Profiling the Mortality due to XXXX (H1N1) pdm09 at a Tertiary Care Hospital in Jaipur during the Current Season--January _ February 2015.

@entity1 @entity684 @entity295 @entity55 @entity683 @entity881 @entity204
BACKGROUND: The onset of winter of 2014-2015 saw an alarming spurt in @entity683 A (H1N1) pdm 09 leading to a significant mortality. Rajasthan was one of the foremost affected state bearing the frontal attack in which majority of @entity204 occurred early and in the young. OBJECTIVE: To sketch out the mortality profile with respect to demographic and clinical progression with an aim to identify the groups, this virus conspicuously picked up with a perspective to control some of the avoidable factors. METHODS: We analyzed the epidemiological data in 76 RT-PCR confirmed @entity204 of H1N1 @entity1 that occurred between 1st January 2015 and 28 February 2015 over a period of 59 days at SMS Medical College Hospital, Jaipur. RESULTS: A total of 412 @entity1 got hospitalized during two months period from 1st January 2015 to 28th February 2015, out of which 76 fatal cases presenting with category C symptoms along with radiological evidence of @entity55 were analyzed. 48.6% @entity204 occurred in the 18-40 years of age group. The mean age being 44.01    15.07 years. Females had a marginally increased mortality rate (F: M-1.23:1). The mean time of onset of symptoms to hospitalization was 6.79    4.63 days. Fifty-one (67.1% 0) @entity1 were from urban areas, whereas 25 (32.89%) belonged to rural areas. Only 7.83% @entity1 presented within 24 - 48 hours whereas 46% presented within 5 days of onset of symptoms. 66.9% succumbed within 5 days of hospitalization, despite of starting @entity684 in a dose of 150 mg/bd on the day of admission. 64.5% had predisposing risk factors. @entity55 was observed in all the 76 @entity1 , @entity295 in 21.12%, @entity881 in 30.26% and AKI in 9.21%. CONCLUSIONS: The in-hospital mortality of 17.79% despite of starting @entity684 has raised concern about identifying the so called "Rapid Progressors" [66.9% succumbing within 5 days of hospitalization]. As a corollary of this analysis the authors are of the opinion that a rejig of the existing guidelines to identify and treat @entity683 like illness be made available at the national level. What factors promote rapid progression especially in a group without any predisposing risk condition should form the focus of future studies. As risk group individuals formed a major chunk of @entity204 , the need to vaccinate this group should form a scaffold on which future directions and interventions have to be built up to combat the morbidity and mortality.
