Cases Of Swine Flu Research Articles

A Study to assess the knowledge of youths regarding Swine Flu and it’s prevention in selected urban area of Bengaluru south with a view to develop an information booklet

Swine flu one of the communicable diseases which affected large portion of the general public, it can be treated and it is a vaccine preventable disease. WHO says that youths are at risk of swine and it is an urban youth syndrome. As studies shown that swine flu cases are found more in urban youths. Education plays a vital role in development of the human potential, through which we can achieve control and prevention of swine flu. Methods: Descriptive approach which is an non-experimental design was adopted. The target population for the study were selected from Kenchanahally area, Bangarappa Nagar PHC, Bengaluru South. This population was selected by non probability purposive sampling technique. The total samples under the study were 100 youths (male and female). The data was collected by structured questionnaire schedule which was designed to assess the knowledge of youths regarding swine flu and it’s prevention. The results were described by using descriptive and inferential statistics. Results: The respondent’s mean knowledge score was 55.2 % in the aspect of mode of transmission of swine flu, 52 % in treatment and prevention aspect, 51% in meaning and causes, and 48.8 % in signs and symptoms. Overall mean knowledge score was 51.9%. Among the demographic variables analyzed in the study, age, gender, education, marital status, per capita income, were found to have significant association with knowledge scores. And there was no significant association found between occupational status, type of family, source of information with knowledge scores. Conclusion: The study concluded that, if the youths are provided with some sort of educational interventions such as information booklets, modules on swine flu and it’s prevention will definitely beef up their knowledge, which in turn contributes to improve the total quality of one’s health.

STUDY OF TWO YEARS EPIDEMIOLOGICAL TREND OF SWINE FLU (H1N1) CASES BY CROSS SECTIONAL ANALYSIS IN TERTIARY CARE TEACHING HOSPITAL OF WESTERN INDIA

BACKGROUND & OBJECTIVE: To study region-wise monthly incidence, alteration in seasonal trend and geographical distribution of Swine Flu (H1N1) cases in district of western India for two years. After Ethics Committee approval, a cross-sectionalMATERIAL AND METHOD: study was carried out with analysis of two years' demographic prole, geographical distribution and seasonal variation of real time Reverse Transcription–Polymerase Chain Reaction (RT-PCR) - H1N1 positive cases. Annual change in pattern of positive cases was analyzed by independent sample student's t - test (P < 0.05). Out of 3,524 Seasonal Flu cases investigated by Inuenza A (H1N1) RT-PCR, total 1,600RESULT: Seasonal Flu–positive cases were analyzed. On looking at Age-wise distribution of patients, during rst year, maximum number of Seasonal Flu positive cases was from age group of 1 to 10 years, while during next year, maximum number of cases was from age group of 51 to 60 years. During rst year of epidemic, incidence of 836.12 cases per 1,00,000 population per year was detected with peak during winter as compared to 121.49 cases per 1,00,000 population per year with peak during monsoon in second year of epidemic. DuringINTERPRETATION & CONCLUSION: Epidemic of Seasonal Flu, Swine Flu (H1N1) positive cases got reduced annually, and seasonal pattern of H1N1 positive cases changed with peak during monsoon as compared to conventional winter peak. Overall change in seasonal trend, pediatric age distribution suggests need of in depth analysis of development of herd immunity, and risk factors involved for monsoon peak with alarming precaution by epidemic preparedness.

Study of Profile of Swine Flu Cases Admitted in Tertiary Care Hospital: Lessons Learned!

Introduction Swine flu is caused by a novel strain of H1N1 influenza A virus that evolved by genetic assortment. The global pandemic affected India in May 2009. Sporadic cases continue to occur and cause significant morbidity and mortality. Aim To study the clinical profile, laboratory parameters, and outcome of the confirmed cases of swine flu. Methods This was a retrospective study involving confirmed swine flu cases admitted with category B2 and C symptoms from February to September 2019 in Tata Main Hospital. Their case records were analyzed for demographic characteristics, clinical features, treatment, and various outcomes. Reverse transcriptase polymerase chain reaction on the samples was used to confirm the infection. Observation Of the 12 cases, 33.7% were men and 66.7% were women. There were 66.7% in the age group 41 to 60 years. Case fatality ratio was 25%. Average duration of symptoms was 3.5 ± 2.4 days. Fever and breathlessness (100%) were the commonest symptoms followed by cough and weakness (83.3%). Comorbidities, like diabetes, hypertension and chronic kidney disease, were seen in 25% patients. Pneumonia was the commonest complication. Average length of hospital stay was 17.8 days. Twenty-five percent of the patients needed supplemental oxygen, whereas 25% required noninvasive ventilation and 50% needed mechanical ventilation. Male sex, older age, severity of hypoxemia, need for mechanical ventilation, and involvement of more than 3 radiological zones were the predictors of mortality (P < 0.0001). Conclusions H1N1 influenza can present with severe life-threatening illness. The most common cause of death is pneumonia. Mortality is higher in elderly, men, and those requiring invasive ventilation.

