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CLINICAL PROFILE OF H1N1

INFLUENZA & ITS AWARENESS :


EXPERIENCE AT A TERTIARY
CARE CENTRE IN SOUTH INDIA
DR
HARIKRISHNA ANNAM
POST GRADUATE
KAKATIYA MEDICAL COLLEGE

INTRODUCTION
Influenza is most frequently
described as a respiratory illness
characterized by systemic
symptoms, such as headache,
fever, chills, myalgia, and
malaise, as well as
accompanying respiratory tract
signs and symptoms, particularly
cough and sore throat.

METHODS & MATERIALS


All the cases presented with symptoms of flu during the period
January 2015 to march 2015 were admitted in the hospital and were
evaluated accordingly.
Among 102 suspected flu cases, there were 25 confirmed cases of
H1N1, diagnosed by RT-PCR of nasopharyngeal throat swab. These
confirmed cases were prospectively studied.

The confirmed cases were categorized into different categories as per


the guidelines provided by the government of India.
There are three categories namely :
Category A.
Category B, which includes B(i) and B(ii).
Category C.

Category- A: Patients with mild fever plus cough / sore throat


with or without body ache, headache, diarrhoea and vomiting will be
categorised as Category-A.
Category-B: In addition to all the signs and symptoms mentioned
under Category-A, if the patient has high grade fever and severe sore
throat or individuals having one or more of the high risk condition
will be categorized as B(i) and B(ii) respectively.

HIGH RISK CONDITIONS


Children less than 5 years old.
Pregnant women.
Persons aged 65 years or older.
Patients with lung diseases, heart disease, liver disease, kidney
disease, blood disorders, diabetes, neurological disorders, cancer and
HIV.

CATEGORY-C
In addition to the signs and symptoms of Category-A and B, if the
patient has one or more of the following:
Breathlessness, chest pain, drowsiness, fall in blood pressure,
sputum mixed with blood, bluish discolouration of nails.
Irritability among small children, refusal to accept feed.
Worsening of underlying chronic conditions.

RESULTS
Among 25 confirmed cases , 16

Sex ratio

were females (64%) and 9 were


males (36%).
9; 36%

Mean age was 30.7 (13.1) and

16; 64%

the range being 2years to 60


years.
males

females

Categories & no of patients


10
9

9
8
7
6
5

5
4

4
3

3
2

1
0

Category B(i)

Category B(ii)
male

female

Category C

RESULTS
Among the 25 patients 2 have died; both were category C patients.
One was a 2 year old girl and another was a 46 year old male who
was diabetic and asthmatic ,both were from karimnagar district.
All the cases were treated with oseltamivir 75mg twice daily PO for 5
days and empirical prophylactic antibiotics.
Lymphocytosis(mean of 56%) was noted in all category C patients &
3 category B(ii) patients and the leucocyte count was
normal in all cases except leukocytosis was noted in one patient of
category B(ii) and leukopenia was noted in four cases of category B(ii) .

RESULTS
Regarding awareness of H1N1 influenza; Only 4 (16%) had
knowledge of vaccine, 10 (40%) were aware of Personal Protective
Equipment (PPE) and hand hygiene.
Complications noted were thrombocytopenia (8%) and hepatitis (4%).
Mean duration of hospital stay was 8.56 days.
Among the cases 3 of them were postgraduates and one was intern.

CONCLUSIONS
Females are affected more than the males and the morbidity is high
in them compared to males.
Lymphocytosis noted in all category C patients ,could be predictor of
morbidity & mortality.
Appropriate campaigning has to be done regarding the hand hygiene
and PPE, and importance of vaccination in the high risk group in
order to contain the spread of infection.

In the year 2015 till march 30th 2015, total 33761 cases were reported
in our country of which 2035 cases have died, mortality rate (6.02%).
In the state of Telangana till march 30th 2015, total 2140 cases were
reported of which 75 cases have died, mortality rate (3.5%)
Highest number of cases were reported in Rajasthan, Gujurat 6559 &
6495 respectively.
Lowest mortality rate was reported in Delhi (0.3%) and highest in
Kerala (48%).

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