THE STUDY OF CLINICAL PRESENTATION, MORBIDITY PROFILE AND OUTCOME WITH H1N1 INFLUENZA A IN ADMITTED CHILDREN

Yudhavir S. Shekhawat*, Anurag Singh and Pramod Sharma

ABSTRACT

Background- Influenza virus is a common human pathogen that has caused serious respiratory illness and death. In April 2009 a new strain of Influenza virus A H1N1 began to spread in several countries around the world and India confirmed its first case on 16 May 2009. The 2013-2014 influenza season was marked by the resurgence of pandemic A/H1N1virus causing substantial morbidity and mortality around the world. Objective- The study of clinical presentation, morbidity profile and outcome of H1N1 influenza A in admitted children of a Tertiary health centre. Methods-130 patients satisfying the WHO criteria of CAP were enrolled. Nasopharyngeal Aspirates of these patients were tested for H1N1 virus by using the Real Time Reverse Transcriptase Polymerase Chain Reaction assay. Clinico-epidemiological profile and outcome of positive patients were analysed. Results- Twenty-three (17.7%) patients were confirmed (positive) for H1N1influenza A. Maximum 13(56.5 %) patients were in the age group 1-5 years. Male (73.9%) were affected more than Females (26.1%). The common symptoms were rapid breathing (100%), fever (82.6%) and cough (95.7%). Malnutrition was present in 10 (43.5%) cases. Total 3 (13.0%) patients were taken on mechanical ventilator, out of them no one survived. Conclusion- Clinician should consider H1N1 influenza A in the differential diagnosis of patients who presented with acute onset of fever, cough and breathlessness. The routine laboratory investigations in children with H1N1 influenza A were non-specific. There was no specific laboratory characteristic shown to have a significant association with the severity of illness or poor outcome. Poor prognostic factors as derived in the current study were the development of ARDS, need of mechanical ventilation and associated co-morbid illness.

Keywords: H1N1 influenza A, Community Acquired Pneumonia (CAP), (RT-PCR) Real Time Reverse- Transcriptase Polymerase Chain Reaction.