Abstract

Bihar reported an increased number of cases with influenza like illness (ILI) during February to April 2015. The cases were investigated to confirm the outbreak, descriptive epidemiology of the cases was studied and control measures were undertaken for the control of outbreak. A suspected case of influenza like illness (ILI) was defined as acute onset of fever (>38°C) with cough or sore throat and a confirmed case as ILI case with throat swab positive for influenza A (H1N1) on RT-PCR. The demographic and clinical details were collected from patients attending the swine flu OPD of Rajendra Memorial Research Institute (RMRI), Patna (State Nodal Lab for H1N1 diagnosis) during Feb 24 2015 to Apr 23 2015. Overall 1269 patients with ILI attended the swine flu OPD of RMRI during the study period, of which 346 were positive for influenza A (H1N1). 2 patients died (case fatality ratio: 0.57%). Besides fever, common symptoms included cough (71%), running nose (52%), sore throat (43%), respiratory distress (22%) and diarrhea (2%). Out of 2 deaths, 1 case had co-morbidity. The outbreak started on 23 Feb, showed 2 peaks, one from 28 Feb to 4 Mar and other peak from 18 Mar to 22 Mar. The peak subsided by 23 Apr 2015.Out of total 346 H1N1 positive cases, 74% were indigenous while 26% showed migration history from other Swine flu affected States. Age group 21-30 (31%) was most affected. Males (61%) were more affected than females (39%).

State Health Department implemented several interventions to limit the outbreak including daily screening of passengers visiting the State from other Swine Flu affected States at key railway stations and Airports, Helpline Number was activated in each district to address public queries on H1N1, training of medical officers and health care providers in case management and infection control, vaccination of health care workers, creation of isolation wards and administration of Oseltamivir to ILI patients, daily monitoring on the health status of each case and IEC activities on community health education through newspapers, media etc.

Keywords

Influenza A, H1N1, Swine flu, RT-PCR, Oseltamivir, Immunogenic, Pandemic, Sneezing, Respiratory, transmission, Protective, Epidemiological, surveillance, Throat, Symptoms, Monitoring, Travellers, Outbreak, Isolation, Cleanliness, Disease, Infectious