creators_name: Chudasama, Rajesh K creators_name: Patel, Umed V creators_name: Verma, Pramod B creators_name: Amin, Chikitsa D creators_name: Shah, Hitesh M creators_name: Banerjee, Anupam creators_name: Patel, Ravikant R creators_id: dranakonda@yahoo.com editors_name: Kakkilaya, Srinivas editors_id: BS Kakkilaya type: journale datestamp: 2011-05-02 17:17:22 lastmod: 2011-05-02 17:17:22 metadata_visibility: show title: Characteristics of Fatal Cases of Pandemic Influenza A (H1N1) from September 2009 to January 2010 in Saurashtra Region, India ispublished: pub subjects: OJHAS full_text_status: public keywords: Influenza A (H1N1); Epidemiology; Fatal cases; RT-PCR; Pregnancy; Antiviral drug abstract: Background: India reported first case of 2009 pandemic influenza A (H1N1) virus infection in May, 2009 and Saurashtra region in August, 2009. We describe the characteristics of fatal cases of 2009 influenza A (H1N1) infection reported in Saurashtra region. Methods: From September, 2009 to January, 2010, we observed 71 fatal cases that were infected with 2009 influenza A (H1N1) virus and admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features were observed and documented. Results: Median age of the deceased (71) was 29 years, and 57.7% were females. Median time observed was 5 days from onset of illness to diagnosis of influenza A (H1N1), and 57.7% were referred from general practitioner (OR=0.42, CI=0.24-0.74). Median hospital stay reported was 3 days. All admitted patients received oseltamivir, but only 16.9% received it within 2 days of onset of illness. The most common symptoms were cough (97.2%), fever (93%), sore throat and shortness of breath. Co-morbid conditions were present in almost half of the patients who ultimately died, the most common of which was pregnancy (OR=0.15, CI=0.04-0.52). Radiological pneumonia was reported in 98% patients. Conclusion: Residing in urban area, delayed referral from general practitioner, presence of co-existing condition, especially pregnancy was responsible for mortality among influenza A (H1N1) infected positive. date: 2011-01-20 date_type: published publication: Online Journal of Health and Allied Sciences volume: 9 number: 4 publisher: BS Kakkilaya refereed: TRUE referencetext: 1. Novel swine origin influenza A (H1N1) virus investigation team. Emergence of a novel swine origin influenza A (H1N1) virus in humans. N Engl J Med 2009;360:2605-2615. 2. Centers for Disease Control and Prevention (CDC). Swine influenza A (H1N1) infection in two children-Southern California, March-April 2009. MMWR 2009;58:400-402. 3. Ministry of Health & Family Welfare, Government of India. Factsheet Influenza A (H1N1). Available from: http://pib.nic.in/h1n1/factsheet.pdf. Accessed on March 06, 2010. 4. 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