Azam Mushtaq, Muhammad Atiq-ul Manan, Muhammad Imran Shahzad, Muqarrab Hussain Kamran, Humayoun Ghulam Murtaza, Muhammad Usman.
Seasonal Influenza a (H1N1) 2017-18, experience of dealing with a deadly disease.
Pak J Chest Med Jan ;25(4):161-5.

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.

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