Influenza Hospitalizations Among American Indian/Alaska Native People and in the United States General Population

Gounder, Prabhu; Callinan, Laura S.; Holman, Robert C.; Cheng, Po Yung; Bruce, Michael G.; Redd, John T.; Steiner, Claudia; Bresee, Joseph S.; Hennessy, Thomas W.

doi:10.1093/ofid/ofu031

Cited by 17 publications

(30 citation statements)

References 21 publications

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“…Hospital admission criteria, ICD-9-CM diagnostic coding, and/or pathogen-specific diagnostic workups for RSV or influenza, and sensitivity or specificity of diagnostic tests may vary between hospitals. The LRTI trends during the H1N1 influenza pandemic are not representative of long-term trends ( 50 ). No standard criteria for pneumonia diagnosis are in use nationally, so pneumonia rate comparisons should be made with caution ( 51 , 52 ).…”

Section: Discussionmentioning

confidence: 99%

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

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Singleton

Holman

et al. 2015

International Journal of Circumpolar Health

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BackgroundThe lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998–2008, yet remained 1.6 times higher than the general US child population in 2006–2008.PurposeDescribe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years.MethodsA retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009–2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998–1999 rates prior to pneumococcal conjugate vaccine introduction.ResultsThe average annual LRTI-associated hospitalization rate declined from 1998–1999 to 2009–2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009–2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6–14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009–2010 H1N1 influenza-associated hospitalizations.ConclusionsAlthough the LRTI-associated hospitalization rate declined, the 2009–2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.

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Section: Discussionmentioning

confidence: 99%

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

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Singleton

Holman

et al. 2015

International Journal of Circumpolar Health

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“…b American Indian/Alaska Native (AI/AN) children have higher rate of influenza complications. [13][14][15][16] Most at-risk AI/AN children will also qualify in other high-risk categories to receive appropriate antiviral treatment. In the setting of a shortage, AI/AN children should be prioritized to receive influenza vaccine or anti-viral medications according to local public health guidelines.…”

Section: High-risk Groups In Pediatricsmentioning

confidence: 99%

Recommendations for Prevention and Control of Influenza in Children, 2020–2021

2020

Pediatrics

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This statement updates the recommendations of the American Academy of Pediatrics for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2020-2021 season. The American Academy of Pediatrics (AAP) recommends routine influenza immunization of all children without medical contraindications, starting at 6 months of age. Influenza vaccination is an important intervention to protect vulnerable populations and reduce the burden of respiratory illnesses during the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) pandemic. Any licensed, recommended, age-appropriate vaccine available can be administered, without preference for one product or formulation over another. Antiviral treatment of influenza with any licensed, recommended, ageappropriate influenza antiviral medication is recommended for children with suspected or confirmed influenza who are hospitalized, have severe or progressive disease, or have underlying conditions that increase their risk of complications of influenza. Antiviral treatment may be considered for any previously healthy, symptomatic outpatient not at high risk for influenza complications in whom an influenza diagnosis is confirmed or suspected, if treatment can be initiated within 48 hours of illness onset, and for children whose siblings or household contacts either are younger than 6 months or have a high-risk condition that predisposes them to complications of influenza. UPDATES FOR THE 2020-2021 INFLUENZA SEASON 1. The composition of the influenza vaccines for 2020-2021 has been updated. The recommended influenza A(H1N1)pdm09 and A(H3N2) components and the influenza B/Victoria component of the vaccine are new for this season. The B/Yamagata component is unchanged from the previous season. All quadrivalent influenza vaccines include these 4 components. The trivalent vaccines do not include influenza B/Yamagata.

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“…2,[14][15][16] Among these groups vulnerable to influenza, indigenous children of developed circumpolar nations experience a higher incidence and severity of illness from the influenza virus than non-indigenous children living in the same region. 3,6,[17][18][19][20] This difference in severity has been demonstrated by studies that reveal 0.2-9.1…”

mentioning

confidence: 86%

“…evidence also suggests that the lack of primary healthcare services in the immediate environment of indigenous children creates risk for influenza, as access to Risk factors and mitigation of influenza among Indigenous children in Australia, Canada, United States, and New Zealand: a scoping review Peer reView healthcare and health surveillance in the community is diminished. [17][18][19]39,42,43 rural and remote location, defined by each country's indexing system, is believed to further contribute to poor access to primary healthcare services as residents must travel significantly longer distance to access healthcare services and less public health monitoring is occurring in these areas. 12,42 However, in this review, biological factors of comorbidity, previous history of respiratory illness, and young age occurred with greater frequency than any other category of risk factors.…”

Section: Risk Factorsmentioning

confidence: 99%

“…Specific chronic illnesses attributed with a higher risk of influenza among indigenous children were established in the literature as diabetes, obesity, and immunosuppressive disorders. 8,[16][17][18]22,38 Previous respiratory illness was described as a separate entity to chronic illness in 11 studies due to the greater severity and duration of influenza-related illness observed with recurrent respiratory infections. 10,11,[15][16][17][18][19]22,33,41 Finally, indigenous infants have exemplified higher rates of nasopharyngeal influenza virus colonization than those of nonindigenous descent, which is believed to be caused by higher densities of nasal epithelium.…”

Section: Risk Factorsmentioning

confidence: 99%

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Risk factors and mitigation of influenza among Indigenous children in Australia, Canada, United States, and New Zealand: a scoping review

McLeod

Adunuri

Booth

2019

Perspect Public Health

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Aim: This review considers prominent risk factors and mitigation strategies of influenza among Indigenous children. Methods: Seven electronic databases were searched from the period of 2004–2017 to locate articles discussing influenza among Indigenous children in the developed circumpolar nations of Australia, Canada, United States, and New Zealand. Articles selected for inclusion discussed influenza among Indigenous children as either individuals or as a part of a community. Ancestry searches of articles meeting the review criteria were also undertaken to discern seminal research in this topic area. Results: From the 39 primary research studies included, marked risk factors and mitigation strategies of influenza among Indigenous children were identified using inductive analysis. Notable risk factors included age under 2 years, cigarette smoke exposure, presence of a chronic illness, and crowded living conditions. Successful mitigation of influenza for Indigenous children included strategies to improve vaccine coverage, provision of health education, and policy change. Conclusion: In the past, the impact of influenza upon Indigenous communities has been devastating for both children and their families. By utilizing existing public health infrastructure and collaborating with culturally unique Indigenous groups, preventive action for Indigenous children at significant risk of contracting influenza can be realized.

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Influenza Hospitalizations Among American Indian/Alaska Native People and in the United States General Population

Abstract: American Indian/Alaska Native (AI/AN) people appear to be at increased risk for hospitalization from influenza illness compared with the general US population. Our results should inform policymakers on seasonal epidemic and pandemic influenza preparedness and response.

Cited by 17 publications

References 21 publications

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

Recommendations for Prevention and Control of Influenza in Children, 2020–2021

Risk factors and mitigation of influenza among Indigenous children in Australia, Canada, United States, and New Zealand: a scoping review

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