Time Trend of Swine Flu at a Tertiary Care Centre of Western Rajasthan: A Decadal Analysis

Manoj  Verma; Suman  Bhansali; Arun  Kumar

doi:10.5455/njcm.20190919083800

Authors

Manoj Verma Dr. S.N. Medical College, Jodhpur
Suman Bhansali Dr. S.N. Medical College, Jodhpur
Arun Kumar Dr. S.N. Medical College, Jodhpur

DOI:

https://doi.org/10.5455/njcm.20190919083800

Keywords:

Swine flu, influenza, outbreak, epidemic, pandemic

Abstract

Background: Swine flu had been established as seasonal influenza, but antigenic variation continues to result in epidemics that necessitate continued surveillance. Present study aims to describe the time trend of swine flu from its initiation in 2009 to 2019 from western zone of Rajasthan.

Material and Methods: This secondary analysis of swine flu data from established seasonal disease reporting was conducted at a tertiary care centre of western Rajasthan which was the only swine flu testing centre in this area. Only Lab confirmed cases from this centre were included for month wise distribution.

Results: First case from Jodhpur was seen in August 2009. Large peaked outbreaks were seen around every 4 years namely 2009-10, 2014-15, 2018-19 corresponding to the antigenic variation of this virus namely California, Michigan and Brisbane strain respectively. Cases were seen in mostly in winters with peak in December/January. Mortality rate among these lab confirmed cases varied from 0–22% in different outbreaks.

Conclusion: Continued laboratory surveillance is necessary to identify the time pattern of outbreaks and for early identification of emergence of new strain to ensure early and timely preparedness for impending epidemics.

References

Roosa K. Analysis of Seasonal Influenza Outbreak Trends in the United States from 2005-2015 [Internet]. Georgia State University; 2017. Available from: https://scholarworks. gsu.edu/iph_theses/531

WHO | Pandemic influenza: an evolving challenge. WHO [Internet]. 2018 [cited 2019 Apr 13]; Available from: https://www.who.int/influenza/pandemic-influenza-an-evolving-challenge/en/

Saunders-Hastings PR, Krewski D. Reviewing the history of pandemic influenza: Understanding patterns of emergence and transmission. Pathogens. 2016;5(4).

Nickol ME, Kindrachuk J. A year of terror and a century of reflection : perspectives on the great influenza pandemic of 1918 – 1919. BMC Infect Dis. 2019;19(117):1–10.

Timeline on the pandemic (H1N1) 2009 [Internet]. European centre for disease control and prevention. [cited 2019 Apr 18]. Available from: https://ecdc.europa.eu/en/seasonal-influenza /2009-influenza-h1n1-timeiline

Gupta SD, Lal V, Jain R, Gupta OP. Modeling of H1N1 Outbreak in Rajasthan: Methods and Approaches. Indian J Community Med. 2011 Jan;36(1):36–8.

WHO. Influenza Update N 338 [Internet]. 2019 [cited 2019 Apr 5]. Available from: http://www.emro.who.int/health-

WHO. Influenza (Seasonal) [Internet]. [cited 2019 Apr 9]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/influenza-(seasonal)

Bhatnagar R, Singhal Y. Demographic analysis of influenza-like illness categories including seasonal trend of swine flu cases attending a teaching hospital in Southern Rajasthan. Int J Med Sci Public Heal. 2019;8(7):526–9.

Dangi T, Jain B, Singh AK, Mohan M, Dwivedi M, Singh J V, et al. Influenza virus genotypes circulating in and around Lucknow, Uttar Pradesh, India, during post pandemic period, August 2010--September 2012. Indian J Med Res. 2014 Mar;139(3): 418–26.

Gelotar P, Durani K, Gandha K, Sanghavi M. Epidemiological characteristics including seasonal trend of hospital based swine flu cases in Jamnagar region , Gujarat , India. India J Res Med Den Sci 2015;3(1)39-42. 2015;3(1):39–42.

Chandora A, Khatri PK, Meena S, Bora A. Study of Swine Flu Virus Re-Emergence in Western Rajasthan Jodhpur in Reference to Different Age Groups (Risk Factor). Int J Curr Microbiol App Sci. 2015;4(7):352–8.

CDC. How the Flu Virus Can Change: “Drift” and “Shift” | CDC [Internet]. CDC Atlanta. [cited 2019 Aug 28]. Available from: https://www.cdc.gov/flu/about/viruses/change.htm

Wright, P. Webster, R. Knipe, D. Howley P. Orthomyxoviruses. In Fields Virology. 4th ed. Lippincott Williams &Wilkins: Philadelphia, PA, USA; 2001. 1533–1579 p.

Koul P, Khan U, Bhat K, Saha S, Broor S, Lal R, et al. Recrudescent Wave of A/H1N1 pdm09 Influenza Viruses in Winter 2012-2013 in Kashmir, India. PLoS Curr. 5.

Sardar J, Sau A, Mandal P. Clinico-epidemiological profile of confirmed swine flu ( H1N1 ) cases admitted at an infectious disease hospital in Kolkata , India. Int J Community Med Public Heal. 2016;3(8):2340–3.

Malhotra B, Singh R, Sharma P, Meena D, Gupta J, Atreya A, et al. Epidemiological & clinical profile of influenza A ( H1N1 ) 2009 virus infections during 2015 epidemic in Rajasthan. Indian J Med Res 144,. 2016;144(December 2016):918–23.

Jilani TN, Siddiqui AH. H1N1 Influenza ( Swine Flu )[Updated 2019 Jun 9] [Internet]. StatPearls Publishing. In: StatPearls [Internet]. Treasure Island (FL):; 2019 [cited 2019 Sep 8]. 2-7 p. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK513241/

Gao J, Couzens L, Burke DF, Wan H, Wilson P, Memoli MJ, et al. Antigenic Drift of the Influenza A(H1N1)pdm09 Virus Neuraminidase Results in Reduced Effectiveness of A/California/7/2009 (H1N1pdm09)-Specific Antibodies. MBio. 2019;10(2):1–17.

WHO | Recommended composition of influenza virus vaccines for use in the 2019-2020 northern hemisphere influenza season. WHO [Internet]. 2019 [cited 2019 Aug 28]; Available from: https://www.who.int/influenza/vaccines/virus/recommendations/2019_20_north/en/

WHO. GISRS-FluNet-Real time influenza virus circulation. Country wise influenza data [Internet]. [cited 2019 Aug 28]. Available from: https://www.who.int/influenza /gisrs_ laboratory/updates/summaryreport/en/

WHO GISRS FluNet charts. Comparison of number of influenza detection by sub types by country, area or teritory [Internet]. WHO. [cited 2019 Aug 28]. Available from: https:// www.who.int/influenza/gisrs_laboratory/flunet/charts/en/

Dandagi GL, Byahatti SM. An insight into the swine-influenza A (H1N1) virus infection in humans. Lung India. 2011;28(1):34–8.

Kshatriya RM, Khara N V, Ganjiwale J, Lote SD, Patel SN, Paliwal RP. Lessons learnt from the Indian H1N1 ( swine flu ) epidemic : Predictors of outcome based on epidemiological and clinical profile. J Fam Med Prim Care. 2018;7:1506–9.

Radusin M. The Spanish Flu – Part II : the second and third wave Španska groznica – II deo : drugi i tre ü i talas Key words : 2012;69(10):917–27.