The impact of influenza on the Canadian First Nations

In March and April 2009, pandemic H1N1 2009 influenza A virus (pH1N1 2009) emerged among residents of and travelers to Mexico, the United States and Canada. During the 2009 pandemic, cases of pH1N1 2009 infection were reported from over 214 countries, with at least 18,449 recorded deaths. In Canada, over 8,500 cases were hospitalized, 16.8% of which required intensive care. A particularly concerning occurrence was the spread of pH1N1 2009 into First Nations communities in Canada. Although Aboriginal peoples constitute only 3.8% of Canada's population, members of the First Nations were 6.5 times more likely to be admitted to an ICU with pH1N1 2009 influenza than non-First Nations, and had rates of hospitalization nearly triple that of the national cumulative crude rate for all Canadians. We herein provide a succinct review of our current understanding of the risk of influenza among First Nations populations in Canada.