Cases Of Swine Flu Research Articles

Study of clinico-epidemiological profile, drug utilization pattern, and outcome of swine flu cases: A recent epidemic in Latur

Background: Swine flu, an acute respiratory tract disease, is caused by swine flu virus. The World Health Organization (WHO) declared the H1N1 pandemic in June 2009 after more than 70 countries reported cases of H1N1 infection. Since 2009-2014, 59,677 cases and 4141 deaths have been reported in India. Objective: To study the clinico-epidemiological profile, drug utilization pattern, and outcome of H1N1 positive cases admitted to swine flu ward from January 2015 to September 2015 at a tertiary care hospital in Latur. Materials and Methods: The study was conducted from January 2015 to September 2015 at Government Medical College (GMC), Latur. Clinicoepidemiological profile, treatment details, and outcome of the patients were recorded. Prescription pattern was analyzed using the WHO International Network for Rational Use of Drug use indicators. Results: A total of 52 swine flu positive cases were admitted to GMC, Latur, out of which 38 (73.07%) were female patients and 14 (26.92%) were male patients. Total numbers of drugs prescribed were 267. The most common antimicrobial prescribed was oseltamivir. Total drugs prescribed from the National List of Essential Medicine 2015 were 98 (36.70%). Conclusion: This study is an attempt to know the clinico-epidemiological profile, drug utilization pattern, and outcome in swine flu positive patients. A good adherence to the WHO guideline for clinical management of swine flu cases, the Joint Indian Chest Society and the National College of Chest Physician guidelines, and the WHO Essential Drug List was seen in our study. However, prescription with the brand name, polypharmacy, and excessive use of fixed dose combinations are a matter of concern.

Laboratory surveillance of H1N1 swine influenza A virus infection in patients with severe acute respiratory illness (SARI)-an institutional study

Introduction: Lower respiratory tract infections (LRTI) are a leading cause of death in developing countries and are also third leading cause of death worldwide. Influenza is an acute viral and highly contagious respiratory infection causing significant morbidity and mortality. The 2009, swine flu pandemic is caused by a novel reassorted H1N1 subtype of H1N1 influenza A virus. Objectives: The present laboratory study was conducted for the active surveillance of H1N1 swine influenza A virus infection in type C category of patients with Severe acute respiratory illnesses (SARI). Materials and Methods: In clinically suspected cases of swine flu, a total of 130 deep nasal / throat swabs were collected and inoculated into viral transport medium (Himedia labs ) and In the reference lab, samples were tested with Real time reverse transcriptase PCR for universal influenza A (inf A), swine influenza A (SWinfA) and swine H1 (SW H1) probes. Results: Among the total 130 samples, 32 are showing positive by Real time RT-PCR with a prevalence of 24.61%. In 0-5 age group, 10 were positive with prevalence of 62.5%. In total 66 were males with 12 positives (18.18 %), 64 were females with 20 positives (31.25%). Conclusion: H1N1 influenza A is a potentially infectious disease, which spreads by droplet infection, so laboratory based surveillance is necessary to know the intensity of infection, seasonal trends and epidemiological factors like variations according to gender, age and region; which is also helpful for local health authorities to take the appropriate control measures.

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

Background: Swine flu is an acute infection of respiratory tract, caused by swine origin influenza A (H1N1) virus. Antigenic drift and shift of this virus is responsible for epidemic or pandemic in different parts of the world from time to time. Last pandemic started in 2009 at Mexico and USA, and spread globally with in a very short period of time. Post pandemic resurgence was noticed in various parts of India from 2010 to 2015. Methods: A record based descriptive study was carried out among the 89 confirmed swine flu (H1N1) cases admitted at Beliaghata ID and BG Hospital, Kolkata during last post pandemic resurgence in India between February 2015 to March 2015. Results: Among 89 confirmed swine flu cases 52.81% were male and 47.19% were female. Mean (±Standard Deviation) age was 38 (±18) yrs. Mean (±Standard Deviation) duration of hospital stay was 6.5 (±1.7) days. Among the admitted patients, 84 patients were discharged from the hospital but 5 patients succumbed to their illness. 95.51% patient presented with the chief complaint of fever. Among the admitted cases, 21.34% had either history of travel to swine flu (H1N1) infected area or contact with swine flu infected patients. There was a statistically significant association between outcome (death / discharge) and co-morbid conditions, (P value-0.047, α-5%, df-1). Conclusions: This study will help clinicians and public health specialist to understand the clinico-epidemiological profile of swine flu (H1N1) cases to diagnose, treat and to develop preventive strategies in future.

