, 695 patients were screened for H1N1 influenza infection during the epidemic, out of whom 380 patients (54.6%) were in category A, 264 (37.9%) were in category B, and 51 (7.3%) were in category C. Throat swabs were collected and examined for 192 ( 27.6%) patients, and 59 ( 8.4%) cases were positive for H1N1 infection.
Conclusion: According to the results of this study, close vigilance over the symptoms of patients infected with H1N1 influenza is more important than treatment and screening of suspicious cases during the epidemics of this infection. This is a retrospective cross sectional study. Hence, there were no comparative controls. The limitation of this study is,  thus the lack of control.

Keywords


  1. Simonsen L. The global impact of influenza on morbidity and mortality. Vaccine 1999;17 (Suppl 1):S3-10.
  2. Singh M and Sharma S. An epidemiological study of recent outbreak of In-fluenza A H1N1 (Swine Flu) in Western Rajasthan region of India. J Med Allied Sci 2013;3(2).
  3. Tambe M. P, Parande M, Jamkar A.V, Pardesi R.R, Baliwant K, Rathod P.S ,et al. An Epidemiological Study of Confirmed H1N1 Admitted Cases in an Infectious Disease Hospital, Pune. JKIMSU, Vol. 1, No. 2, July-Dec. 2012.
  4. Chudasama RK, Patel UV, Verma PB, Amin CD, Savaria D, Ninama R, Fichadiya N. Clinicoepidemiological features of hospitalized patients with 2009 pandemic Influenza A(H1N1) virus infection in Saurashtra region, India (September, 2009 to February 2010). Lung India. 2011; 28(1):11-16.
  5. P. Sriram et al. Clinical Profile of Swine Flu in Children at Puducherry. Indian J Pediatr 2010 77:1093–1095.
  6. Poon LLM, Chan KH, Smith GJ, Leung CSW, Guan Y, Yuen KY, et al. Molecular detection of a novel human influenza(H1N1) of pandemic potential by conventional and Real- time Quantitative RT-PCR assays. Clin Chem. 2009;55:1555–8.
  7. Ministry of Health and Family Welfare, India. Guidelines on categorization of Influenza A H1N1 cases during screening for home isolation, testing treatment, and hospitalization. http://mohfw.nic.in/showfile.php?lid=1169. Accessed on May 19, 2015.
  8. Swine origin influenza (H1N1) virus infection in a school-New York  city, April  2009.MMWR Mortal wkly Rep 2009;58:470-2
  9. Swine influenza A (H1N1) in two children-Southern California, March-April 2009.MMWR Morb Mortal Wkly Rep 2009; 58: 400-2
  10. Outbreak of Swine Origin influenza A [H1N1] virus infection-Mexico; Mar -Apr 2009. MMWR Morb Mortal wkly Repot 2009; 58:467:670
  11.  Update: infection with a swine –origin influenza A [H1N1]-United States and other countries, April 28, 2009.MWMR Morb Mortal wkly Rep 2009; 58:431-3
  12. Naffakh.N, Vander werf SV .April 2009: an outbreak of swine origin influenza A [H1N1] with evidence for human to human transmission. Microbes Infect 2009; 11:725-8
  13. Novel Swine-origin Influenza [H1N1] virus investigation team. Emergence of a Novel Swine –origin influenza A (H1N1) virus in humans. N. Eng. J. Med; 360:2605-15.
  14. Trifonov V, Khabhasian H, Greenbaun B ,Rabadan R. The origin of the recent Swine influenza A [H1N1] virus infecting humans. EURO Survelliance-2009:14.
  15.  Update: Drug sensitivity of swine origin influenza [H1N1] virus, April 2009. MMWR Morb Mortal wkly Rep 2009; 58:433-5.
  16.  Influenza A [H1N1]-Update 14.Geneva: World Health Organization, 2009.[Accessed November 30,2009]
  17. Interim WHO guidance for the surveillance of human infection with swine influenza A [H1N1] virus, Global alert and response.10 July 2009 [http://www.who.int/csr/resources/publications/swine flu/interim guidance/en/index.html.)
  18.  Advise on the use of masks in the community setting in influenza A [H1N1] outbreaks. World Health Organization: Global alert and response- 3rd may 2009.