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

Azam Mushtaq, Muhammad Atiq Ul Manan, Muhammad Imran Shahzad, Muqarrab Hussain Kamran, Humayoun Ghulam Murtaza, Muhammad Usman

Abstract


Background: Influenza has caused multiple outbreaks throughout the world in
20th century but the emergence of influenza A H1N1 pandemic has resulted in
increased mortality throughout the world. Although WHO has announced in
2010 that influenza pandemic was over but seasonal outbreaks are there
annually. Pakistani population also suffer from this outbreak. In December
2017 and January 2018 largest number of cases have been reported in Nishtar
Medical University Hospital Multan due to its large catchment area (Whole
south Punjab, part of Sindh, Balochistan and KPK).
Methodology: We reviewed the record of all suspected H1N1 patients
admitted in Isolation ward Nishtar hospital Multan, Pakistan from 1st
December 2017 to 31st January 2018. we followed the WHO SOP for diagnosis
and treatment of H1N1 , detailed History of ILI (influenza like illness) and SARI
(severe acute respiratory illness) and co morbidities like previous respiratory
illness, Diabetes Mellitus, Chronic Renal Failure, pregnancy, Heart failure,
malignancy or drugs like anti cancer chemotherapy, prolonged use of steroids
was also taken in to account. X ray chest PA view, Nasopharyngeal swab of all
suspected H1N1 cases were sent for PCR. Data included clinical details of
patients as well as their respective areas.
Results: Total 277 suspected cases were admitted in isolation ward during
these two months, 130 cases (46.93%) turned out to be positive by PCR. Age
range was 3 to 90 years, male to female ratio was 1: 1.5. Mortality rate among
these 130 cases was 32.3% (42 cases).
Conclusion: This is high number of cases admitted in isolation and ICU ward
from different regions of Punjab in two months and 46.93% were detected as
positive, among these positive cases mortality rate was also high i.e 32.3%.
Immense preventive measures such as identification of risk factors, vaccination
of high risk groups i.e extremes of ages, and co morbidities like diabetes,
pregnancy and other conditions like, chronic lung diseases, immune
compromised states due to any reason etc and awareness of general public
about hand hygiene etc, should be taken in order to avoid or minimize such
epidemics in future.


Keywords


Key Words: H1N1 Pandemic; Isolation ward, Morbidity, Mortality, Prevention.

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