Hospitalizations, deaths higher among indigenous people, MMWR reports

Indigenous populations from Australia, Canada and New Zealand have been found to have a three to eight times higher rate of hospitalization and death associated with infection with the 2009 pandemic H1N1 influenza virus, according to the Mortality and Morbidity Weekly Report released Dec. 11.

In October, Arizona and New Mexico observed a disproportionate number of deaths related to H1N1 among American Indians and Alaskan Natives.

These observations, plus incomplete reporting of race/ethnicity at the national level, led to the formation of a workgroup composed of representatives from 12 state health departments, the Council of State and Territorial Epidemiologists, tribal epidemiology centers, the Indian Health Service, and Centers for Disease Control and Prevention.

The workgroup assessed the burden of H1N1 influenza deaths in those two populations by compiling surveillance data from the states and comparing death rates.

The results indicated that from April 15 to Nov. 13, American Indians and Alaskan Natives in the 12 participating states had an H1N1 mortality rate four times higher than people in all other racial/ethnic populations combined.

Reasons for this disparity in death rates are unknown and need further investigation, the report stated. However, researchers said the reasons might include a high prevalence of chronic health conditions among American Indians and Alaskan Natives that predisposes them to influenza complications, poverty, and delayed access to care.

The researchers said efforts are needed to increase awareness among these people and their health-care providers of the potential severity of influenza and current recommendations regarding the timely use of antiviral medications. They also said efforts to promote the use of the H1N1 influenza vaccine among the American Indian and Alaskan Native populations should be expanded.