Clinico-epidemiological profile of Influenza A H1N1 cases at a tertiary care institute of Uttarakhand.

Introduction:The swine (H1N1) virus responsible for worldwide pandemics since 2009 is now causing seasonal epidemics. Since then alarming spikes of swine flu cases have been reported from Uttarakhand every year. There are limited studies conducted in this Himalayan belt to evaluate the clinical and epidemiological profile of the patients admitted in tertiary care hospitals.Aims & Objectives:This study aims to summarize the clinical and epidemiological attributes of swine flu and to approximate the burden of Influenza A H1N1 (Swine Flu) cases in this Himalayan belt.Material and Methods:Clinical and epidemiological characteristics of influenza A H1N1 cases from October 2018 to April 2019 were retrospectively and descriptively analyzed using data from the Medical Records Section and the isolation ward at Shri Guru Ram Rai Institute of Medical and Health Sciences; Shri Mahant Indiresh hospital.Results:A total of 1126 (51.6%) patients were tested of which 30% (338) patients were found to be H1N1 positive. Maximum cases and positivity were detected in the months of January (26.4%), February (50.3%), and March (14.8%), and the patients in the age groups of 41–50 (21.9%) and 51–60 years (19.3%) accounted for majority of the cases. The most common symptoms were fever (85.8%), cough (82.2%), sore throat (82%), and breathlessness (71.3%). A case fatality ratio of 10.9% was observed. A significant statistical association (p value < 0.00001) was reported between co-morbid conditions and death.Conclusion:According to the results of this study, close caution should be exercised in case of patients infected with H1N1 particularly those with co-morbidities.

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

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 &amp; 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 &gt;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.

Clinical Evaluation of Significance of 25(Oh)D (Vitamin D) Status in Swine Flu (H1N1)

Background Since swine flu has been declared pandemic in 2009 it has become a major challenging public-health problem associated with high morbidity and mortality. 25(OH)D deficiency is also pandemic and has been reported to be clinically correlated with decreased immunity and respiratory infections. The possible role of vitamin D in infections is implied from its impact on the innate and adaptive immune responses. This study is planned to evaluate clinical significance of 25(OH)D status on course and outcome in hospitalized cases of swine flu and to compare it with normal healthy subjects living in the same vicinity to evaluate if vitamin D is having any protective effect. Material &amp; Methods Present prospective cross-sectional study was conducted on 79 RT-PCR confirmed cases of swine flu admitted during recent epidemic. All patients were evaluated thoroughly by clinical history physical examination and laboratory investigations as per Performa and followed-up during hospital stay. 25-hydroxyvitamin D (25(OH)D) estimation was done by electro-chemiluminescent Assay in all the cases and it was also done in 36 normal healthy family members of study patients living in the same vicinity (control group). Results High prevalence (70.9%) of low (≤30ng/ml) status of 25(OH)D was observed in cases of swine flu as compared to control group. 25(OH)D status was associated with severity of illness. Mean value of 25(OH)D in mechanically ventilated patients was 9.81±6.43 while it was 22.76±11.35 ng/ml in patients who do not required ventilation (p&lt;0.05). Mean 25(OH)D level in patients who stayed in hospital for &lt;5 days was 28.60±8.79 ng/ml, 24.18±11.67 for 6-10 days and 8.23±2.12 for &gt;10 days (p&lt;0.01). Mean value of 25(OH)D in patients who died was 9.59±5.90 ng/ml as compared to 23.13±11.62 ng/ml who survived (p&lt;0.01). Conclusion Our study suggests that 25(OH)D may have preventive role for swine flu infection. Low level of 25(OH)D is associated with high morbidity in terms of increase requirement for mechanical ventilation, multiorgan dysfunction and long duration of hospital stay. 25(OH)D deficiency is associated with high mortality in swine flu. 25(OH)D status should be given due consideration in high risk patients especially during winter season.

