Dr KK AggarwalFactsIn the United States, 0.3% of all cases require admissions.The mortality rate of flu pandemic is 0.12 deaths per 100,000 population.Total number of deaths caused by pandemic H1N1 influenza A in the United States was lower than the number of deaths caused by seasonal influenza during non-pandemic yearsEarly and prompt initiation of antiviral therapy is recommended for children, adolescents, or adults with suspected or confirmed swine flu with any of the following features:Flu requiring hospitalizationProgressive, severe, or complicated fluSeverely immunosuppressed patients (receiving treatment for malignancies, hematopoietic or solid organ transplant recipients)Swine flu at high risk for complications:Children <5 years particularly those <2 yearsElderly =65 yearsPregnant womenWomen up to 2 weeks postpartumResidents of nursing homes and other chronic care facilitiesIndividuals with chronic medical conditions including: lung disease, including asthma (particularly if steroids have been required during the past year); heart disease, except isolated hypertension; active malignancy; chronic kidney disease, chronic liver disease, diabetes, sickle cell disease, other chronic disabling diseases and morbid obesity.Severity of fluAsymptomatic swine flu: Many contact illnesses may pass off without symptoms. In all 19 percent had serologically confirmed infection and 28 percent of those who were infected may remain asymptomatic.Mild or uncomplicated swine flu (require no treatment, no hospitalization, no investigations)Fever, cough, sore throat, nasal discharge, muscle pain, headache, chills, malaise and sometimes diarrhea and vomitingNo shortness of breathLittle change in chronic health conditions.Progressive illness. Requires hospitalizationAbove symptoms plusChest painPoor oxygenation (high respiratory rate, hypoxia, labored breathing in children)Low blood pressureConfusion, altered mental statusSevere dehydrationExacerbations of asthma, chronic bronchitis, chronic renal failure, diabetes, or other cardiovascular conditionsSevere or complicated illness requires hospitalizationSigns of lower respiratory tract diseaseLow oxygen requiring supplemental oxygenPneumonia on x-rayBrain involvementBP lower than 80, organ failureHeart involvementPersistent high fever and other symptoms beyond 3 days