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First Nations represented bulk of Manitoba's severe H1N1 infection: study

Shiloh

Editor, Senior Moderator
Source: http://www.windsorstar.com/health/F...evere+H1N1+infection+study/2474378/story.html

First Nations represented bulk of Manitoba's severe H1N1 infection: study
By Amy Husser, Canwest News ServiceJanuary 22, 2010 6:03 PM

Manitoba residents of First Nations origin were disproportionally hit with severe H1N1 infection during the first wave of the virus last spring, a team of researchers has found.

University of Manitoba researchers, led by Dr. Ryan Zarychanski, examined 795 cases of H1N1 in the province from the time the outbreak started last April until Sept. 5, 2009.

Sixty per cent of the 45 severe cases ? defined as those requiring admittance to the ICU ? were First Nations people.

The study, published Thursday in the online edition of the Canadian Medical Association Journal, also found that the likelihood of severe infection was related to delays in receiving antiviral treatment.

The average time between onset of symptoms in confirmed H1N1 cases and the start of antiviral treatment grew with severity: two days for community cases, four days for hospitalization cases and six days for the most severe cases, those admitted to an intensive care unit.

That same exponential pattern was noted for First Nations people: they represented 28 per cent of community cases, 54 per cent of hospitalization cases and 60 per cent of ICU cases, suggesting a genetic predisposition.

"This finding is consistent with historical records from the 1918 Spanish influenza pandemic, during which mortality in Aboriginal communities was far higher than in non-Aboriginal communities," the study noted.

It also drew a parallel between First Nations populations and Aboriginals in Australia and New Zealand, who were also both overrepresented by severe H1N1 infections last year and during the Spanish influenza ? a finding attributed to social conditions.

"Intriguing as this hypothesis may be, Canadian Aboriginal people and Australian Aboriginals and Torres Strait Islanders do not share a common ancestry," the report read. "What they do have in common is a history of colonization, combined with historic and continuing social inequities that have led to significant health disparities."

Other factors such as housing, inadequate income, diet, underlying conditions or access to health-care resources could play a role in the First Nation finding, the researchers said.

Manitoba had the highest proportion of severe H1N1 cases at the peak of the pandemic, which is linked to 425 Canadian deaths to date. Reserve communities in the northern part of the province were among the hardest hit.

Aboriginals make up less than four per cent of Canada's population but accounted for 11.1 per cent of the total number of reported H1N1 cases. In Manitoba, they represented one of every four cases.
 
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