2009 Pandemic Influenza A H1N1 in Alaska: Temporal and Geographic Characteristics of Spread and Increased Risk of Hospitalization among Alaska Native and Asian/Pacific Islander People

The purpose of this study was to determine the incidence of HPV-positive (HPV+) and HPV-negative (HPV-) head and neck cancer (HNC) in the American Indian/Alaska Native (AI/AN) population in California to assess whether incidence is higher among AI/ANs compared to other ethnicities. We analyzed data from the California Cancer Registry, which contains data reported to the Cancer Surveillance Section of the Department of Public Health. A total of 51,289 HNC patients were identified for the years 2009–2018. Outcomes of interest included sex, stage at presentation, 5-year survival rate, tobacco use, and HPV status. AI/AN and White patients had the highest burden of late stage HNC (AI/AN 6.3:100,000; 95% CI 5.3–7.4, White 5.8:100,000; 95% CI 5.7–5.9) compared to all ethnicities or races (Black: 5.2; 95% CI 4.9–5.5; Asian/Pacific Islander: 3.2; 95% CI 3–3.3; and Hispanic: 3.1; 95% CI 3–3.2 per 100,000). Additionally, AI/AN and White patients had the highest burden of HPV+ lip, oral cavity, and pharynx HNC (AI/AN 0.9:100,000; 95% CI 0.6–1.4, White 1.1:100,000; 95% CI 1–1.1) compared to all ethnicities or races (Black: 0.8:100,000; 95% CI 0.7–0.9; Asian/Pacific Islander: 0.4; 95% CI 0.4–0.5; and Hispanic: 0.6; 95% CI 0.5–0.6). AI/ANs had a decreased 5-year survival rate compared to White patients (AI/AN 59.9%; 95% CI 51.9–67.0% and White 67.7%; 95% CI 67.00–68.50%) and a higher incidence of HNC in former and current tobacco users. These findings underscore the disparities that exist in HNC for California AI/AN populations. Future studies should aim to elucidate why the unequal burden of HNC outcomes exists, how to address increased tobacco usage, and HPV vaccination patterns to create culturally and community-based interventions.

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Hospitalization in two waves of pandemic influenza A(H1N1) in England

Epidemiology and Infection ◽

10.1017/s0950268810002657 ◽

2010 ◽

Vol 139 (10) ◽

pp. 1560-1569 ◽

Cited By ~ 27

Author(s):

C. N. J. CAMPBELL ◽

O. T. MYTTON ◽

E. M. McLEAN ◽

P. D. RUTTER ◽

R. G. PEBODY ◽

...

Keyword(s):

Pandemic Influenza ◽

Influenza A ◽

Chronic Respiratory Disease ◽

Policy Makers ◽

Relative Risks ◽

Increased Risk ◽

Influenza A H1n1 ◽

Prevalence Estimates ◽

Antiviral Medication ◽

Northern And Southern Hemispheres

SUMMARYUncertainties exist regarding the population risks of hospitalization due to pandemic influenza A(H1N1). Understanding these risks is important for patients, clinicians and policy makers. This study aimed to clarify these uncertainties. A national surveillance system was established for patients hospitalized with laboratory-confirmed pandemic influenza A(H1N1) in England. Information was captured on demographics, pre-existing conditions, treatment and outcomes. The relative risks of hospitalization associated with pre-existing conditions were estimated by combining the captured data with population prevalence estimates. A total of 2416 hospitalizations were reported up to 6 January 2010. Within the population, 4·7 people/100 000 were hospitalized with pandemic influenza A(H1N1). The estimated hospitalization rate of cases showed a U-shaped distribution with age. Chronic kidney disease, chronic neurological disease, chronic respiratory disease and immunosuppression were each associated with a 10- to 20-fold increased risk of hospitalization. Patients who received antiviral medication within 48 h of symptom onset were less likely to be admitted to critical care than those who received them after this time (adjusted odds ratio 0·64, 95% confidence interval 0·44–0·94, P=0·024). In England the risk of hospitalization with pandemic influenza A(H1N1) has been concentrated in the young and those with pre-existing conditions. By quantifying these risks, this study will prove useful in planning for the next winter in the northern and southern hemispheres, and for future pandemics.

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Detection of Respiratory Viruses Among Pilgrims in Saudi Arabia During the Time of a Declared Influenza A(H1N1) Pandemic

Journal of Travel Medicine ◽

10.1111/j.1708-8305.2011.00575.x ◽

2011 ◽

Vol 19 (1) ◽

pp. 15-21 ◽

Cited By ~ 50

Author(s):

Ziad A. Memish ◽

Abdullah M. Assiri ◽

Raheela Hussain ◽

Ibrahim Alomar ◽

Gwen Stephens

Keyword(s):

