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Epidemiological characteristics of H1N1 positive deaths: A study from tertiary care hospital in western India

Chandrashekhar Shivaji Taklikar, Mangesh Balu Nanaware.

Abstract
Background: In India as of 31st March 2010, there were 30917 laboratory confirmed H1N1 positive cases out of which 1453 were deaths with positivity index of 22.87% and mortality was 4.8%. But there was alarming sign after comparing these figures with those on 3rd October 2010 which showed 44687 confirmed H1N1 Positive cases with 2574 deaths with rise in positivity index to 23.3% and mortality rate of 5.7%. From the available data core issue of deaths occurring due to H1N1 positivity in short period of time in this year and risk factors associated with fatality were needed to look in detail.

Aims & Objective: To study the epidemiologic characteristics of reported deaths, high-risk profiles linked with underlying disease among reported deaths who died after infection with H1N1 influenza.

Material and Methods: Retrospective Record based study. Data was collected from prescribed format for swine flu patients admitted in IIW (Identified Isolation Ward) of Tertiary care hospital in Pune, State Maharashtra, India. Epidemiological characteristics like age, gender, residential address, time lag of Oseltamivir (Tamiflu) initiation, co morbidities, etc. were included. Confirmation of H1N1 positivity among cases was done by conducting Real Time PCR at National Institute of Virology, Pune. Trend of Occurrence of positive cases and death was drawn. Results were presented in the form of percentages for the respective variables. Case fatality rate was calculated for H1N1 Deaths.

Results: Maximum positive cases and deaths were in the month of August 2010. Deaths were more among age group of 20 years and above and female’s proportion was high. Thirty one deaths were in Pune urban area from April 2010 to September 2010. Time lag in initiation of Oseltamivir (Tamiflu) was seen among 63 (79%) deaths. Asthma, Diabetes and hypertension were co morbid condition and pregnancy was associated condition with H1N1 fatality.

Conclusion: Mortality was seen among adult population. Time lag in initiation of Oseltamivir (Tamiflu) was seen among majority of deaths.

Key words: H1N1 positive deaths, Tamiflu Lag, Obesity, Pregnancy, Pune



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