Warning of the pH1N1 Threat to Indigenous Peoples

After the realization of a global pandemic involving a novel type A / H1N1 influenza virus (pH1N1) in April 2009, Veratect analysts were concerned about the potential impact of the pandemic as it pertains to vulnerable populations.  Of particular concern was the possibility of severe clinical and sociological impact potentially observed in the indigenous peoples of the Americas.  As was seen during the 1918 influenza pandemic, severe negative impact was seen in the Inuit peoples another indigenous peoples of the Americas, with high case fatality rates documented.  The reasons proposed for this apparent higher risk of adverse clinical outcomes included poor access to medical care and genetic predisposition, among other factors.

 

Veratect first documented an outbreak of suspected pH1N1 virus affecting indigenous peoples in Cauca, Colombia on May 14, 2009.  Then, fatalities were reported in Tocumen and Cascabel, Panama with clinical and epidemiological features consistent with pH1N1 among several different indigenous communities, which included the Kuna who were native to both Panama and Colombia.  On May 29^th, Veratect reported the first confirmed case of pH1N1 in Nunavut Province, Canada, which is a predominantly Inuit population.  On June 1^st, Veratect reported medical evacuations due to pH1N1 from Nunavut to Yellowknife.

 

Then, on June 2^nd, an outbreak of influenza A was reported among the First Nations community in St. Theresa Point in Manitoba Province, Canada.  This required medivac of seven individuals to Winnipeg for treatment as tribal leaders struggled to calm the community.  The same day, Veratect sent an advisory to the American Indian Health Service (IHS) expressing concern about this event and implications for the Inuit peoples and other Native American Tribal Nations.  This was followed up the next day with an advisory sent to the international pediatric critical care community.  Over the course of the next several days, several other First Nations communities in Manitoba were affected.  On June 9^th, the World Health Organization publicly expressed concern about the events involving the First Nations communities in Manitoba, following up with a statement of concern about aboriginal peoples on June 10^th.

 

On June 15^th, Veratect reported the first pH1N1 infections among aboriginal peoples in Australia.  Two weeks later, Veratect reported on high infection rates and adverse clinical outcomes among aboriginal peoples in the Northern and Western Territories and Queensland.  Summary findings were presented by Veratect to the international pediatric intensive care community on July 3^rd.  On July 7^th and 13^th, Veratect shared its findings with an online physician social network managed by Ozmosis.com.

 

On July 19^th, Veratect reached out to the National Congress of American Indians (NCAI) as documentation of indigenous peoples adversely affected by the pandemic increased from Canada, Australia, Panama, and Colombia.  Then, on August 11^th, NCAI invited Veratect to present its findings at the both the Health and Homeland Security Subcommittees of the NCAI Annual Conference in Palm Springs, California, which we did on October 13^th.  We are thankful to NCAI for the opportunity to speak in those important meetings.

 

On December 11^th, the United States Centers for Disease Control and Prevention validated our concerns with its publication in the Morbidity and Mortality Weekly Report (MMWR), “Deaths Related to 2009 Pandemic Influenza A (H1N1) Among American Indian/Alaska Natives --- United States, 2009”.