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A Concurrent Comparison of the Epidemiology and Clinical Presentation of Patients Hospitalized with Pandemic 2009 (H1N1) Influenza and Seasonal Influenza-A in Sub-himalayan Region of Himachal Pradesh

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  • A Concurrent Comparison of the Epidemiology and Clinical Presentation of Patients Hospitalized with Pandemic 2009 (H1N1) Influenza and Seasonal Influenza-A in Sub-himalayan Region of Himachal Pradesh

    J Assoc Physicians India. 2019 Mar;67(3):70-74.
    A Concurrent Comparison of the Epidemiology and Clinical Presentation of Patients Hospitalized with Pandemic 2009 (H1N1) Influenza and Seasonal Influenza-A in Sub-himalayan Region of Himachal Pradesh.

    C T1, Dv S2, A S3, V K3, A K2.
    Author information

    Abstract

    Background:

    Pandemic influenza (H1N1) 2009 emerged in April 2009 and spread widely in India. Although an unprecedented number of cases required intensive care, comparative community-based studies with seasonal influenza strains have not shown any significant differences in clinical symptoms or severity.
    Methods:

    The authors performed active surveillance on confirmed influenza-related admissions and compared the clinical profile of patients with pandemic (H1N1) 2009 influenza and patients with seasonal influenza at a tertiary care hospital in Shimla, Himachal Pradesh.
    Results:

    A total of 309 patients with flu like illness (category-C) admitted at IGMC were tested for influenza A infection and 58 (18.77%) patients had laboratory confirmed influenza A infection. Out of 58 patients, 22 with pandemic A (H1N1) and 36 with seasonal influenza A infection were analyzed. Compared with seasonal influenza, pandemic A (H1N1) patients were more likely to have sore throat (68.2% vs 16.7%, p=0.001),g.i.t symptoms (63.6% vs 16.7%, p=0.001),myalgia (36.4% vs 13.9%, p=0.047), radiologically confirmed pneumonia(81.8% vs 55.6%, p=0.042), multifocal changes on CXRs (72.7% vs 36.1%, p=0.012) and hypothyroidism as a risk factor(22.7% v 0%, p= 0.002) Patients with pandemic A (H1N1) were more likely to receive oseltamivir (91.3% vs 40.2%, p=0.002). ARDS was the major reason for intensive care unit admission in both the groups. There were no statistical significant differences in the other clinical features, comorbidities, rate of intensive care unit admission and mortality.
    Conclusions:

    The clinical features and outcomes of pandemic (H1N1) 2009 influenza and current circulating seasonal influenza A strains were comparable in hospitalised patients. However, since both seasonal and pandemic influenza can lead to significant morbidity and mortality, the impact of pre-existing seasonal influenza should not be underestimated during the pandemic period.
    ? Journal of the Association of Physicians of India 2011.


    PMID: 31304711
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