Flu pandemic would hit Maori harder

Many Maori are especially vulnerable to the risk of pandemic influenza, and there has been discussion about whether they should be given priority access to anti-viral drugs such as Tamiflu, says Naida Glavish of Ngati Whatua.

Ms Glavish, spokeswoman for the Auckland Maori Pandemic Planning Group, said that concerns about a higher genetic susceptibility among people of Polynesian descent to respiratory disease had raised the issue of accessing Tamiflu and Relenza.

"That's been asked, and we were told that at this point the Government – which has a stock of Tamiflu – is very cautious about how it distributes it because there might several, increasingly more virulent, waves of influenza," she said.

The Government has 1.25 million doses of Tamiflu, and has just ordered 125,000 doses of another anti-viral medication, Relenza.

A former director of public health, Colin Tukuitonga, warned at the height of the Sars viral pneumonia outbreak in 2003 that it was logical to consider Maori and other Polynesians as potentially at greater risk because historically they had shown a greater susceptibility to respiratory disease than people of European descent.

Some researchers, such as noted New Zealand virologist Robert Webster, of St Jude's Children's Research Hospital in Memphis, have previously questioned whether Maori – whose ancestors passed through a genetic "bottleneck" in their voyages across the Pacific – have a genetic susceptibility to respiratory viruses.

During the 1918 influenza pandemic, Maori died at about 42.3 people per 1000, seven times the rate of Europeans. Maori had one of the world's highest known mortality rates, and 4 percent of the Maori population died in two months.

By December 1918, influenza had killed 8600 New Zealanders, including at least 2160 Maori, and the death rate in 1918 was higher among other Polynesians as well: 20 percent of those who fell ill in Samoa died, and in French Polynesia, the flu killed 25 percent of the people who fell ill.

When the potential for a bird flu pandemic brought comprehensive planning for another such outbreak, health officials said they might need to give some population groups – such as Maori and other Polynesians – priority in the rationing of anti-viral drugs.

But Ms Glavish said authorities were likely to hold off on deciding how they would use Tamiflu and Relenza until they had some idea of how any pandemic flu infected and killed people.

She said there were reassuring signs that the swine flu virus was less severe than originally thought, but it was not yet possible to accurately estimate its severity.

"Past experience with pandemics tells us however that a second wave could be worse," she said.

But she emphasised Maori were especially vulnerable.

"Our health profile is poorer than other groups, and we are communal in the way we live," she said.

"In the event of a pandemic we are more likely to be seriously affected.

"At the moment our people see this issue as far removed from them – we need to learn from our history.

"We must continue to be vigilant and prepared for a pandemic outbreak."

The planning group has a list of advice for Maori communities, including asking people who are sick to stay at home, rather than attending hui or tangi during a flu pandemic.

- NZPA