H1N1, or why eastern Ontario was sicker than the rest

The high rate of poverty and chronic disease in the united counties resulted in this area being hit hardest by the H1N1 flu virus in all of Ontario.

Dr. Paul Roumeliotis, chief medical officer of health with the Eastern Ontario Health Unit (EOHU), made a presentation about the impact of H1N1 at the United Counties of Prescott-Russell (UCPR) council meeting on Tuesday, February 16.

"This was a difficult year for the health unit," Dr. Roumeliotis stated. "The H1N1 pandemic created a lot of work for us and made it a very challenging year."

The EOHU represents the united counties, as well as the City of Cornwall and the United Counties of Stormont, Dundas and Glengarry (SD&G).

He explained that the H1N1 flu virus is a new strain of pandemic influenza that is different than the seasonal flu. He said the population has no natural immunity to protect against this virus.

"The H1N1 flu virus emerged in April 2009," Roumeliotis noted. "In the past, it usually only affected pigs, but this past spring, it began emerging in people in North America. The health unit was very concerned about this area when we heard about the virus because the rate of chronic disease is so elevated."

While the seasonal flu virus generally poses the most threat to the senior population,  Roumeliotis said, this flu attacked the younger segment of the population and those with a history of chronic illness and/or other risk factors.

"We predicted that this area would be very hard hit by H1N1, largely because of the high prevalence of chronic disease," he said. "It turns out, we were right."

He said emergency room visits peaked in October and November, as the second wave of H1N1 descended upon the area. In the united counties, Roumeliotis pointed out, most of those affected were between the ages of 10 and 14, while more than half were under the age 18.

"There are 120 schools in the united counties all together," he commented. "Seventy of those schools were affected and it was reported that there were 10 per cent more absences during that period. Once an illness affects 50 per cent of our schools or more, we are considered to be in a state of pandemic."

Hospital admission rates were four times higher than the provincial average in the united counties, Roumeliotis noted. Of those admissions, 10 per cent ended up in the intensive care unit (ICU).

"The number of people who ended up in ICU in this area was six times higher than all of Ontario," he said. "Eight per cent of those hospitalized had underlying chronic conditions and/or risk factors. The mortality rate was 5.7 times higher than that of the province and statistics show that many of the people hospitalized were from this area."

He said immunization clinics began in November and were "highly successful." In Cornwall, he noted, 62 per cent of 42,000 people were vaccinated; in SD&G, 34 per cent of 61,000 people were vaccinated and in the UCPR, 46 per cent of 79,000 people received the vaccination.

"Of a total population of 184,000 people, some 82,600 were vaccinated, which represents 45 per cent of the total population," Roumeliotis stated. "The province managed to vaccinate approximately 30 per cent of the total population, so we did quite well. I think we would have fared much better had we received the vaccination a few weeks earlier, but considering, things weren't as bad as they could have been."

Locally, he said, a 10-year-old child died as a result of H1N1, while another 13-year-old girl almost died.

"We were told to give the vaccine to priority groups at first," the doctor said. "In my heart, I could not turn away any parent that wanted to have their child vaccinated. Knowing that this virus attacks young children, there was no way, in good conscience, I turn any parent away."

While H1N1 has been dormant for the past few months, Roumeliotis warned that Canadian health organizations are gearing up for a third wave of the virus in March. Because many people have been vaccinated, he said this third wave may not take as much of a toll as the first and second waves.

"The vaccine is still available, as is the vaccine for the seasonal flu," he commented. "We encourage everyone to get vaccinated. Next year, the seasonal flu vaccine will include the H1N1 strain."