Editor’s note: CIDRAP News learned on Jun 10 that some of the Canadian indigenous groups that have been hit by serious cases of H1N1 influenza are not Inuit, but rather are among the groups known in Canada as First Nations or aboriginals. In particular, a Canwest News Service report referred to hundreds of cases and 20 hospitalizations at St. Theresa Point, a First Nation in northern Manitoba. Jun 9, 2009 (CIDRAP News) – An official from the World Health Organization (WHO) said today that health experts are closely monitoring novel H1N1 influenza infections in Canada’s Inuit populations, following reports that the communities are seeing more than their share of severe cases.Keiji Fukuda, MD, told reporters at a press briefing, “We can say now that we know a larger number than expected of young Inuit people developed serious illnesses and had to get hospitalized.”He added that the WHO doesn’t know if the trend is linked to socioeconomic factors, genetic factors, or chronic underlying diseases, and commented that Inuit groups were hit hard in some earlier pandemics. Fukuda is the WHO’s assistant director-general for health security and the environment.Yesterday, Joel Kettner, MD, Manitoba’s chief medical officer, told reporters that 26 people were being treated in intensive care units for suspected novel influenza infections, which is unusual for an influenza outbreak, the Canadian Broadcasting Corporation (CBC) reported. He said more than half of the patients are of aboriginal descent, with an average age of 35.Manitoba’s health department said in a statement yesterday that 15 extra ventilators have arrived at the province’s ICUs and that the Winnipeg Regional Health Authority is helping the departments prioritize patients and was considering deferring non-urgent surgical procedures that would normally require use of the units.As of yesterday, Manitoba said it had confirmed 40 novel flu cases in 6 of its 11 health regions.Meanwhile, health officials in Canada’s Nunavut territory today said the number of confirmed novel flu cases has jumped from 25 to 53, with six patients in the hospital, the CBC reported. Nunavut’s population is primarily Inuit.Donald R. Olson, MPH, research director for the International Society for Disease Surveillance, based in New York City, told CIDRAP News that the severe cases in Canada’s Inuit populations are puzzling. However, he added that among remote populations, the 1918 pandemic influenza was more severe and didn’t follow the age patterns seen in the rest of the world.”Inuit groups didn’t show the same apparent sparing of the elderly, so possibly the older proportion of the population had not been exposed” to previous viruses related to the pandemic strain, he said.The medical literature tells of “flu orphans” from remote Alaskan villages who survived the 1918-19 pandemic, though their parents and grandparents died, presumably because they had not been exposed to earlier H1-like viruses.In 2006 at a state summit in Alaska, former US Health and Human Services Secretary Mike Leavitt described the impact of the 1918 pandemic virus on Alaska’s native populations. “The Alaska native population in Nome was decimated—176 of the 300 Alaska Natives in the region died,” he said in comments posted on the HHS pandemic flu Web site. “The pandemic swept through communities, killing whole villages.”Preexisting health conditions may also have contributed to the severity of the 1918 pandemic in Inuit populations, which also had high tuberculosis rates in the early 20th century, Olson said.Officials don’t know if higher rates of chronic illnesses in today’s Inuit populations are playing a role in the high number of severe cases. However, Health Canada reports that when compared to the rest of the nation, First Nations and Inuit people have 1.5 times the rate of heart disease, 3 to 5 times the rate of type 2 diabetes, and 8 to 10 times the rate of tuberculosis infection.Yesterday, an Australian health expert from Darwin warned that the country’s indigenous populations might be at greater risk for novel H1N1 infections.Besides citing lack of exposure to similar virus and underlying conditions as possible risk factors, experts have also theorized that remote populations might have a genetic predisposition that makes them more susceptible to the virus, Olson said. But he expressed doubt that the factor is playing a role in Canada’s current outbreak.The signals coming out of Canada are worrying, he said. “The less developed world may have a terrible experience with this, though there is a lot of coughing and sneezing in the rest of the world,” Olson said.Danuta Skowronski, MD, a physician and epidemiologist at the University of British Columbia, told CIDRAP News that over the past few years, circulation of seasonal H1N1 viruses in North America has been patchy, and people in remote communities are likely to have had less exposure to the viruses than have people living in urban settings.There’s still much that researchers don’t know about possible cross-protection against the novel H1N1 virus from exposure to previous H1N1 strains, she said. Though researchers have identified antibody markers and determined that seasonal vaccination offers little protection, they still haven’t gauged the cell-mediated response—which can offer protection during severe infections—afforded by exposure to previous H1N1 strains, Skowronski added.Public health officials will also be looking for environmental factors that might be contributing to the infections in the First Nations and Inuit groups, she said. For example, large numbers of people living in one household may have greater exposure to the virus. “This all needs to be assessed, because we’re picking up possible signals of concern,” Skowronski said.See also:Jun 8 Manitoba press releaseHealth Canada disease and health condition statisticsAhmed R, Oldstone MBA, Palese P. Protective immunity and susceptibility to infectious diseases: lessons from the 1918 influenza pandemic. Nature Immunol 2007 Nov;18(11):1188-93 [Abstract]
Categories: Letters to the Editor, OpinionRe Feb. 21 article, “Union College introduces new leader”: Let’s stop with the firsts.Union College appoints a well-qualified and distinguished man as its next president and what is your lead take on it? “Dr. David Harris will be the first African-American …” Seriously?I think the picture would lead us to believe that he is black. How about leading with his job record, accomplishments, preparation? No, jump right to race. Not only is that divisive, but in a way cheapens his accomplishment. Was he the best candidate in the field (I would imagine he was) or was he the best black candidate?Martin Luther King Jr. wanted us to move to a place where a person is judged on the content of his character, not the color of his skin. You led with the latter when the former would have served everyone better.John MetalloSlingerlandsMore from The Daily Gazette:EDITORIAL: Find a way to get family members into nursing homesEDITORIAL: Beware of voter intimidationEDITORIAL: Urgent: Today is the last day to complete the censusAlbany County warns of COVID increaseFoss: Should main downtown branch of the Schenectady County Public Library reopen?
