Abstract
There are few structured data available to assess the risks associated with pandemic influenza A(H1N1)v infection according to ethnic groups. In countries of the Americas and the Pacific where these data are available, the attack rates are higher in indigenous populations, who also appear to be at approximately three to six-fold higher risk of developing severe disease and of dying. These observations may be associated with documented risk factors for severe disease and death associated with pandemic H1N1 influenza infection (especially the generally higher prevalence of diabetes, obesity, asthma, chronic obstructive pulmonary disease and pregnancy in indigenous populations). More speculative factors include those associated with the risk of infection (e.g. family size, crowding and poverty), differences in access to health services and, perhaps, genetic factors. Whatever the causes, this increased vulnerability of indigenous populations justify specific immediate actions in the control of the current pandemic including primary prevention (intensified hygiene promotion, chemoprophylaxis and vaccination) and secondary prevention (improved access to services and early treatment following symptoms onset) of severe pandemic H1N1 influenza infection.
Highlights
Five months into its progression, the pandemic H1N1 influenza has affected countries on all continents
The role of pregnancy, asthma, chronic obstructive pulmonary disease and metabolic conditions in the occurrence of severe pandemic H1N1 influenza infection has been documented [2,3]
Pandemic H1N1 influenza data The most structured and accessible nationwide data were available from Canada, Australia and New Zealand
Summary
Five months into its progression, the pandemic H1N1 influenza has affected countries on all continents. In Mexico, where the pandemic is likely to have started, the outbreak affected the central states first and extended to other parts of the country. In the northern hemisphere (United States, Canada, Japan and the United Kingdom), imported cases were followed by sustained community transmission and epidemics in some countries. Importation in the southern hemisphere of cases from the northern hemisphere coincided with the beginning of the austral winter and influenza season, with a much more intense epidemic in several of these countries. Hundreds of thousands of confirmed cases have been reported throughout the world, including over 4,735 confirmed and notified deaths [1]. Much progress has been made in documenting the pandemic and the causative virus. The role of pregnancy, asthma, chronic obstructive pulmonary disease and metabolic conditions (diabetes mellitus - a recognized risk factor for severe disease associated with seasonal flu - and obesity which has not been considered as a risk factor in previous pandemics or for seasonal influenza) in the occurrence of severe pandemic H1N1 influenza infection has been documented [2,3]
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