title: Clinico-epidemiological features of the hospitalized patients with 2009 pandemic influenza A (H1N1) virus infection in Saurashtra region, India (September, 2009 to February, 2010).
abstract: BACKGROUND
  The first case of 2009 pandemic influenza A (H1N1) virus infection in India was reported in May, 2009 and in Saurashtra region in August, 2009. We describe the clinico-epidemiological characteristics of patients who were hospitalized with 2009 influenza A (H1N1) infection in Saurashtra region.
  
  
  METHODS
  From September, 2009 to February, 2010, we observed 274 persons infected with 2009 influenza A (H1N1) virus who were admitted in different hospitals in Rajkot city. Real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) testing was used to confirm infection; the clinico-epidemiological features of the disease were closely monitored.
  
  
  RESULTS
  Of 274 patients, median age was 29.5 years, and 51.5% were males. Only 1.1% patients had recent travel history to infected region. Median time of five days was observed from onset of illness to influenza A (H1N1) diagnosis, while median time of six days reported for hospital stay. All admitted patients received oseltamivir drug, but only 16.1% received it within two days of onset of illness. One fourth of admitted patients were expired. The most common symptoms were cough (96.7%), fever (92%), sore throat and shortness of breathing, and coexisting conditions including diabetes mellitus (9.9%), hypertension (8.8%), chronic pulmonary diseases (5.5%) and pregnancy (5.5%) (P<0.05). Pneumonia was reported in 93% patients with chest radiography.
  
  
  CONCLUSIONS
  We have demonstrated that infection-related illness affects both children and adults with survival of 74% patients. The median time from onset of illness to virus detection with use of real-time RT-PCR is five days. Pregnancy is found as a significant (P<0.05) risk factor for severe disease.
authors.affiliation: Department of Community Medicine, Government Medical College, Rajkot, Gujarat, India.
authors.forename: Rajesh K
authors.initials: RK
authors.lastname: Chudasama
authors.forename: Umed V
authors.initials: UV
authors.lastname: Patel
authors.forename: Pramod B
authors.initials: PB
authors.lastname: Verma
authors.forename: Chikitsa D
authors.initials: CD
authors.lastname: Amin
authors.forename: Dinkar
authors.initials: D
authors.lastname: Savaria
authors.forename: Rakesh
authors.initials: R
authors.lastname: Ninama
authors.forename: Nilesh
authors.initials: N
authors.lastname: Fichadiya