Press Association A House of Lords report was published on Tuesday which recommended the two clubs work together and even suggests the League One side be granted occasional use of the stadium, something they have long been pushing for. It adds another layer to what has been a seemingly interminable saga over who would move into the stadium and one that twisted this way and that for years before negotiations ended in March this year with the LLDC signing off West Ham as anchor tenants. The agreement saw the Barclays Premier League club take on a 99-year lease, with the stadium to be transformed into a 60,000-seater venue in time for the 2016-17 season. While Orient chairman Barry Hearn wants there to be three-way talks between the two clubs and the LLDC, for West Ham any discussions should be just between the League One club and the LLDC which owns and manages the stadium. “Looking forward, our focus is solely on creating a stunning new home for the club and its supporters in 2016, alongside a long-term legacy for the community of east London,” a spokesman for the Premier League club said. “What goes on with other interested parties is very much a matter for (Leyton Orient) and the LLDC and not West Ham United. “We welcome the committee’s comments and are happy the House of Lords have recognised that West Ham United’s selection will ensure the stadium reaches its full legacy potential.” Orient welcomed the report and on their website a statement from Hearn read: “I agree with the House of Lords recommendation – ourselves, West Ham and the LLDC should sit down and work this out together once and for all. “Leyton Orient is a local club which undertakes a huge amount of community work in one of the poorest areas in London. “It has been said that Orient did not bid enough to cover its costs of using the stadium, but we were bidding within our means and against ourselves – we do not know what the LLDC want from us because they will not tell us. “So we ask them again, publicly, to say what we have to pay to share the stadium, a national asset which is on our doorstep. “We are writing to the LLDC seeking a meeting so that we can have an open and transparent discussion about what part we can play in the future use of the Olympic Stadium.” A spokesman for the LLDC was not immediately available for comment. West Ham believe Leyton Orient need to hold discussions directly with the London Legacy Development Corporation without involving them if they are to come to a satisfactory solution over the Olympic Stadium.
By Brian DeakyneSeveral things have improved since Monday when Hurricane Sandy left her vicious mark in the Two River area, but one thing definitely hasn’t gotten better.As of Friday afternoon, lines at gasoline stations were still miles long, leaving some residents distraught after sitting for hours and still far to go.“I went to get gas at the Wawa in Leonardo and was waiting for four hours,” said John Sykes of Atlantic Highlands. “I was waiting in my car, and they told me the car wait was longer, so I got out of my car and stood there” with gas cans.Some residents have suggested getting gas at odd hours, such as in the middle of the night, hoping that the lines might be less crowded and the wait would be shorter.While many residents were angry about the wait, Sykes noted that some people had joined together during the hour-long wait.“Surprisingly, people were in good spirits. They had State Troopers controlling the area, so it was pretty crazy,” he said.Many gasoline stations were closed down on Friday. Some never opened after the hurricane, others ran out of gas after begin able to open shortly after roads were re-opened Wednesday and Thursday.“I got pretty lucky, actually,” said Mary Chamerblin of Little Silver. “I had to get gas on (Thursday and Friday) and I never waited longer than an hour for either one.”Like practically everyone else on the line, Chamberlin had to get gas for two different things, her car and a generator. Also like others, she said her car was running on fumes by the time she reached the pump. She got gas at the BP gasoline station in West Long Branch and the Wawa in Tinton Falls.One of the few open stations Friday afternoon was the Shell Gas Station on Shrewsbury Avenue. At one point the line stretched from the station at the corner of Newman Springs Road all the way to the Red Bank railroad station. That forced police officers to divert other traffic to side streets and direct those trying to get into the gas line.Some residents, who did not want to give their names, were angry that so few gasoline stations were open four days after the hurricane. They were also unhappy that some stations ran out of gas even through they sat in line for hours.Throughout Red Bank and sections of Middletown, traffic was snarled as many people searched for gas that will be hard to come until power is restored.The Exxon station on Shrewsbury Avenue, across the street from Shell station, was closed Friday, along with the Exxon station and BP station at the corner of Swimming River and Newman Springs roads in Middletown.“I’m surprised a lot more gas stations don’t have generators to get going,” Sykes said. “They could be making bank.”