title: Serological survey of the novel influenza A H1N1 in inner city Winnipeg, Manitoba, 2009.
abstract: BACKGROUND
  Little is known about the determinants of pandemic H1N1 (pH1N1) infection in Canada among low-income, inner city populations. To inform future influenza planning, the seroprevalence of pH1N1 antibodies among inner city clinic attendees in Winnipeg (Manitoba) according to sociodemographic and risk factor characteristics were estimated and vaccination rates were explored.
  
  
  METHODS
  Adults presenting to three inner city community clinics in Winnipeg from October 2009 to December 2009 were recruited as study participants (n=458). A questionnaire was administered to collect demographic, risk factor and symptom information, and a venous blood sample was collected for hemagglutination inhibition assay testing to detect the presence of antibodies against pH1N1.
  
  
  RESULTS
  Approximately one-half (53%) of the study participants reported an annual household income of <$10,000/year, and 65% identified as Aboriginal. pH1N1 positivity was 5.7% among those enrolled early in the study and 15.5% among those enrolled later in the study. Positivity was higher among participants who were female, Aboriginal and in contact with children ≤5 years of age. The overall pH1N1 vaccination rate was 28%.
  
  
  CONCLUSIONS
  pH1N1 positivity was high among low-income adults accessing clinics in Winnipeg's inner city compared with the general population. Of further concern were the low rates of uptake of both seasonal and pH1N1 influenza vaccinations. When planning for future influenza outbreaks, it is important to incorporate strategies for the prevention, control, and care of influenza among low-income and inner city adults.
authors.affiliation: Community Health Sciences;
authors.forename: Laura H
authors.initials: LH
authors.lastname: Thompson
authors.forename: Salaheddin M
authors.initials: SM
authors.lastname: Mahmud
authors.forename: Yoav
authors.initials: Y
authors.lastname: Keynan
authors.forename: James F
authors.initials: JF
authors.lastname: Blanchard
authors.forename: Joyce
authors.initials: J
authors.lastname: Slater
authors.forename: Magdy
authors.initials: M
authors.lastname: Dawood
authors.forename: Keith
authors.initials: K
authors.lastname: Fowke
authors.forename: Paul
authors.initials: P
authors.lastname: Van Caeseele
authors.forename: Marissa
authors.initials: M
authors.lastname: Becker
keywords: Epidemiology; Hemagglutination inhibition assay; Inner city; Pandemic Influenza A H1N1; Serological survey; pH1N1