Investigation of early epidemiological signals of COVID-19 in India using outbreak surveillance data

Background: The epidemic of novel coronavirus disease (COVID-19) started in Wuhan, China, in December 2019, has been progressed to a pandemic level with high morbidity and mortality affecting many countries globally. Due to varied clinical characteristics of the disease, diagnosis can be missed easily among the affected population. The epidemiological data and early signals of COVID-19 infection are crucial for the disease investigation. Aim: To assess the presence of early signals of COVID-19 in India before official reporting of cases in the country and to compare epidemiological characters using different surveillance sources in the study. Methods: This study uses Epiwatch outbreaks surveillance data from November 2019 to March 2020 was used to determine the trend of pneumonia of unknown causes in India in order to assess if the COVID-19 could have been detected before the first case was reported.The search was carried out using the search terms defined in the study to identify the early signals of COVID-19.The COVID-19 line list extracted from the crowdsourced database (https://www.covid19india.org/) was additionally used to determine the demographic characteristics of cases. A descriptive analysis was conducted. Results: A total of 379 reports was extracted from Epiwatch. In 2019, there were only six reports of pneumonia of unknown causes in India, and the majority of the reports were focused on swine flu or undetected influenza cases. In 2020, there were 312 news reports of unknown pneumonia and COVID-19. The early signals of COVID-19 in India were observed from 24th January 2020 as the trend of pneumonia news had moderately increased. The trend of pneumonia reporting was low before the first confirmed case was reported in India. The study findings also suggested that there was under-reporting of COVID-19 cases in India by the World Health Organization (WHO) and the Ministry of Health, India when compared to data reported by Epiwatch and the line list. Conclusion: The study findings suggested that there were early signals of COVID-19 in India around 24th January when there was a slight increase in the trend of pneumonia reports in the country. The number of COVID-19 cases in India is under-reported by the Ministry of Health and the WHO. The use of online media surveillance reports such as Epiwatch and the line list could provide real-time assessment and timely investigation of emerging diseases globally.

Trend and seasonality of infectious diseases – An overview from a tertiary care hospital of West Bengal, India

Background: Most of the developing countries still suffer from a high burden of communicable diseases. The paucity of proper data about the current trends and seasonal variations of different infectious diseases (IDs) further prevents the policy makers from devising an effective, preventive, and curative response. Hospital ID wards are a useful source of surveillance data that can indicate changing health-care requirements. Materials and Methods: A retrospective analysis of inpatient hospital database of past 5 years (January 2014–December 2018) was done to identify the pattern and trend of different IDs including seasonal variations. Results: Among 127,762 admissions during 2014–2018, diarrheal diseases (87%) were most common, followed by dengue (6.6%), chicken pox (2.4%), measles (1.6%), and diphtheria (1.2%). Measles and chicken pox cases had shown peak during February–May months, whereas dengue in September–October, and swine flu cases were at peak during the winter season. Over the past 5 years, the admission rate of measles cases showed a cyclical rising trend, chicken pox showed an inclining trend, whereas tetanus showed a declining trend. The admission trend of diphtheria cases was more or less similar throughout consecutive years except a fall in 2018. The admission rate of dengue cases showed a steep rise in 2016, followed by gradual decline in respective years. However, swine flu admission rate showed a zigzag pattern over the past 5 years. Conclusion: The review of hospital records provided information regarding the overall burden and pattern of admissions in the IDs hospital.

