Editorial: The H1N1 influenza 09 and its potential impact on the Australian nursing workforce

Abstract

Emerging diseases continue to have a deleterious impact on global health. The spread of infectious diseases is now much more rapid, and while it may have taken months to spread between countries in the past, pandemics now have the potential to spread between continents within hours (Mathews, Chesson, McCraw, & Mc Vernon, 2009). In June of this year (2009) the first influenza pandemic in 41 years was announced (WHO, 2009). The H1N1 Influenza 09, or Human Swine Influenza virus, has already infected almost 36,000 people in 76 countries (WHO, 2009). It is estimated that the disease will infect up to 40% of Australians, particularly the most vulnerable. Adolescents and children appear to be over-represented in the current pandemic, and people with chronic co-morbidities are more severely affected by the H1N1 Influenza 09 virus (MMWR, 2009). Older people, especially those in institutions, are also more vulnerable as too are pregnant women (Cheng et al., 2009). In the current H1N1 09 outbreak, a healthy pregnant woman was the second death in the USA (Jamieson et al., 2009). Indigenous people are also more at risk from influenza. Previous influenza pandemics took a devastating toll on Indigenous Australians when mortality rates approached 50% in some communities compared to the national rate of 0.3% (Curson & McCraken, 2006). While Indigenous people are thus more at risk from the current H1N1 09 outbreak, Indigenous Australians living in rural areas may be at even higher risk because of their already disadvantaged situation which includes overcrowded housing, excess co-morbidity, poorer access to health services, communication problems with health professionals, and reduced access to medications (Massey et al., 2009). While plans for the management of the current influenza outbreak are being developed, marginalized communities are often neglected in these plans (Massey et al., 2009). It is also interesting to note that tropical regions, including Northern Australia, show a peculiar pattern of bimodal influenza outbreaks during the calendar year: an early peak in February/March which precedes the winter epidemic, followed by a second larger peak in August/September (National Influenza Surveillance report, 2008; National Influenza Surveillance report, 1997; National Influenza Surveillance report, 1996). There is also evidence to suggest the H1N1 09 virus may also have a second peak in tropical regions (Rambaut et al., 2008; Nelson & Holmes, 2007). This means that tropical regions such as Northern Queensland, as well as feeling the impact of the current outbreak of H1N1 09, may actually have to manage a second outbreak in the New Year. This has the potential to place an even greater demand on staff and health services in tropical regions and rural/remote communities.