Virus Infection ◽

Pandemic Influenza ◽

Influenza A ◽

Respiratory Virus ◽

Preventive Measures ◽

Respiratory Viruses ◽

H1n1 Vaccine ◽

Increased Risk ◽

Influenza A H1n1 ◽

Respiratory Virus Infection

Abstract Background The objectives of this study were to determine whether pilgrim attendance at the Hajj was associated with an increased risk of acquiring influenza, and other respiratory viruses, and to evaluate the compliance of pilgrims with influenza vaccination and other recommended preventive measures. Methods A cross-sectional survey was conducted among pilgrims as they arrived at the King Abdulaziz International Airport in Jeddah for the 2009 Hajj and as they departed from the same airport during the week after the Hajj. Nasopharyngeal and throat swabs were tested for 18 respiratory virus types and subtypes using the xTAG Respiratory Viral Panel FAST assay. Results A total of 519 arriving pilgrims and 2,699 departing pilgrims were examined. Their mean age was 49 years and 58% were male. In all, 30% of pilgrims stated that they had received pandemic influenza A(H1N1) vaccine before leaving for the Hajj and 35% of arriving pilgrims reported wearing a face mask. Only 50% of arriving pilgrims were aware of preventive measures such as hand hygiene and wearing a mask. The prevalence of any respiratory-virus infection was 14.5% (12.5% among arriving pilgrims and 14.8% among departing pilgrims). The main viruses detected (both groups combined) were rhinovirus-enterovirus (N = 414, 12.9%), coronaviruses (N = 27, 0.8%), respiratory syncytial virus (N = 8, 0.2%), and influenza A virus (N = 8, 0.2%) including pandemic influenza A(H1N1) (N = 3, 0.1%). The prevalence of pandemic influenza A(H1N1) was 0.2% (N = 1) among arriving pilgrims and 0.1% (N = 2) among departing pilgrims. The prevalence of any respiratory virus infection was lower among those who said they received H1N1 vaccine compared to those who said they did not receive it (11.8% vs 15.6%, respectively, p = 0.009). Conclusion We found very low pandemic influenza A(H1N1) prevalence among arriving pilgrims and no evidence that amplification of transmission had occurred among departing pilgrims.

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MATERNAL EDUCATIONAL ATTAINMENT AND SEX RATIO AT BIRTH BY RACE IN THE UNITED STATES, 2007–2015

Journal of Biosocial Science ◽

10.1017/s0021932018000123 ◽

2018 ◽

Vol 51 (3) ◽

pp. 457-462 ◽

Cited By ~ 1

Author(s):

Victor Grech

Keyword(s):

Educational Attainment ◽

American Indian ◽

Alaska Native ◽

Maternal Education ◽

Pacific Islander ◽

The United States ◽

Live Births ◽

Asian Pacific Islander ◽

Education Levels ◽

Asian Pacific

SummaryMany factors influence the male:female birth ratio (number of male births divided by total births, M/T). Studies have suggested that this ratio may be positively correlated with the education levels of mothers. This study assessed the effect of maternal education on M/T in the US population overall and by racial group. Number of live births by sex of the child, maternal educational level reached and race were obtained from the Centres for Disease Control (CDC Wonder) for the period 2007–2015. The total study sample comprised 28,268,183 live births. Overall, for the four available recorded racial groups (Asian/Pacific Islander, White, American Indian/Alaska Native and Black/African American), M/T rose significantly with increasing education levels (p<0.0001). When analysed by race, this relationship was only found for White births (p<0.0001). The M/T of Black births rose with increasing maternal education level up to associate degree level (p=ns), then fell significantly with higher levels of education (χ2=4.5, p=0.03). No significant trends were present for Asian/Pacific Islander or American Indian/Alaska Native births. Socioeconomic indicators are generally indicators of better condition and in this study educational attainment was overall found to be positively correlated with M/T, supporting the Trivers–Willard hypothesis.

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Hospitalisation associated with the 2009 H1N1 pandemic and seasonal influenza in Hong Kong, 2005 to 2010

Eurosurveillance ◽

10.2807/ese.17.45.20309-en ◽

2012 ◽

Vol 17 (45) ◽

Author(s):

L Yang ◽

X L Wang ◽

K P Chan ◽

P H Cao ◽

H Y Lau ◽

...

Keyword(s):

Hong Kong ◽

Chronic Diseases ◽

Pandemic Influenza ◽

Influenza A ◽

Seasonal Influenza ◽

H1n1 Influenza ◽

Morbidity Burden ◽

Increased Risk ◽

Influenza A H1n1 ◽

2009 H1n1

Reliable estimates of the morbidity burden caused by the 2009 pandemic influenza (pH1N1) are important for assessing the severity of the pandemic. Poisson regression models were fitted to weekly numbers of cause-specific hospitalisation in Hong Kong from 2005 to 2010. Excess hospitalisation associated with the 2009 pandemic and seasonal influenza was derived from the model by incorporating the proxy variables of weekly proportions of specimens positive for the pandemic influenza A(H1N1)pdm09, seasonal influenza A (subtypes H3N2 and H1N1) and B viruses. Compared with seasonal influenza, pH1N1 influenza was associated with higher hospitalisation rates for acute respiratory disease (ARD) among children younger than 18 years and adults aged between 18 and 64 years, but among the elderly aged 65 years and older the hospitalisation rates were lower for pH1N1 than for seasonal H3N2 and H1N1 influenza. Hospitalisation rates for chronic diseases associated with pH1N1 influenza were generally higher than those associated with seasonal influenza. The reported hospitalised cases with laboratory-confirmed pandemic infections accounted for only 16% of pH1N1 influenza-associated hospitalisations for ARD in the age group 75 years and older, and 5?66% of hospitalisations for chronic diseases in those older than 40 years. The 2009 H1N1 influenza pandemic was associated with a dramatically increased risk of hospitalisation among children and young adults. The morbidity burden of pandemic was underreported in old people and in those with chronic conditions.

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