Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India.
The burden of the pandemic (H1N1) 2009 influenza might be underestimated if detection of the virus is mandated to diagnose infection. Using an alternate approach, we propose that a much higher pandemic burden was experienced in our institution.Consecutive patients (n = 2588) presenting to our hospit...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3434194?pdf=render |
| _version_ | 1818081443549544448 |
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| author | Mahesh Moorthy Prasanna Samuel John Victor Peter Saranya Vijayakumar Dipika Sekhar Valsan P Verghese Indira Agarwal Prabhakar D Moses Kala Ebenezer Ooriapadickal Cherian Abraham Kurien Thomas Prasad Mathews Akhilesh C Mishra Renu Lal Jayaprakash Muliyil Asha Mary Abraham |
| author_facet | Mahesh Moorthy Prasanna Samuel John Victor Peter Saranya Vijayakumar Dipika Sekhar Valsan P Verghese Indira Agarwal Prabhakar D Moses Kala Ebenezer Ooriapadickal Cherian Abraham Kurien Thomas Prasad Mathews Akhilesh C Mishra Renu Lal Jayaprakash Muliyil Asha Mary Abraham |
| author_sort | Mahesh Moorthy |
| collection | DOAJ |
| description | The burden of the pandemic (H1N1) 2009 influenza might be underestimated if detection of the virus is mandated to diagnose infection. Using an alternate approach, we propose that a much higher pandemic burden was experienced in our institution.Consecutive patients (n = 2588) presenting to our hospital with influenza like illness (ILI) or severe acute respiratory infection (SARI) during a 1-year period (May 2009-April 2010) were prospectively recruited and tested for influenza A by real-time RT-PCR. Analysis of weekly trends showed an 11-fold increase in patients presenting with ILI/SARI during the peak pandemic period when compared with the pre-pandemic period and a significant (P<0.001) increase in SARI admissions during the pandemic period (30 ± 15.9 admissions/week) when compared with pre-pandemic (7 ± 2.5) and post-pandemic periods (5 ± 3.8). However, Influenza A was detected in less than one-third of patients with ILI/SARI [699 (27.0%)]; a majority of these (557/699, 79.7%) were Pandemic (H1N1)2009 virus [A/H1N1/09]. An A/H1N1/09 positive test was correlated with shorter symptom duration prior to presentation (p = 0.03). More ILI cases tested positive for A/H1N1/09 when compared with SARI (27.4% vs. 14.6%, P = 0.037). When the entire study population was considered, A/H1N1/09 positivity was associated with lower risk of hospitalization (p<0.0001) and ICU admission (p = 0.013) suggesting mild self-limiting illness in a majority.Analysis of weekly trends of ILI/SARI suggest a higher burden of the pandemic attributable to A/H1N1/09 than estimates assessed by a positive PCR test alone. The study highlights methodological consideration in the estimation of burden of pandemic influenza in developing countries using hospital-based data that may help assess the impact of future outbreaks of respiratory illnesses. |
| first_indexed | 2024-12-10T19:06:17Z |
| format | Article |
| id | doaj.art-07c2340d35ee4de38ff95175a597ee8d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T19:06:17Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
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| spelling | doaj.art-07c2340d35ee4de38ff95175a597ee8d2022-12-22T01:36:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4150710.1371/journal.pone.0041507Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India.Mahesh MoorthyPrasanna SamuelJohn Victor PeterSaranya VijayakumarDipika SekharValsan P VergheseIndira AgarwalPrabhakar D MosesKala EbenezerOoriapadickal Cherian AbrahamKurien ThomasPrasad MathewsAkhilesh C MishraRenu LalJayaprakash MuliyilAsha Mary AbrahamThe burden of the pandemic (H1N1) 2009 influenza might be underestimated if detection of the virus is mandated to diagnose infection. Using an alternate approach, we propose that a much higher pandemic burden was experienced in our institution.Consecutive patients (n = 2588) presenting to our hospital with influenza like illness (ILI) or severe acute respiratory infection (SARI) during a 1-year period (May 2009-April 2010) were prospectively recruited and tested for influenza A by real-time RT-PCR. Analysis of weekly trends showed an 11-fold increase in patients presenting with ILI/SARI during the peak pandemic period when compared with the pre-pandemic period and a significant (P<0.001) increase in SARI admissions during the pandemic period (30 ± 15.9 admissions/week) when compared with pre-pandemic (7 ± 2.5) and post-pandemic periods (5 ± 3.8). However, Influenza A was detected in less than one-third of patients with ILI/SARI [699 (27.0%)]; a majority of these (557/699, 79.7%) were Pandemic (H1N1)2009 virus [A/H1N1/09]. An A/H1N1/09 positive test was correlated with shorter symptom duration prior to presentation (p = 0.03). More ILI cases tested positive for A/H1N1/09 when compared with SARI (27.4% vs. 14.6%, P = 0.037). When the entire study population was considered, A/H1N1/09 positivity was associated with lower risk of hospitalization (p<0.0001) and ICU admission (p = 0.013) suggesting mild self-limiting illness in a majority.Analysis of weekly trends of ILI/SARI suggest a higher burden of the pandemic attributable to A/H1N1/09 than estimates assessed by a positive PCR test alone. The study highlights methodological consideration in the estimation of burden of pandemic influenza in developing countries using hospital-based data that may help assess the impact of future outbreaks of respiratory illnesses.http://europepmc.org/articles/PMC3434194?pdf=render |
| spellingShingle | Mahesh Moorthy Prasanna Samuel John Victor Peter Saranya Vijayakumar Dipika Sekhar Valsan P Verghese Indira Agarwal Prabhakar D Moses Kala Ebenezer Ooriapadickal Cherian Abraham Kurien Thomas Prasad Mathews Akhilesh C Mishra Renu Lal Jayaprakash Muliyil Asha Mary Abraham Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India. PLoS ONE |
| title | Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India. |
| title_full | Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India. |
| title_fullStr | Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India. |
| title_full_unstemmed | Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India. |
| title_short | Estimation of the burden of pandemic(H1N1)2009 in developing countries: experience from a tertiary care center in South India. |
| title_sort | estimation of the burden of pandemic h1n1 2009 in developing countries experience from a tertiary care center in south india |
| url | http://europepmc.org/articles/PMC3434194?pdf=render |
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