With H1N1 cases seeing a recent rise in India, it is important to stay alert to its symptoms and take necessary precautions. The infection, commonly known as swine flu, can initially resemble an ordinary viral illness, with symptoms such as fever, cough, sore throat, body aches and unusual fatigue that may be easy to overlook. However, early recognition is especially important for pregnant women, older adults, young children and people with underlying health conditions, who may be at greater risk of complications.
Is further investigation necessary?
Dr Bimalpreet Mohan is the director and head of the department of radiology at Capital Health & Diagnostic Clinic, Hauz Khas, New Delhi, with over 15 years of experience in advanced diagnostic imaging. Because h1N1 does not always present dramatically, hT Lifestyle reached out to Dr Bimalpreet Mohan – the director, chief radiologist and women’s health specialist from Capital Health Clinic in Hauz Khas, New Delhi – who highlights that the first few days can be misleading. Because physiological changes during pregnancy can make respiratory infections more difficult to tolerate, in addition, pregnancy deserves particular attention.
She explains, “One of the reasons influenza gets overlooked is that its early symptoms overlap with many other viral infections. A person may initially complain of fever, headache, body ache, chills, sore throat or cough and assume it will settle in a couple of days. What matters is the pattern of symptoms and whether the person is improving or deteriorating. Not every fever requires an H1N1 test or hospital visit. However, persistent or high fever accompanied by significant weakness, worsening cough or breathing difficulty should not be ignored. “Women often juggle work, family responsibilities and health concerns, so it is not unusual for them to push through fever and exhaustion. But if there is persistent fever with breathlessness, chest discomfort, dizziness, confusion, dehydration or a significant fall in oxygen saturation, it is important to seek medical evaluation rather than simply waiting it out,” she highlights. Influenza can infect otherwise healthy people as well, but certain groups have a higher risk of complications. These include pregnant women, young children, older adults and people with chronic conditions such as asthma , chronic lung disease, heart disease, diabetes or kidney problems. Individuals with weakened immunity, including some cancer patients, may also require closer monitoring. The radiologist explains, “Pregnancy is a period when the body undergoes major cardiovascular, respiratory and immune changes. That does not mean every pregnant woman with H1N1 will become seriously ill, but it does mean that significant flu symptoms should be discussed with the treating doctor early rather than being dismissed as a routine seasonal infection. A clinical examination remains important, and testing is not automatically necessary for every person with flu-like symptoms. Where confirmation is clinically indicated, doctors may recommend a respiratory sample, commonly collected through a nasal or nasopharyngeal swab. Molecular tests such as RT-PCR can identify influenza infection. Dr Mohan emphasises that testing decisions should be individualised. “The question should not simply be, ‘Do I have H1N1? The more useful questions are how unwell the person is, whether they belong to a high-risk group and whether the result will influence treatment or further management. Unnecessary testing can create anxiety, while delaying evaluation in a vulnerable patient can be more problematic,” she elaborates. Dr Mohan explains, “A chest X-ray or CT scan is not something everyone with influenza needs. Imaging becomes more relevant when there is persistent or worsening breathlessness, low oxygen saturation, chest pain, prolonged fever or suspicion of pneumonia. The choice of imaging depends on the clinical picture. She also cautions against relying solely on oxygen readings or a test report. “A normal oxygen reading at one point does not necessarily mean the illness cannot worsen later. Symptoms, examination findings and the patient’s risk profile have to be considered together,” the radiologist adds. For most people, influenza improves with supportive care and appropriate medical management. The concern is greater when infection occurs in someone whose body has less physiological reserve. For high-risk individuals, prevention remains equally important: avoiding close exposure to people who are unwell, maintaining hand and respiratory hygiene, keeping indoor spaces ventilated and discussing seasonal influenza vaccination with the treating doctor when appropriate. “With H1N1, the goal should not be to panic at the first fever, but neither should we normalise symptoms that are clearly getting worse. Knowing the red flags, understanding who is vulnerable and seeking medical advice at the right time can prevent a potentially manageable infection from becoming a serious illness,” concludes Dr Mohan. Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition. She specialises in MRI, CT scans, ultrasound, doppler imaging, mammography and breast imaging.
Women, in particular, should be cautious about attributing every symptom to fatigue, hormonal changes or a routine viral infection, according to Dr Mohan. Chest imaging has a specific role when there are signs suggesting lower respiratory involvement, according to the radiologist.