Evaluation of Cardiovascular System Involvement in Hospitalized Cases of Swine Flu

Evaluation of Cardiovascular System Involvement in Hospitalized Cases of Swine Flu

Human infection with pandemic Influenza (H1N1): A Review Article

Swine flu, also known as the H1N1 virus, is new strain of an influenza virus that causes symptoms similar to the regular flu. It originated in pigs, but is spread rapidly from person to person. Therefore, the objectives of this article are to highlight on H1N1 Influenza, its mode of transmission, risk factor, clinical spectrums and preventive ways. Studies published relevant to swine flu was searched through scientific databases like MEDLINE, Pubmed and online search engines like ‘Google Scholar’. Eligible studies involved at least one factor related to ‘influenza A virus’, ‘H1N1 subtype’, ‘epidemiology’, ‘transmission” and ‘preventive measures’ etc. Searches were limited to human only and also looked at the websites of the leading health authorities (e.g. WHO, CDC, HPA). Swine is a new flu virus that appears in human and spreads very quickly from person to person. In Nepal, the first case was detected on June 2009 after that the case is increasing day by day. In 2010 till May there were 172 confirmed positive cases, likewise on August 7, 2017 there were 10 death and 354 positive cases of swine flu in Nepal. Therefore, Government of Nepal has broadcasted awareness programs, organized seminars and meetings, to make people aware regarding H1N1 Influenza. But, it seems challenging to decrease its outbreak in Nepal because of low financial resources, low manpower, limited technology and political instability.

Cardiovascular manifestation in hospitalised cases of swine flu

Cardiovascular manifestation in hospitalised cases of swine flu

Cardiovascular manifestation in hospitalised cases of swine flu

Cardiovascular manifestation in hospitalised cases of swine flu

Effect of health seeking interval on outcome in swine flu cases attended a tertiary care hospital in southern Rajasthan region of India

Background: Swine flu influenza is an infection by H1N1 type of swine influenza virus. Swine influenza virus or swine-origin influenza virus (SIV or S-OIV) is a strain of the family of influenza viruses that’s endemic in swine (pigs). Early diagnosis and treatment is key approach to control the morbidity and mortality associated with swine flu which can be achieved by improving health seeking behaviour of community. Understanding of behaviour of community is essential for planning strategies for prevention and control. Aim of this study is to establish a relation between healthcare interval and outcome of swine flu.Methods: A complete data of all the patients visiting swine flu OPDs, swine flu wards and ICU were maintained for year 2015. Each patient visiting either the swine flu OPD or the swine flu ward, who was suspected clinically to be H1N1 positive were tested for real time PCR. Data was collected in a standardized pre-structured questionnaire.Results: Out of 1247 samples tested for rt-PCR, number of patients found to be swine positive was 491 (39.37%). Total 267 patients were admitted in swine flu ward and ICU, out of them 62 was expired. Clinical care intervals of more than 5 days from onset of symptoms to swab collection, diagnosis and admission were more in female and rural population. Mean duration between onset of symptom to hospitalization, swab collection and diagnosis was significantly higher in deceased patients than survived.Conclusions: Early presentation to healthcare facility is associated with better prognosis and outcome. After patient report to the health care setup, early sample collection and diagnosis help to reduce mortality.

Mortality profile of confirmed cases of swine flu attending a tertiary care center of Udaipur region of Rajasthan, India

Background: Mortality profile is an analytical tool used to identify the various factors responsible for poor outcome of disease and it can also use to evaluate quality and efficiency of healthcare providers. The aim of this study is to summarise the clinical and epidemiological factors as well as to identify the risk factors associated with mortality among swine flu cases.Methods: It is a cross-sectional, descriptive, hospital-based study conducted on 62 deceased patients due to swine flu reported at Maharana Bhupal Government Hospital, Udaipur, Rajasthan during the outbreak of influenza A H1N1 in the year 2015. A standardized pre-structured questionnaire with consent was filled by help of bed head tickets and by interview of attendants of deceased patients.Results: Deaths were higher among age group of 31-45 years (35.48%). Case fatality rate for male patients (13.88%) was higher. Mortality was highest in females of rural background 27(43.55%). Majority of deceased patients (70.97%) had delay of 4-7 days in admission after onset of symptoms. Diabetes, cardiovascular diseases and pregnancy was the major risk factors for poor outcome.Conclusions: Delay in diagnosis and admission may be the reason for higher mortality rate. The most common co morbid illness was Diabetes mellitus, cardiovascular diseases (Ischemic heart disease, Rheumatic heart disease, Hypertension) and pregnancy.