Swine flu fibrosis: Regressive or progressive?

Swine flu influenza had spread the world over in 2009. The main pathology was bilateral pneumonia. Majority of these cases recovered from pneumonia fully. Though in some cases, pulmonary fibrosis was reported as a sequel. However, long-term progression of such pulmonary fibrosis is uncertain. We are hereby reporting two cases of swine flu that showed residual pulmonary fibrosis. The clinical and laboratory parameters were also recorded. In both the cases, radiological shadows and spirometric values did not show deterioration. We conclude that swine flu pulmonary fibrosis is not a progressive condition.

Swine Flu and the Role Pharmacist to Prevent it

Swine flu is a disease of respiratory system, caused by the H1N1 virus or type A influenza virus, and has been declared as a pandemic by the World Health Organization. Initially swine flu was reported only in pigs, but of recent, a considerable number of cases of swine flu in humans too, have been reported all over the world. Cases of swine flu are rising on a daily basis and this calls for different treatment options that are effective in relieving swine flu symptoms. It also calls for more awareness on its causes, symptoms, diagnosis, prevention, treatments and the role of pharmacist of prevention of it.

An Review on Swine flu

Swine flu has been a dangerous effect in the world and globe. Swine flu is the viral infection disease caused by swine influenza virus. The World Health Organization (WHO) is closely monitoring cases of swine flu globally to see whether this virus develops into a pandemic. Because it's a new virus. The swine flu spread by direct

Correlation of days of illness on which oseltamivir was started with outcome in swine flu patients, in Government Medical College, Aurangabad (Jan-2015 to May 2015)

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Since 2009, Government Medical College, Aurangabad, a tertiary care hospital in the Marathwada region of Maharashtra, India, has been regularly admitting cases of pneumonia and ARDS, that are labeled as swine flu suspects.</span> Oseltamivir is effective in swine flu cases if given within 48 hours and better, within 24 hours of start of illness. However most of our patients do not get oseltamivir within 48 hours. Hence we decided to compare the outcome in patients who received oseltamivir within 48 hours and after that.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> This is an observational, cross-sectional study comparing the time lag between the start of symptoms and getting the first dose of oseltamivir. 59 H1N1 positive patients were admitted to the swine flu ward between January to May 2015. We compared the two groups, one that received oseltamivir within 48 hours of start of symptoms and one that received after 48 hours and compared it with the outcome, i. e survival or death.</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>38 patients (64.40%) in our study belonged to the age group of 31-50. Out of 59 positive patients, only 7 received oseltamivir within 48 hours, of whom 4 died. 52 received oseltamivir after 48 hours of whom 20 died. All the 11 who were given non-invasive ventilation, whereas only 1 of the 25 on invasive ventilation survived. </p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Oseltamavir does not appear to have made a difference for survival whether it was given within 48 hours as compared to after 48 hours of onset of symptoms. However, these two groups were not comparable.</p>

Our Experiences of Swine Flu Cases in Office Practice in Jan-Feb: 2015

Our Experiences of Swine Flu Cases in Office Practice in Jan-Feb: 2015

Clinical profile and outcome of recent outbreak of influenza A H1N1 (swine flu) at a tertiary care center in Hyderabad, Telangana

Background: Swine influenza, also called swine flu, hog flu, and pig flu, is an infection caused by any one of the several types of swine influenza viruses. The World Health organization ( WHO) raised a worldwide pandemic alert for swine flu on June 11, 2009 that was a first of its kind in the past 70 years. In India, the index cases were reported from Pune, Maharashtra. We witnessed a recent outbreak in India during late 2014 and early 2015. Methodology: A retrospective study was carried out to describe the clinical profile and outcome of the confirmed cases of swine flu who were admitted at our center between December 10, 2014 and May 11, 2015. The cases were confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) on respiratory specimens. Results: A total of 514 patients with symptoms suggestive of swine flu were tested for hemagglutinin type 1 and neuraminidase type 1 (H1N1) out of whom 88 were positive, which accounted for 17.12% positivity. The mean age was 31.15 years with a range of 11-90 years, with equal distribution among males and females (males: 45, females: 43). The epidemic peaked in the month of January (n = 44.50%). Fever (95.45%) was the most common clinical manifestation followed by cough (85.22%), breathlessness (51.22%), and myalgia (50%). The majority were in category C (59.09%) based on the severity of the illness. All the patients were hospitalized and treated with oseltamivir. Of all the positive patients, 39 (44.31%) were advised home isolation after discharge for 5-7 days in view of the mild disease. Hypertension, diabetes, existing lung diseases, cardiovascular diseases, smoking habit, alcohol consumption, and pregnancy were found to be the major risk factors. Women in the third trimester of their pregnancy were found to be at a higher risk. Our study had an overall mortality of 14.77% (n = 13). Mortality was higher among pregnant women (n = 1/6, 16.66%) compared to nonpregnant women (n = 5/37, 13.51%). Multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were the most common causes of death. Conclusion: Swine flu activity has come down significantly, with a single case being reported in the month of April and none in May in 2015 at our center.

