Overrepresentation of South Asian ethnic groups among cases of influenza A(H1N1)pdm09 during the first phase of the 2009 pandemic in England

Trienekens, Suzan C. M., Shepherd, Wendi, Pebody, Richard G., Mangtani, Punam and Cleary, Paul (2021) 'Overrepresentation of South Asian ethnic groups among cases of influenza A(H1N1)pdm09 during the first phase of the 2009 pandemic in England'. Influenza and Other Respiratory Viruses, Vol 15, Issue 2, pp. 270-277.

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Abstract

Background
During the first wave of the influenza A(H1N1)pdm09 pandemic in England in 2009, morbidity and mortality were higher in patients of South Asian (Indian, Pakistani or Bangladeshi) ethnic minority groups.

Objectives
This study aims to provide insights in the representation of this group among reported cases, indicating susceptibility and exposure.

Methods
All laboratory‐confirmed cases including basic demographic and limited clinical information that were reported to the FluZone surveillance system between April and October 2009 were retrieved. Missing ethnicity data were imputed using the previously developed and validated South Asian Names and Group Recognition Algorithm (SANGRA). Differences between ethnic groups were calculated using chi‐square, log‐rank and t tests and rate ratios. Geographic clustering was compared using Ripley's K functions.

Results
SANGRA identified 2447 (28%) of the total of 8748 reported cases as South Asian. South Asian cases were younger (P < .001), more often male (P = .002) and more often from deprived areas (P < .001) than cases of other ethnic groups. Time between onset of symptoms and laboratory sampling was longer in this group (P < .001), and they were less often advised antiviral treatment (P < .001), however, declined treatment less. The highest cumulative incidence was seen in the West Midlands region (32.7/10 000), London (7.0/10 000) and East of England region (5.7/10 000).

Conclusions
People of South Asian ethnic groups were disproportionally affected by the first wave of the influenza pandemic in England in 2009. The findings presented contribute to further understanding of demographic, socioeconomic and ethnic factors of the outbreak and inform future influenza preparedness to ensure appropriate prevention and care.

Item Type:	Article
Subjects:	WA Public Health > WA 105 Epidemiology WA Public Health > Health Problems of Special Population Groups > WA 300 General. Refugees WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 515 Human influenza
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1111/irv.12801
Depositing User:	Stacy Murtagh
Date Deposited:	15 Sep 2020 10:05
Last Modified:	05 Mar 2021 09:34
URI:	https://archive.lstmed.ac.uk/id/eprint/15539

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