Clinical profile, morbidity and mortality among swine flu (H1N1) infected patients: 2015 Gwalior, Madhya Pradesh pandemic, India

Abstract

Background: Influenza is known to cause annual seasonal epidemics in Asian subcontinent. Our study assessed the clinical profile, factors influencing the response, prognosis and outcome in H1N1 positive patients during FebruaryMarch 2015. We aimed to understand the epidemiology and patterns of the disease so that the high risks groups could be identified. Methods: Medical records of the patients who were admitted during Feb-March 2015, as a suspected case to the swine flu ward of J A Hospital and G R Medical College, Gwalior, India were manually retrieved and retrospectively studied. H1N1 positive patients, who were diagnosed clinically and confirmed by RT-PCR method, were included for analysis. Results: Out of 208 patients were admitted for suspicion of swine flu influenza and underwent testing out of which 88 (42.30%) were found to be positive for H1N1. Most common (37.40%) affected age group was 20-30 years. Females were more involved (62.5%), out of which 20% were antenatal. The common presenting symptoms were cough, fever, breathlessness. Overall case fatality ratio was 4.45%. Conclusions:Patients with influenza like illness should not panic as many of them become negative for H1N1. In our area prevalence of H1N1 was high in young and females. Most of the patients recovered with symptomatic treatment and oseltamivir therapy. Proper prevention steps, personal hygiene and admission to designated swine flu ward can be helpful in preventing the spread in the community.

Lessons learnt from the Indian H1N1 (swine flu) epidemic: Predictors of outcome based on epidemiological and clinical profile

“…In our study, the symptoms on presentation in descending order were cough (100%), followed by throat pain (96.9%), common cold (93.85%), fever (93.85%), breathlessness (83.1%), headache (52%), chest pain (49.2%), sputum production (46.2%), vomiting (24.6%), and hemoptysis (7.7%), whereas in the study by Dhawale et al ., cough (97.72%) and fever (77.27%) were the most common presenting symptoms followed by breathlessness in 29.54% patients,[6] whereas in other study of 2011 conducted in New Delhi, fever (100%), cough (87.5%), sore throat (43.7%), and breathlessness (87.5%) were found to be the most common symptoms in Influenza A H1N1. [9] In the study by Srinivasa et al .,[10] the commonest symptoms identified were cough (100%), fever (90%), sore throat (25%), and difficulties/shortness of breath (50%).…”

“…In another study on epidemic of swine flu of 2015 by Dhawale et al ., average age was found <50 years, whereas in our study, it was more than 50 years. [6]…”

Clinico-epidemiological profile of confirmed swine flu (H1N1) cases admitted at an infectious disease hospital in Kolkata, India

“…3 Influenza cases infected by swine origin influenza A (H1N1) virus, was also reported from West Bengal from the month of February to March 2015 at Beliaghata ID and BG Hospital, a tertiary care hospital in Kolkata, West Bengal, India. 6 During the last resurgence in 2015, this hospital was acted as a referral center for H1N1 infected persons. H1N1 cases were confirmed by real time reverse transcriptase polymerase chain reaction (RT-PCR) on throat swab.…”

Evaluation of Cardiovascular System Involvement in Hospitalized Cases of Swine Flu

“…We found significant number of the cases of swine flu (74.7%) presented with symptoms suggestive of cardiovascular involvement (72.2% breathlessness, 27.8% chest pain, 16.5% palpitation, 10.1% presyncope, 7.6% syncope and 5.1% giddiness) at the time of hospitalization. We did not find any study evaluating cardiovascular symptoms at the time of presentation in cases of swine flu although previous study on clinical profile has shown breathlessness in 29.54% to 83.1% cases, chest pain in 13.3%-49.2% and syncope in 6.7% [16][17][18][19]. Thus our study suggests that evaluation for sign and symptoms of cardiovascular symptoms should be done at the time of presentation as they are often overlooked because of focus on respiratory symptoms like rhinorrhea, cold symptoms, throat pain and cough and patients also often ignore symptoms related to the cardiovascular system.…”

“…A total of 13 cases (16.4%) were having underlying one or more PCVD. Previous studies has also reported underlying cardiovascular disease in 4.4% to 7.89% [1,[17][18][19]. Mean age of subjects with PCVD was 63.38 ± 9.07 years as compared to 47.14 ± 17.8 without PCVD.…”