Epidemiological characteristics including seasonal trend of hospital based swine flu cases in Jamnagar region, Gujarat, India

Epidemiological characteristics including seasonal trend of hospital based swine flu cases in Jamnagar region, Gujarat, India

A study of the outcome of confirmed avian flu and swine flu cases admitted to Abbassia Chest Hospital between 2006 and 2010

Type A viruses are the most virulent human pathogens among the three influenza types and cause the most severe disease: H1N1, which caused swine flu in 2009, and H5N1, which caused avian flu in 2004. The aim of this study was to evaluate the clinical and epidemiological features and the treatment outcome of confirmed cases of avian flu and swine flu admitted in Abbassia Chest Hospital between 2006 and 2010. This was a retrospective study that included 213 patients PCR-positive for influenza A H1N1 and 23 patients PCR-positive for influenza A H5N1, who were admitted to Abbassia Chest Hospital during the period from March 2006 to December 2010. The following data were collected by retrospective reviews of hospital records for each patient: epidemiological data through interview with the patient or their relatives, full history data, complete clinical examination data, full laboratory investigations, chest radiograph film at the time of admission and during the hospitalization period, a nasopharyngeal swab, ECG, and arterial blood gases. Statistical analysis of the data was then carried out. Regarding swine flu cases, there was no statistical difference with regard to the age distribution, the sex distribution, the presence of comorbidities, and the time of presentation among the studied patients. The results showed that 170 patients recovered, whereas 43 died, with a mortality rate of 20.2%. Among the avian flu cases, seven patients recovered, whereas 16 died, with a mortality rate of 69.5%. The mortality rate was high in renal patients, patients having bilateral complicating pneumonia, and in the patients who needed mechanical ventilation. Some comorbidities, such as diabetes mellitus, cardiac illness, and chronic chest illness, have no implication on mortality. In contrast, renal conditions and the need of mechanical ventilation were associated with a high mortality rate. Egypt J Broncho 2014 8:70–78

A case of swine flu superinfected with carbapenem resistant Klebsiella

Swine flu is caused by antigenic shift of influenza A virus with clinical features similar to seasonal influenza virus. Majority of the morbidity and mortality due to swine flu are attributable to pneumonia and the acute respiratory distress syndrome (ARDS). Bacterial superinfection can occur, though it is rare in adults. Here we report a case of swine flu superinfected with carbapenem resistant Klebsiella, which is often coined as Klebsiella ‘superbug’. Asian Journal of Medical Science, Volume-5(3) 2014: 120-122 http://dx.doi.org/10.3126/ajms.v5i3.8589

The H1N1 Pandemic Flu. Some Critical Remarks from a Legal Point of View

Aim: This paper analyses the global and European responses to the break out of the H1N1 virus in 2009 and highlights the major deficiencies of the European authorization procedure of vaccines against H1N1 pandemic flu.Study Design: The study analyses the institutional reactions to the spread of the H1N1 pandemic flu (commonly called swine flu). The study reports the fundamental steps undertaken by global and European Institutions since 2009 to face the spreading of the H1N1 flu.Methodology: The study applies a legal methodology proceeding from formal rules towards the substantial effects taking place in the specific health protection field considered.Results: The analysis of the European authorization procedure of vaccines against H1N1 pandemic flu shows the lack of coordination between Member States and the European Union, as well as coordination between the European Medicines Agency (EMA) and the European Office of the World Health Organization (WHO); moreover, a fundamental violation of the precautionary principle emerged. In the European context, in fact, the principle does not coincide with the temporary nature of the measures, but reflects the fundamental distinction between assessment and risk management.Conclusions: The supranational mediation of the European Union has offered in many cases the guarantee of health protection within contexts in which the multiplicity of involved interests increases the level of conflict. That mediation has definitely failed in the case of swine flu because of the lack of supranational constituency representation within the European Medicines Agency that allows the intergovernmental component andthe underlying unilateral protection of economic interests to resurface.In the case of swine flu, the trust relationships between global and European bodies have been affected by the lack of transparency of the responsible organizations (WHO and EMA) and the lack of pluralistic openness to different interests in the decision-making procedures.

