Swine flu death rate elevated for American Indians, Alaska natives

By David Brown
Washington Post Staff Writer
Friday, December 11, 2009

The death rate from pandemic H1N1 influenza is four times higher in American Indians and Alaska natives than in the rest of the U.S. population, government epidemiologists reported Thursday.

An examination of flu deaths in 12 states found that Indians and Alaska natives suffered 3.7 deaths per 100,000 people, compared with 0.9 deaths per 100,000 for all other ethnic groups.

Indian and Alaska-native flu victims were slightly more likely than other Americans to have preexisting illnesses (81 percent vs. 78 percent), and were twice as likely to have asthma (31 percent vs. 14 percent) or diabetes (45 percent vs. 24 percent).

The cause of this difference in mortality is not known. Thomas R. Frieden, director of the federal Centers for Disease Control and Prevention, told reporters that the findings are more likely "a reflection of environmental factors and underlying conditions . . . [and] access to health care rather than genetics or ethnicity."

Increased rates of hospitalization and death from H1N1 flu among aboriginal peoples have been reported in Canada, Australia and New Zealand. A similar phenomenon was seen in previous pandemics, too.

The "Spanish flu" of 1918-19 devastated Inuit villages in Alaska. In one, Brevig Mission, 72 out of 80 residents died over five days in November 1918. A researcher extracted tissue samples in 1997 from a body buried there in a mass grave in the permafrost, allowing scientists to reconstruct that fatal strain of influenza.

CDC epidemiologists now estimate that since the emergence of the pandemic H1N1 flu strain last spring, about 50 million Americans have been infected, about 200,000 people have been hospitalized and nearly 10,000 have died.

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