(Re)emergence of A(H1N1)pdm09 influenza viruses with pandemic markers in the 2018/2019 flu season in the USA

During the 2009 pandemic, the Centers for Disease and Control and Prevention (CDC) estimated that 43 to 89 million cases of swine flu were reported during a 1-year span, with 1799 deaths in 178 countries worldwide. Now, nine years later, A(H1N1)pdm09 influenza viruses, which caused this pandemic, have reemerged and become the dominant subtype for the current 2018/19 flu season in the USA. The in silico analysis of A(H1N1)pdm09 viruses isolated in USA in October and November 2018, performed using the electronic biology platform “wEB”, showed that these viruses carry previously identified pandemic markers suggesting their increased pandemic potential. Possible consequences of these findings are discussed.

Demographic analysis of influenza-like illness categories including seasonal trend of swine flu cases attending a teaching hospital in Southern Rajasthan, India

Background: Influenza-like illness is a self-limiting non-specific acute respiratory illness characterized by common clinical features including fever, chills, malaise, headache, coughing, nausea, loss of appetite, and generalized weakness. Influenza A H1N1 is an important cause of ILI because it can lead to serious complications requiring hospitalization. Swine flu infection rates usually higher during the winter season in temperate regions. Objectives: This study is designed to analyze the demographic data of different ILI categories including seasonal trend of H1N1-related ILI in the patients attending a teaching hospital to know the spread and severity of diseases in Southern Rajasthan in India. Materials and Methods: It is a hospital-based retrospective study in which epidemiological and demographic data of all the patients attended swine flu outpatient departments, isolation wards, and intensive care unit were obtained and analyzed. All patients of ILI-B and ILI-C categories were tested for real-time polymerase chain reaction. Results: Of 3933 patients, 2686 (68.29%) patients were categorized in ILI-A, 724 (18.41%) patients were in ILI-B, and remaining 523 (13.30%) patients were in ILI-C. Overall, swine positivity among ILI-B and ILI-C categories was significantly (

Clinical aspects and outcome of patients with swine flu among survivors and non-survivors

Background: Swine flu is an infective disease caused by any one of the several types of Influenza viruses. The world saw its first pandemic of swine flu this century in the year 2009 when the WHO raised a world-wide pandemic alert to level 6 on June 11, 2009. In India, first few cases (index cases) of swine flu were reported from Pune, Maharashtra. The most recent outbreak of this dreaded infection was reported during late winter of 2015.Methods: The present study was retrospective study. In order to collect the data, we reviewed medical charts of patients who were hospitalized in our hospital during the study period. Diagnosis of swine flu was confirmed after sending the blood-samples to Government approved laboratories in Pune and Mumbai. Real time, Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) method was employed for serological diagnosis. Forty-five confirmed cases of swine flu were included in this retrospective study. The primary objective of this study was to highlight the differences in the clinical profile as well as outcome between the patients who survived the attack of swine flu and those who did not.Results: Forty-five of these patients tested positive for H1N1 amounting to a positivity rate of 52.94%. Cough (93.3%) was the most common symptom followed by fever (88.8%) and breathlessness (82.2%). Patients who did not survive were more likely to have associated co-morbid conditions like Hypertension, Diabetes, cardio-vascular disease, pre-existing lung disease and pregnancy though this was not statistically significant ( p=0.189). Acute Respiratory Distress Syndrome (ARDS), Multi-Organ Dysfunction (MOD) and secondary bacterial infections were among the most common conditions that lead to death.Conclusions: Early detection of swine flu through meticulous screening in the community with a high index of suspicion followed by prompt and adequate treatment can go a long way in preventing another pandemic. Creating awareness among the lay people about personal as well as public hygiene is also vital to prevent the spread of this viral illness.

