Seasonal Influenza A (H1N1) 2017-18, experience of dealing with a deadly disease

Abstract

Background: Influenza has caused multiple outbreaks throughout the world in20th century but the emergence of influenza A H1N1 pandemic has resulted inincreased mortality throughout the world. Although WHO has announced in2010 that influenza pandemic was over but seasonal outbreaks are thereannually. Pakistani population also suffer from this outbreak. In December2017 and January 2018 largest number of cases have been reported in NishtarMedical University Hospital Multan due to its large catchment area (Wholesouth Punjab, part of Sindh, Balochistan and KPK).Methodology: We reviewed the record of all suspected H1N1 patientsadmitted in Isolation ward Nishtar hospital Multan, Pakistan from 1stDecember 2017 to 31st January 2018. we followed the WHO SOP for diagnosisand treatment of H1N1 , detailed History of ILI (influenza like illness) and SARI(severe acute respiratory illness) and co morbidities like previous respiratoryillness, Diabetes Mellitus, Chronic Renal Failure, pregnancy, Heart failure,malignancy or drugs like anti cancer chemotherapy, prolonged use of steroidswas also taken in to account. X ray chest PA view, Nasopharyngeal swab of allsuspected H1N1 cases were sent for PCR. Data included clinical details ofpatients as well as their respective areas.Results: Total 277 suspected cases were admitted in isolation ward duringthese two months, 130 cases (46.93%) turned out to be positive by PCR. Agerange was 3 to 90 years, male to female ratio was 1: 1.5. Mortality rate amongthese 130 cases was 32.3% (42 cases).Conclusion: This is high number of cases admitted in isolation and ICU wardfrom different regions of Punjab in two months and 46.93% were detected aspositive, among these positive cases mortality rate was also high i.e 32.3%.Immense preventive measures such as identification of risk factors, vaccinationof high risk groups i.e extremes of ages, and co morbidities like diabetes,pregnancy and other conditions like, chronic lung diseases, immunecompromised states due to any reason etc and awareness of general publicabout hand hygiene etc, should be taken in order to avoid or minimize suchepidemics in future.