PURPOSE: In New Mexico, during the months of September-December 2009, there appeared to be a disproportionate amount of severe H1N1 infection and a higher frequency of death in Native Americans versus non-Hispanic Caucasian and Hispanics. This correlated with national and international trends that were demonstrated previously among Australian and Alaskan Native American populations 1.
METHODS: Patients were included if they were admitted to the ICU, confirmed H1N1, or presumed H1N1 with a strong clinical suspicion, from September 2009 to December 2009. The University of New Mexico served as the primary referral center for all severe H1N1 cases in the state. Ethnicity was determined from an admissions database, based on self reporting as well as source of funding, such as Indian Health Services. We collected data on age, sex, ethnicity, and past medical history. Death rates were obtained by determining the incidence of death at 30 days in each ethnicity.
RESULTS: Of the 42 patients that were included in our H1N1 database, 13 were Native American. Of these, 4 died, giving a 30% death rate. Hispanics had a 10% death rate, while Caucasians had a 25% death rate. Average age of the Native Americans was 39, while that of the Hispanic population was 38. Average Caucasian age was 49. Only two of the Native American victims had significant underlying medical problems, while only one of the Hispanics had significant medical history.
CONCLUSION: Among our patients admitted with H1N1, the death rate among Native Americans was significantly higher than that observed of Hispanics and Caucasians, and did not seem related to underlying medical problems. Our data correlates with the national trend of the virus, with highest attack rates in young adults and children, as well as higher death rates seen among Native Americans2.
CLINICAL IMPLICATIONS: In our Native American population, which is largely rural, access to care such as immunization, as well as lack of timely recognition of the clinical syndrome, may have contributed to our higher mortality rate.
DISCLOSURE: Theresa Heynekamp White, No Financial Disclosure Information; No Product/Research Disclosure Information