H1N1 influenza pandemic: What we did and what we learnt?

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Authors: Sameer Jog and Deelip Kadam
Date: September-October 2013
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Editorial
Length: 1,407 words
Lexile Measure: 1670L

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Byline: Sameer. Jog, Deelip. Kadam

The year 2009 came with a great new challenge for the intensivists around the world and in India too. Soon after Mexico and North America, the 2009 H1N1 influenza pandemic hit India in May 2009. In the subsequent monsoon, the pandemic spread in all parts of the country and cases of severe respiratory failure due to H1N1 pneumonia-related acute respiratory distress syndrome (ARDS) were reported from almost all over India. Young and healthy population without any co-morbidities constituted 25-50% of the patients in various case studies. [sup][1] Relentless progression of pneumonia/ARDS and hypoxia in around 30% of intensive care unit (ICU) admitted patients created panic among healthcare professionals. [sup][2] Initially, there was no consensus even in the scientific community and there were no clear guidelines about antiviral treatment, case isolation, prevention of aerosol-mediated infection inside the hospitals and ICUs, use of adjunct therapies, and even ventilatory management. Many ICUs in the country were not prepared for this pandemic and there was a fearful atmosphere among healthcare workers. The experience of the severe acute respiratory syndrome (SARS) epidemic in China was at the back of our minds, where the disease had taken a toll of a few healthcare workers as well. Against this background, we must proudly say that in India, intensive care healthcare professionals accepted this challenge to treat these critically ill patients, even with potential risk to their lives. Many ICUs from public and private hospitals quickly geared their units to treat these patients. Though observational cohort studies started to be published from North America, Europe, and Australia from 2009, there were only a few case reports published from Indian hospitals. [sup][3],[4]

In the current issue of the journal, Chawla et al . [sup][5] have reported their experience of treating H1N1 influenza patients at their tertiary level referral center in Delhi in 2009 and 2010. They have reported a retrospective case study of 77 consecutive confirmed H1N1 influenza cases having an average age of 40.48 [+ or -] 13.45 years. Out of these 77 patients, 43 patients developed respiratory failure and 36 required mechanical ventilation....

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Gale Document Number: GALE|A349652963