Profile of confirmed H1N1 virus infected patients admitted in the swine flu isolation ward of tertiary care hospitals of Baroda district, Gujarat, India
Keywords:Influenza, H1N1, Profile, Swine flu, Tertiary care
Background: Influenza is truly an international disease. It occurs in all countries and affects millions of people every year. The Influenza A H1N1 in humans can be a mild illness or in some people it may result in serious, even life-threatening complications such as pneumonia, acute bronchitis, worsening of chronic conditions, respiratory failure and death. Objective: To study profile of confirmed H1N1 virus infected patients of Category “C” admitted in the swine flu isolation ward of tertiary care hospitals of Baroda District, Gujarat, India.
Methods: This was a cross sectional observational study carried out in Baroda district of Gujarat state, India. All confirmed H1N1 virus infected 54 patients in Category “C” admitted in the swine flu isolation ward of both Government and private hospitals of Baroda district during the period of 1st January to 30th June, 2013 after taking verbal and written consent of the patients were enrolled in study. Before conducting the study approval was obtained from institutional ethical committee for human research. Data safety and confidentiality was also given due consideration. A predesigned semi-structured Performa was used. Detailed demographic and clinical data were recorded. Data was statistically analyzed using SPSS software (trial version).
Results: Out of total 54 influenza A H1N1 cases, 23 patients (42.59%) were males. 4 (12.91%) female patients were pregnant. Majority (75%) of the cases were between 21-50 years of age group. Majority (90.7%) of the patients were from urban areas. Majority cases (94.4%) presented with cough, followed by 36 cases (66.7%) exhibiting high grade fever, 35 Cases (64.8%) had complain of breathlessness and 25 cases(46.3%) presented with sore throat. 19 cases (35%) had co-morbid condition with the influenza A H1N1 disease. In this study among patients with associated Comorbid condition, 16(84%) were discharged and only 3(16%) patients died. Whereas among patients without Comorbid condition, 29(83%) were discharged and 6(17%) died. This difference was not statistically significant (p=0.940).15 cases (27%) required ventilator support. Mortality of 9 cases (17%) occurred in the given duration of study and rest of cases 45(83%) were discharged from the hospital. Out of 54 cases, 4 cases had diabetes mellitus and from that 3 case were died. The difference was statistically significant (p=0.012).
Conclusions: Influenza A H1N1 infection predominantly affects young age and equally affecting both genders. One fourth of total cases had severe illness and required ventilator support. Majority of patients died within 8 day of critical illness. All deaths were reported from urban area. Most common symptom in fatal cases of influenza A H1N1 was cough followed by breathlessness, high grade fever, mild fever and sore throat and the most common co morbidity was Diabetes Mellitus.
Davenport. In Viral Infection of Human: Epidemiology and Control. Plenum Medical, New York. 1977.
Patel Bhavin D SVS, Patel Ameekumari B, Modi Bhautik P. Clinico-Epidemiological Correlates of Hospitalized H1N1 Pneumonitis Cases in A Teaching Hospital of Western India During 2009-2010 Pandemic. NJMR. 2012;2(2):218-22.
Douglas RGaRFB. in Principle and Practice of Infectious Diseases, Mandell, G. L. et al (eds), John Wiley, New York. 1979.
Feigin TbopId, Philadelphia, Lippincott, company, Page. No. 2783-2795.
Polit TboNrpam, 5th edition, Philadelphia JBLc, 1995, Page. No - 42.
K. Park tbopasm, 22th edition, New Delhi, Jaypee brother’s medical publishers, Page No.250-254.
Rana H, Parikh P, Shah AN, Gandhi S. Epidemiology and clinical outcome of H1N1 in Gujarat from July 2009 to March 2010. J Assoc Physicians India. 2012;60:95-7.
Choudhry A, Singh S, Khare S, Rai A, Rawat DS, Aggarwal RK, et al. Emergence of pandemic 2009 influenza A H1N1, India. Indian J Med Res. 2012;135(4):534-7.
Jagannatha Rao SR, Rao MJ, Swamy N, Umapathy BL. Profile of H1N1 infection in a tertiary care center. Indian J Pathol Microbiol. 2011;54(2):323-5.
Chudasama RK, Patel UV, Verma PB, Agarwal P, Bhalodiya S, Dholakiya D. Clinical and epidemiological characteristics of 2009 pandemic influenza A in hospitalized paediatric patients of the Saurashtra region, India. World J Pediatr. 2012;8(4):321-7.
Patel A, Naik E, Patel K, Patel K, Patel K, Mehta P, et al. Clinical outcome of novel H1N1 (Swine Flu)-infected patients during 2009 pandemic at tertiary referral hospital in western India. Journal of Global Infectious Diseases.2013;5(3):93-7.
V. R. Malkar USJ, M. M. Raut. Clinico-epidemiological profile of patients of h1n1 influenza (swine flu) virus infection at a tertiary care hospital in Maharashtra. Int J Biol Med Res. 2012;3(3).
Kumar A, Zarychanski R, Pinto R, et al. Critically ill patients with 2009 influenza a(h1n1) infection in Canada. JAMA. [Doi: 10.1001/jama.2009.1496]. 2009;302(17):1872-9.
Gupta BD, Purohit A. A clinical study of hospitalized H1N1 infected children in Western Rajasthan. J Trop Pediatr. 2011;57(2):87-90.
Webb SA, Pettila V, Seppelt I, Bellomo R, Bailey M, Cooper DJ, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med. 2009;361(20):1925-34.
Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med. 2009;361(20):1935-44.