Rizikos komunikacija Lietuvos žiniasklaidoje kiaulių gripo metu

In 2008 The Independent reported on a new influenza pandemic which can cause loss of more than fifty million lives around the world. The British Lords were talking about a bird flu strain which can rapidly spread due to conducive conditions. After a year, the World Health Organization declared the sixth threat level of swine flu pandemic. The new rapidly spreading virus became stronger and more dangerous to all people in the world. The USA was one of the first countries that recognized the epidemic being not only a health problem as the situation can be easily manipulated by psychosis. Political scenarists were creating one scenario worse after another. Swine flu swept across the Lithuania media too. The study involved the selection of keywords that served as the basis for selection of publications on swine flu; the content was divided into categories, while categories in turn were divided in subcategories; the content data was interpreted. The study of the mass media texts focused on the agenda-setting by the mass media, construction of texts and creation of social reality. The qualitative and quantitative study period spans from November 2009 to April 2010. The beginning of the analysed period was selected for the reason that in November 2009 Lithuania declared flu pandemic. June 2009 saw some sporadic reports on swine flu, however, the Lithuanian mass media did not pay much attention to the issue. However, the information flow started increasing from November when cases of swine flu become more frequent. The end of the analysed period was selected for the reason that it saw a significantly decreased spread of reports on swine flu in the analysed sources. The sources for qualitative and quantitative anglysis were selected purposefully, aiming to analyse the information in the traditional mass media: press, television and the Internet. A commercial channel of printed media, a commercial online news portal and the Lithuanian national TV channel were picked. News portal Delfi.lt and daily Lietuvos Rytas were chosen for being the most popular in Lithuania, while Lithuanian National Television was selected as the only non-commercial TV channel. A sum up of the quantitative and qualitative content analysis showed that the mass media constantly worked to inform society about swine flu, however, the content of the published informatikon was viewed negatively since it lacked the educational aspect of how to protect oneself from pandemic, it also fell short of critical and analytical evaluation of the situation. Reasoning of the experts formed a negative opinion about public authorities and their ability to manage the risk. At first the media presents these experts as authorities to be trusted yet, subsequently this trust starts sagging, a move to the attacking strategy is made which results in increased distrust both in the mass media itself and the experts. Risk communication was irresponsible.

Pandemic Flu in Islamic Republic of Iran; A Review of Health System Response From July to November

: Background: Pandemic flu is a concerning problem with potentially high mortality and morbidity rates, so needs a proper health system response in each country. Objectives: To evaluate the nationwide health system response in Iran after declaration of H1N1/Swine flu pandemic in June 2009. Patients and Methods: A surveillance system in all regions of country was implemented upon declaration of pandemic flu by the World Health Organization; RT-PCR methods in National influenza reference laboratory in the capital were used to diagnose all types of circulating influenza viruses. Epidemiological data as well as laboratory response, performances of 40 medical universities all over the country concerning case detection and timing of admission were analyzed. Results: 3847 confirmed cases of H1N1/Swine flu were detected up to November 2009, which 140 cases died (i.e.; 3.8% mortality rate), highest mortality rates were observed in infants (7.4%) and those older than 50 years (9%). For about 78% of confirmed cases of Swine flu, the result had been notified within 3 days after sample submission, despite the fact, most of mortalities had occurred in this group of “short result gap”. Conclusions: Although overall mortality rate in such a pandemic was comparable or better than other developing countries, it was shown that late hospital admission and late laboratory diagnosis were associated with higher mortality rates. Better case detection and earlier admission with more available and equipped laboratories seems necessary to improve the health system response for future pandemics in Iran.

A case of swine flu with ARDS : Our experience

After the first outbreak identified in Mexico in March 2009, influenza A sustained by a modified H1N1 virus (“swine flu”) rapidly spread to all continents. Swine-origin influenza (H1N1) virus is considered a worldwide pandemic and is associated with a large number of patients admitted to intensive care. In a proportion of these patients, acute respiratory distress syndrome (ARDS) can develop. This paper describes a case of life-threatening ARDS associated with H1N1 virus confirmed by a throat swab tested with real-time reverse transcription-polymerase chain reaction. The clinical course was extremely eventful in spite of aggressive management with mechanical ventilation and parental antibiotics. In spite of marked clinical and functional recovery on 30th day admission in ICU, radiological findings suggestive of ARDS persisted.

