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Severe acute respiratory infections caused by 2009 pandemic influenza A (H1N1) among American Indians--southwestern United States, May 1-July 21, 2009.
Influenza Other Respir Viruses. 2013 Nov; 7(6):1361-9.IO

Abstract

BACKGROUND

During April-July 2009, U.S. hospitalization rates for 2009 pandemic influenza A (H1N1) virus (H1N1pdm09) infection were estimated at 4·5/100 000 persons. We describe rates and risk factors for H1N1pdm09 infection among American Indians (AIs) in four isolated southwestern U.S. communities served by the Indian Health Service (IHS).

METHODS

We reviewed clinical and demographic information from medical records of AIs hospitalized during May 1-July 21, 2009 with severe acute respiratory infection (SARI). Hospitalization rates were determined using denominator data provided by IHS. H1N1pdm09 infection was confirmed with polymerase chain reaction, rapid tests, or convalescent serology. Risk factors for more severe (SARI) versus milder [influenza-like illness (ILI)] illness were determined by comparing confirmed SARI patients with outpatients with ILI.

RESULTS

Among 168 SARI-hospitalized patients, 52% had confirmed H1N1pdm09 infection and 93% had >1 high-risk condition for influenza complications. The H1N1pdm09 SARI hospitalization rate was 131/100 000 persons [95% confidence interval (CI), 102-160] and was highest among ages 0-4 years (353/100 000; 95% CI, 215-492). Among children, asthma (adjusted odds ratio [aOR] 3·2; 95% CI, 1·2-8·4) and age<2 years (aOR 3·8; 95% CI, 1·4-10·0) were associated with H1N1pdm09 SARI-associated hospitalization, compared with outpatient ILI. Among adults, diabetes (aOR 3·1; 95% CI, 1·5-6·4) was associated with hospitalization after controlling for obesity.

CONCLUSIONS

H1N1pdm09 hospitalization rates among this isolated AI population were higher than reported for other U.S. populations. Almost all case patients had high-risk health conditions. Prevention strategies for future pandemics should prioritize AIs, particularly in isolated rural areas.

Authors+Show Affiliations

Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA; Division of Epidemiology and Disease Prevention, Indian Health Service, Albuquerque, NM, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

23721100

Citation

Suryaprasad, Anil, et al. "Severe Acute Respiratory Infections Caused By 2009 Pandemic Influenza a (H1N1) Among American Indians--southwestern United States, May 1-July 21, 2009." Influenza and Other Respiratory Viruses, vol. 7, no. 6, 2013, pp. 1361-9.
Suryaprasad A, Redd JT, Hancock K, et al. Severe acute respiratory infections caused by 2009 pandemic influenza A (H1N1) among American Indians--southwestern United States, May 1-July 21, 2009. Influenza Other Respir Viruses. 2013;7(6):1361-9.
Suryaprasad, A., Redd, J. T., Hancock, K., Branch, A., Steward-Clark, E., Katz, J. M., Fry, A. M., & Cheek, J. E. (2013). Severe acute respiratory infections caused by 2009 pandemic influenza A (H1N1) among American Indians--southwestern United States, May 1-July 21, 2009. Influenza and Other Respiratory Viruses, 7(6), 1361-9. https://doi.org/10.1111/irv.12123
Suryaprasad A, et al. Severe Acute Respiratory Infections Caused By 2009 Pandemic Influenza a (H1N1) Among American Indians--southwestern United States, May 1-July 21, 2009. Influenza Other Respir Viruses. 2013;7(6):1361-9. PubMed PMID: 23721100.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Severe acute respiratory infections caused by 2009 pandemic influenza A (H1N1) among American Indians--southwestern United States, May 1-July 21, 2009. AU - Suryaprasad,Anil, AU - Redd,John T, AU - Hancock,Kathy, AU - Branch,Alicia, AU - Steward-Clark,Evelene, AU - Katz,Jacqueline M, AU - Fry,Alicia M, AU - Cheek,James E, AU - ,, AU - ,, Y1 - 2013/05/30/ PY - 2013/04/18/accepted PY - 2013/6/1/entrez PY - 2013/6/1/pubmed PY - 2014/6/19/medline KW - American Indians KW - H1N1 subtype KW - hospitalizations KW - influenza viruses SP - 1361 EP - 9 JF - Influenza and other respiratory viruses JO - Influenza Other Respir Viruses VL - 7 IS - 6 N2 - BACKGROUND: During April-July 2009, U.S. hospitalization rates for 2009 pandemic influenza A (H1N1) virus (H1N1pdm09) infection were estimated at 4·5/100 000 persons. We describe rates and risk factors for H1N1pdm09 infection among American Indians (AIs) in four isolated southwestern U.S. communities served by the Indian Health Service (IHS). METHODS: We reviewed clinical and demographic information from medical records of AIs hospitalized during May 1-July 21, 2009 with severe acute respiratory infection (SARI). Hospitalization rates were determined using denominator data provided by IHS. H1N1pdm09 infection was confirmed with polymerase chain reaction, rapid tests, or convalescent serology. Risk factors for more severe (SARI) versus milder [influenza-like illness (ILI)] illness were determined by comparing confirmed SARI patients with outpatients with ILI. RESULTS: Among 168 SARI-hospitalized patients, 52% had confirmed H1N1pdm09 infection and 93% had >1 high-risk condition for influenza complications. The H1N1pdm09 SARI hospitalization rate was 131/100 000 persons [95% confidence interval (CI), 102-160] and was highest among ages 0-4 years (353/100 000; 95% CI, 215-492). Among children, asthma (adjusted odds ratio [aOR] 3·2; 95% CI, 1·2-8·4) and age<2 years (aOR 3·8; 95% CI, 1·4-10·0) were associated with H1N1pdm09 SARI-associated hospitalization, compared with outpatient ILI. Among adults, diabetes (aOR 3·1; 95% CI, 1·5-6·4) was associated with hospitalization after controlling for obesity. CONCLUSIONS: H1N1pdm09 hospitalization rates among this isolated AI population were higher than reported for other U.S. populations. Almost all case patients had high-risk health conditions. Prevention strategies for future pandemics should prioritize AIs, particularly in isolated rural areas. SN - 1750-2659 UR - https://www.unboundmedicine.com/medline/citation/23721100/Severe_acute_respiratory_infections_caused_by_2009_pandemic_influenza_A__H1N1__among_American_Indians__southwestern_United_States_May_1_July_21_2009_ L2 - https://doi.org/10.1111/irv.12123 DB - PRIME DP - Unbound Medicine ER -