Epidemiologic and clinical features among patients hospitalized in Wisconsin with 2009 H1N1 influenza A virus infections, April to August 2009

Abstract

Background: During April 15 through July 23, 2009, Wisconsin reported the most confirmed and probable cases of 2009 influenza A (H1N1) virus (2009 H1N1) infection in the United States. Preliminary reports suggest that 2009 H1N1 infection disproportionately affected minority populations.

Methods: Prospective surveillance among all acute care hospitals in Wisconsin to detect patients hospitalized at least 24 hours with confirmed 2009 H1N1 infection during April 23 through August 15, 2009.

Results: During the study interval, 252 patients were hospitalized and 11 (4%) died. Statewide hospitalization rates by age, sex, and race/ethnicity categories were highest among patients aged <1 year (21.6/100,000), females (4.9/100,000), and African Americans (36.3/100,000). The median age was 28 years: Hispanics (median age=16 years) and African Americans (24 years) were younger than non-Hispanic whites (37 years) and Asians (38 years). African Americans were more likely to have a hematologic condition and be morbidly obese (BMI > or = 40 kg/m2), and less likely to be admitted to an intensive care unit compared to other race/ethnicity groups (P<0.05). Hispanics and non-Hispanic whites were more likely to have cancer, be non-morbidly obese (BMI 30-39.9 kg/m2 or BMI percentile > or = 95%), and be hospitalized for >5 days compared to African Americans and Asians (P<0.05). There were no significant racial/ethnic differences in time from illness onset to admission or receipt of antiviral therapy, need for mechanical ventilation, acute respiratory distress syndrome, or death.

Conclusions: The first wave of the 2009 H1N1 pandemic in Wisconsin disproportionately affected hospitalized patients who were African Americans, Asians, and Hispanics compared to non-Hispanic whites. Preventive measures focused on these populations may reduce morbidity associated with 2009 H1N1 infection.