Chest radiography and computed tomography findings of cases with pandemic influenza A (H1N1/09) infection

To review the radiological findings of the chests of swine flu patients whose infections were confirmed clinically and/or by laboratory tests. Materials and methods: This study was conducted in the radiology and infectious diseases departments of a tertiary care hospital, Ankara Training and Research Hospital, Ankara, Turkey. The X-ray and thorax computed tomography (CT) findings of swine flu patients were evaluated. Results: Included were 53 cases of swine flu. Thirty-eight of the patients (72%) underwent an initial chest X-ray and 17 (32%) underwent thorax CT examinations. The mean age of the patients was 41 years; 23 (43%) patients were male and 30 (57%) were female. In the chest X-rays, the most common pathology was patchy consolidations with a prevalence of 27%. Bilateral symmetrical involvement was observed in 42% of the cases. In the thorax CT, patchy consolidations (47%) and ground glass opacification (24%) were the most commonly observed patterns. Bilateral symmetrical involvement was observed in 41% of the cases. Pleural effusion was seen in 29% of the cases and mediastinal lymphadenopathy was observed in 41% of the cases. Conclusion: The most commonly observed radiological pattern of influenza A (H1N1) pulmonary infection is bilateral, symmetrical, patchy consolidations and/or ground glass opacities, predominantly located in middle-inferior zones with central peribronchovascular distribution. Associated mediastinal lymph nodes, pleural effusion, and tree-in-bud patterns should raise the suspicion of superimposed infection.

Unusual Swine Flu Cases Have H1N1 Links

Unusual Swine Flu Cases Have H1N1 Links

Reflections on the UK's approach to the 2009 swine flu pandemic: Conflicts between national government and the local management of the public health response

The first cases of swine flu in the UK were detected on 27th April 2009. Two weeks later Birmingham became a “hotspot” for the HIN1 pandemic in England. This paper describes the experiences of local public health agencies during the pandemic and the problems encountered when trying to work within a hierarchical and hermetic system of national policy making. We argue that over reliance on the speculative logic of modellers, together with a failure to adapt swiftly the nation's preparedness plans and public health apparatus created in readiness for a serious and fatal disease, led to an institutional void of policy making during the pandemic, where new rules and concepts emerged about what constituted scientifically acceptable and politically legitimate interventions. The imposition of a single national approach to managing the pandemic and a disregard for the role of local authorities seriously impaired the ability of local agencies to respond in a flexible, timely and pragmatic way to the rapidly emerging situation. Future planning for pandemics must recognise that global epidemics are curbed at the local level, and ensure that any response is proportionate, flexible and effective.

Onset of a pandemic: characterizing the initial phase of the swine flu (H1N1) epidemic in Israel

BackgroundThe swine influenza H1N1 first identified in Mexico, spread rapidly across the globe and is considered the fastest moving pandemic in history. The early phase of an outbreak, in which data is relatively scarce, presents scientific challenges on key issues such as: scale, severity and immunity which are fundamental for establishing sound and rapid policy schemes. Our analysis of an Israeli dataset aims at understanding the spatio-temporal dynamics of H1N1 in its initial phase.MethodsWe constructed and analyzed a unique dataset from Israel on all confirmed cases (between April 26 to July 7, 2009), representing most swine flu cases in this period. We estimated and characterized fundamental epidemiological features of the pandemic in Israel (e.g. effective reproductive number, age-class distribution, at-risk social groups, infections between sexes, and spatial dynamics). Contact data collected during this stage was used to estimate the generation time distribution of the pandemic.ResultsWe found a low effective reproductive number (Re = 1.06), an age-class distribution of infected individuals (skewed towards ages 18-25), at-risk social groups (soldiers and ultra Orthodox Jews), and significant differences in infections between sexes (skewed towards males). In terms of spatial dynamics, the pandemic spread from the central coastal plain of Israel to other regions, with higher infection rates in more densely populated sub-districts with higher income households.ConclusionsAnalysis of high quality data holds much promise in reducing uncertainty regarding fundamental aspects of the initial phase of an outbreak (e.g. the effective reproductive number Re, age-class distribution, at-risk social groups). The formulation for determining the effective reproductive number Re used here has many advantages for studying the initial phase of the outbreak since it neither assumes exponential growth of infectives and is independent of the reporting rate. The finding of a low Re (close to unity threshold), combined with identification of social groups with high transmission rates would have enabled the containment of swine flu during the summer in Israel. Our unique use of contact data provided new insights into the differential dynamics of influenza in different ages and sexes, and should be promoted in future epidemiological studies. Thus our work highlights the importance of conducting a comprehensive study of the initial stage of a pandemic in real time.