H1N1

Swine flu, also known as Hog or Pig flu, or H1N1 is a highly contagious viral infection caused by influenza A viruses of the family orthomyxoviridae. The term “influenza” derived from Italian word “influence” was coined in 1357 AD as the disease was thought to be caused by influence of stars, It was first isolated from Pigs in 1930 in USA. It is a viral respiratory disease caused by viruses that infects pigs, resulting in nasal secretions, barking cough, decreased appetite, & listless behavior. Swine virus consist of eight RNA strands, one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu spreads from an infected person to a healthy person by inhalation or ingestions of droplets contaminated with virus while sneezing or coughing. Antiviral drugs effective against this virus are Tamiflu and Relenza, while rapid antigen testing (RITD), DFA testing, viral culture, and molecular testing (RT-PCR) are used for its diagnosis in laboratory.

To assess the use of drugs used in patients of influenza like illness. A Questionnaire was prepared and filled after accessing data from the medical records of patients suffering from influenza like illness including H1N1+ve cases. At the end an evaluation of questionnaires was done and an assessment form was filled. IEC approval was obtained. The H1N1 +ve patients, who received oseltamivir within 36 h, had complete recovery. A higher number of respiratory complications as well as deaths were observed in patients receiving oseltamivir >36h later. An increase in need for antibiotic usage was also observed in those patients who received oseltamivir 36h later. Commonest side effects seen were nausea, vomiting & loose motions. Among the total cases surveyed only 8% did not receive oseltamivir, while more than half the patients receiving oseltamivir turned out to be H1N1 –ve eventually.  The benefits of early use of oseltamivir like rapid clinical recovery & less risk of complications were confirmed. However, more than 50% of these Influenza like illness (ILI) cases received oseltamivir unnecessarily, probably due to phobia of H1N1. The above factors could lead to an increased financial burden on the patient as well as on the already overstretched healthcare system. Early diagnosis of H1N1 infection might be useful to prevent inappropriate use of effective antiviral drugs like oseltamivir