A Prospective Study on Epidemiology, Clinical Profile and Outcome of Hospitalized Cases of Swine Flu (H1N1) During 2018-2019 Outbreak in North West Zone of Rajasthan

Abstract

Background: Since World Health Organization declared H1N1 (Swine flu) a pandemic disease on April 29, 2009, it is continuing to be a major public health problem and it has significant regional and seasonal variation. Therefore, this study was planned to evaluate epidemiology, clinical profile, course of illness and their outcome. Material and Method: Present prospective crosssectional study was conducted on RT-PCR confirmed cases of swine flu admitted in dedicated swine flu ward in the Department of Medicine, S.P. Medical College & Associated Group of P.B.M. Hospitals, Bikaner. All patients were subjected to detailed clinical examination and relevant investigation as per proforma. Clinical and epidemiological data were collected. All patients subjected for routine lab examination including complete blood count, renal function test, liver function test, fasting blood sugar, ABG, X-ray chest PA view and other specific investigation as per requirement. Result: Most females belonged to age group 18-35 years and most of the malesbelonged to age group >55 years. Most of cases belonged to category C (62%) and urban residential area (55.7%). Most common symptom was cough (98.7%) followed by fever (91.1%), sore throat (86.1%), sputum (83.5%), nasal discharge (73.4%), breathlessness (72.2%), headache (58.2%), chest pain (27.8%) and palpitation (16.5%). Our study shows multiple organ involvement during the course of swine flu as indicated by increasing blood urea (36.7%), serum direct bilirubin (19%), serum creatinine (18.9%), SGOT (68.3%), SGPT (37.8%) and decreasing serum albumin (63.3%). Overall mortality rate in our study was 8.8%.It was high in females (9.1%) as compare to males(8.6%).All deceased belonged to category C and cough was the most common presenting symptom followed by sore throat, nasal discharge, sputum and fever. Conclusion: Our study shows there are certain factors which can affect outcome in the cases of swine flu. Female gender, elderly age, co morbidity and the duration of illness(6-10 days) are the important factors associated with poor outcome. Early recognition and alertness is important to reduce morbidity and mortality. Patients should also be screened for multiple organ involvement at the time of hospitalization by laboratory test like CBC, RFT, LFT for early diagnosis of multiple organ involvement so as to treat appropriately to prevent multiple organ failure and mortality.