Native Americans at higher risk from H1N1 swine flu, report warns

President Obama’s advisory council led by the nations’ leading scientists and engineers released a report assessing preparations for H1N1 Influenza A. The report outlined steps to implement nationwide to curtail a serious H1N1 outbreak.

It said that while the precise impact of the resurgence of H1N1 infection is impossible to predict, a plausible scenario is that it could produce infection in 30 to 50 percent of the U.S. population this fall and winter.

And it said that certain populations including Native American groups are considered high risk, with elevated risks of severe outcomes.

The report said it is unlikely that the 2009-H1N1 pandemic will reach the same deadly proportions as happened in the 1918-1920 Spanish flu, also an H1N1 swine flu, but that the outbreak of 2009-H1N1 will be more dangerous than the 1976 swine flu outbreak.

The seriousness of H1N1 is not due to it’s severity but rather the fact that people have no immunity to the virus. The report indicates the possibility that overwhelming numbers of people could become infected, and that mortality could reach 30,000 to 90,000.

Dr. James Cheek, director of the Indian Health Service Division of Epidemiology and Disease Prevention said the IHS is doing much the same as are the Centers for Disease Control and Prevention, like identifying which people are at risk.

"We’ve been in the field the last month and a half, spending a lot of time with the over 200 hospitalized cases among Native Americans in Arizona," Cheek said. "They’re confirmed respiratory disease cases though not 100 percent confirmed H1N1 cases. We’re testing the blood of those who have recovered to see if it was H1N1. " He said the IHS hasn't received additional funding to fight H1N1.

Federal health officials recently announced $350 million in national grants to fight H1N1, but that money is going to states and hospitals, not to the federally recognized tribes, prompting the National Indian Health Board to cite this policy as making reservation communities increasingly vulnerable to epidemics.

An internal document produced by the CDC says a disadvantage of the Public Health Emergency Response grant is that it doesn’t allow enough time for local and tribal concurrence, but instead uses alternative strong language that asks that most or a significant amount of funding should go to local and tribal efforts.

This grant is a little different in that by using the states as a conduit the money is available very fast for communities to use, CDC spokesman Von Roebuck said. “We’re trying to work within the system, and we’re definitely running against the clock.”

Roebuck said the CDC has asked the state health departments to reach out to all local and tribal communities to provide them information about how this funding could be used, and asks that tribal governments provide the states information as to how they could use that funding and why they deserve the highest priority.

“As we learn more about the virus we’ll continue to reach out based on the science into where we feel that it is going to get the most information out to populations,” Roebuck said. “Protecting as many folks and as many locations is definitely our goal.”

Cheek said the IHS as a great record of providing vaccinations, and that their vaccination machine "is geared up to deliver the new H1N1 vaccine to all our populations the minute we get them."

Flu spotlight turns to Canada, as H1N1 swine flu sweeps First Nations and Inuit communities

Left: The 1918 Spanish flu, another A/H1N1 swine flu, devastated Inuit and indigenous communities throughout North America

Inuit Territories, Canada--For a flu that thus far has produced mostly mild disease, the high number and severity of A/H1N1 influenza in Canada’s aboriginal and First Nations communities is sobering.

Canada, which to date has 5,710 confirmed H1N1 flu cases and 11 deaths, has given no indication why the surge is occurring in indigenous communities.

The sharp spike of outbreaks in the predominantly Inuit territories drew alarm from the World Health Organization last week. WHO senior official Keiji Fukuda announced that disproportionate numbers of serious cases in Nunavut and northern Manitoba communities was cause for concern.

Fukuda warned that past pandemics had hit Inuit populations "very severely."

Nunavut’s chief medical officer Dr. Isaac Sobol downplayed WHO’s report saying he didn’t see a disproportionate number of serious cases in Inuit communities--even as cases in Nunavut doubled from 25 to 53.

The next day the number of confirmed cases jumped to 96. The number has since risen to 204. The Nunavut Health Department has reported that outbreaks are spreading to communities throughout the entire region.

Northern Ontario's Sandy Lake First Nation is reporting more than 120 new cases.

Northeast Manitoba has 226 confirmed cases and two deaths in their small aboriginal communities.

Over two-thirds of the seriously ill and those airlifted to hospital intensive care are aboriginals.

“I suspect, by the time this virus has worked its way through Manitoba, as many as half, if not more, Manitobans will have been infected," chief provincial public health officer Dr. Joel Kettner said.

He said that a disproportionate number of Manitobans from First Nations appear to have a severe form of the flu, and aboriginals and people aged 20 to 60 are among the groups most at risk of H1N1 flu infection.

The 1918 Spanish flu, another A/H1N1 swine flu, devastated not only Inuit communities in Canada and Alaska, but other North American indigenous communities as well, and caused extremely high mortality rates among indigenous peoples.

WHO’s Fukuda said any speculation as to causes such as genetic, environmental or due to underlying diseases is premature.

Aboriginal leaders blame poor health and living conditions and accuse federal and provincial governments of leaving them with few resources. Poor nutrition, overcrowding, and substandard housing makes it harder to prevent the disease from spreading. In some communities as many as a dozen people squeeze into two-bedroom homes, and over half have no running water. They also lack full-scale medical clinics.

There is some fear that the virus may travel throughout Canada's Indian country and still be active as a possible second or third H1N1 wave hits this fall and winter. While most people recover without taking anti-virals, WHO said the anti-viral Tamiflu may reduce the symptoms and duration of illness, and may contribute to preventing severe disease and death, putting an emphasis on the importance of its availability in indigenous communities.

The Red Cross website counsels worried families that knowing what to expect, how to prepare and where to find needed information and support will increase your resilience, decrease your stress and minimize the impact on you and your loved ones. Here's pandemic preparedness: http://www.pandemicfluandyou.org/. And here’s advice for Parents on Talking to Children about H1N1 flu: http://bit.ly/7NNCU. Families and friends can stay in touch on the Safe and Well Registry: https://disastersafe.redcross.org/.

The CDC www.cdc.org/swineflu, and the federal government’s pandemic website http://www.pandemicflu.gov/ are good sources of information. The CDC’s toll-free hotline is 1-800-CDC-INFO (1-800-232-4636). The line for the hearing impaired is 1-800-232-6348.