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

Introduction:Influenza A (H1N1) virus has caused serious respiratory illness (swine flu) and death over the years. The first confirmed case of swine flu H1N1 in India was documented in May 2009, but huge numbers of cases were reported thereafter. In 2015, swine flu outbreak in India had led to significant morbidity and mortality.Objective:to study details of swine flu patients admitted in a rural tertiary care center in western India in 2015 and to identify predictors of mortality.Methodology:Retrospective data of swine flu cases admitted at a tertiary care teaching hospital in 2015 and their outcome as either cured or expired was recorded.Result:Out of 65 confirmed cases of severe swine flu that required hospitalization, 40(61%) were male. 55 of 65 (84.61%) patients [mean (SD) age: 50(15)] were cured while 10 patients [mean (SD) age 51(15)] expired. Overall mean (SD) age was 50.23(15) years with average (SD) days of hospitalization were 6.32(3.3) days. The commonest symptoms were cough (100%) followed by throat pain (96.9%), common-cold, fever (93.8%), and breathlessness (83.1%). 40% of patients needed non invasive ventilator support while 16.9% patient required invasive ventilator. Mean temperature on presentation was (99.96’F), RR (25.89/min), SpO2 on room air was 82.06%. Average White Blood Cells were 8274/mm3 with neutrophils were 79.58%. Mean procalcitonin was 0.83 ng/ml. It was found through univariate analysis that sputum production (P = 0.013), chest pain (P = 0.04), Respiratory Rate (P = 0.013), SpO2 on presentation at room air (P = 0.001), Days of non invasive ventilator (P = 0.001), intubation and invasive ventilator (P = 0.001) were statistically significantly associated with outcome but through multivariate analysis it was revealed that only requirement of intubation (invasive ventilator) was significantly predicting mortality(Odds ratio=234) (P = 0.0001).Conclusion:Requirement of intubation was associated with poor outcome.

Clinical Profile of Suspected H1N1 Influenza Patients and Predictor of Mortality in H1N1-Positive Patients

Abstract There were spurts of swine flu cases every year, even though the pandemic was over in August 2010. Most of the studies on swine flu pivoted around pandemic years 2009 to 2010. Here, through this retrospective study conducted at a tertiary care hospital in New Delhi, India, we compared clinical characteristics between H1N1-positive and H1N1-negative patients admitted in years 2015 to 2016. Among H1N1-positive patients, variables were compared among survival and death groups. Among 122 suspected H1N1 patients, 30 were positive for H1N1 reverse transcription–polymerase chain reaction. Symptom of rhinitis and low serum albumin were significantly more in H1N1-positive patients. Applying univariate analysis among H1N1-positive patients, respiratory rate, albumin level, alanine transaminase, aspartate transaminase, and Pao 2/fraction of inspired oxygen (Fio 2) ratio were statistically different between the survival and death groups. Further using simple logistic regression among H1N1-positive patients, Pao 2/Fio 2 less than or equal to 200 had an odds ratio of 9.2 (95% confidence interval [CI], 1.6–51.4), alanine transaminase level more than or equal to 40 U/L had an odds ratio of 7.3 (95% CI, 1.4–38.9), and albumin level less than or equal to 3.0 (gm/dl) had an odds ratio of 44.8 (95% CI, 4.0–497.4), and these were independently associated with death. After considering for causality/plausibility aspects, Pao 2/Fio 2 less than or equal to 200 had significant higher odds ratio of 12.3 (95% CI, 1.7–90.1) for death even if adjusted for age and sex. Hence, the value of Pao 2/Fio 2 at admission is a good predictor of mortality among H1N1-positive patients.

Analyzing the clinical profile of swine flu/influenza A H1N1 infection in central India: a retrospective study.

Recently, India reported an increase in swine flu (influenza A H1N1) activity. There are limited studies on epidemiology of swine flu in Indian context. This study aims to analyze clinical and epidemiological profile of suspected swine flu cases in central India. 171 cases were included in a hospital based, observational, descriptive study conducted from December 2014 to April 2015. Demographics, clinical presentation and outcome of positive and negative cases were compared. Data was analyzed using STATA software. Distribution by age, sex and residence was found similar (p>0.05) in positive and negative cases. Cough (89%), fever (85%) and throat irritation (51%) were chief complaints (avg. duration=4.9days). History of travel, history of contact with swine flu cases (p=0.002) and history of visiting crowded places (p=0.098) was reported considerably in higher proportion in positive cases as compared to negative cases. There were 14 deaths and they occurred significantly in younger age among positive cases as compared to negatives (Mean±SD: 34±2.8 vs 47±8.4years). Case fatality ratio (CFR) in positive cases showing history of travel, contact with swine flu cases, requiring invasive ventilator support and >3 X-ray zones involvement were significantly higher. Outbreak in later part of winter, high case fatality and younger population is more affected. In this study, swine flu infection and outbreaks started later in the year Hospital stay and CFR were increased. Understanding the swine flu infection, changing clinical presentation of swine flu and formulate new strategies for its prevention and management.