CLINICAL PROFILE OF H1N1 INFLUENZA & IT’S 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

were females (64%) and 9 were

males (36%).

• Mean age was 30.7 (±13.1) and

the range being 2years to 60

years.

9 ; 36%16; 64%

Sex ratio

males females

Category B(i) Category B(ii) Category C

male 4 2 3

female 5 9 2

0.5

1.5

2.5

3.5

4.5

5.5

6.5

7.5

8.5

9.5

4

2

3

5

9

2

Categories & no of patients

male female

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%).

THANK YOU