Background: In 2015, the outbreak of H1N1 influenza pdm09 became widespread throughout India. States of Gujarat and Rajasthan are severely affected. We studied clinical profile and outcome of swine flu patients who were hospitalized during outbreak of H1N1 Virus in Bikaner zone of Rajasthan 2015.

Methods: we studied demographic profile clinical features laboratory parameters and outcome of 101 hospitalized H1N1 positive patients from January 2015 to April 2015.

Results: We studied 101 patients, Out of them 40.59%males and 59.41% females.  Mean age was 41 ± 14years.  21.78% had history of contact and 5.94% had history of travel, 65% were from rural areas and 43.56% had at least one predisposing comorbid condition.Mean duration of symptoms to hospitalization was 3.74±2.21 days.  Fever (86.14%), cough (81.19%), and breathlessness (79.21%) were most common symptoms. 72.27% presented with bilateral pneumonitis. 23.76% required mechanical ventilation. Abnormal laboratory findings include leukopenia (18.81%), leukocytosis (19.80%), derange RFT (5.94%); derange LFT (2.97%), dyselectrolytemia (4.95%) and respiratory acidosis (12.87%). Consolidation (34.56%) and Lower zone involvement (61.38%) were most common X–ray findings. Complications developed in 34.65%. Fatal outcome accounted for 12.87% cases. Female sex, residence (rural), presentation after 48 hours, Consolidation, lower zone involvement, SPO2 (<90%), abnormal ABG, ARDS, secondary infection and underlying comorbid condition were associated with poor outcome.

Conclusions: Specific factors that predict an increased risk for progressive disease are incompletely understood. Since H1N1 influenza RT–PCR is restricted to several centers and time consuming, a syndromic approach may be helpful in identifying patients on risk for severe disease and predict outcome. As 2009 pandemic evolved again continues investigations needed to define better clinical spectrum of disease and risk factor for severity of illness. Study will guide prevention and control activities and will allow modify strategies for case management.