Swine-origin influenza A (H1N1) in Indian children.
BACKGROUND
Swine-origin influenza A H1N1 (S-OIV) has not been systematically studied in Indian children.


OBJECTIVE
To study the clinical characteristics, morbidity and mortality pattern in children with S-OIV infection.


METHODS
This prospective study was conducted during the 'containment phase' of the pandemic in New Delhi from 10 June to 5 August 2009. All children suspected of being infected by S-OIV were admitted to the isolation wards and clinically evaluated according to WHO guidelines. Nasal and throat swabs were collected immediately for real-time reverse transcriptase polymerase chain reaction (RT-PCR). Haemoglobin, total leucocyte and platelet counts and chest radiography were undertaken in all patients. Those who tested positive for S-OIV infection were treated with oseltamivir for 5 days in isolation wards.


RESULTS
Thirty-seven children fulfilled the inclusion criteria. Twenty-one tested positive for S-OIV by RT-PCR and 16 tested negative. Comparison of the clinical characteristics of the two groups showed that duration of cough was longer in children with S-OIV (p<0.03). Total leucocyte and lymphocyte counts were significantly less in the S-OIV group (p<0.001 and , 0.02, respectively). Oseltamivir-related gastritis was seen in 38% of children. All improved and were discharged.


CONCLUSIONS
S-OIV infection in Indian children had features similar to those of seasonal influenza. Lymphopenia is an important feature of S-OIV.
Saha
A
A
Department of Pediatrics, Postgraduate Institute of Medical Education & Research and Associated Dr Ram Manohar Lohia Hospital, New Delhi, India. drabhijeetsaha@yahoo.com
Jha
N
N
Dubey
N K
NK
Gupta
V K
VK
Kalaivani
M
M
D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D005756:Gastritis / Q000139:chemically induced; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000821:virology*; D007958:Leukocyte Count; D008231:Lymphopenia; D008297:Male; D009666:Nose / Q000821:virology; D053139:Oseltamivir / Q000009:adverse effects / Q000627:therapeutic use; D010614:Pharynx / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
D012367:RNA, Viral; D053139:Oseltamivir