Week 36
SUMMARY OF THE EPIDEMIOLOGICAL WEEK
▪ Positivity for influenza and other respiratory viruses among the samples with
registered and sentinel units was 29.2% (3,759 / 12,876) for SG and
39.4% (871 / 2.213) for SRAG in ICU.
▪ Influenza was confirmed 26.6% (6,274 / 23,629) of the total samples with classification
of SARS cases reported in universal surveillance, with a predominance of Influenza virus
A (H1 N1) pdm09. Among notifications of SARS deaths, 29.8% (1,277 / 4,290) were
confirmed for influenza, with a predominance of Influenza A (H1N1) virus pdm09.
INFLUENZA SENTINATION SURVEILLANCE
The information on influenza sentinel surveillance presented in this report is based on the
data inserted in the SIVEP-Influenza by sentinel units distributed in all regions of the country. THE
Sentinel surveillance continues to be expanded and in the next bulletins will be incorporated, so
the data of the new sentinel units.
1
Flu Syndrome (SG): individual with fever, even if referred, accompanied by cough or sore throat and onset of symptoms in the last 07 days.
Severe Acute Respiratory Syndrome (SARS): an individual hospitalized with fever, even if reported, accompanied by a cough or sore throat and
dyspnoea. The following signs may also be observed: O2 saturation less than 95% or respiratory discomfort or
respiratory frequency.
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Flu syndrome
By SE 36 of 2018 SG sentries collected 15,207 samples - it is recommended that
collection of 05 weekly samples per sentinel unit. Of these, 12,876 (84.7%) had results
in the system and 29.2% (3,759 / 12,876) had positive results for respiratory viruses, of which
2,247 (59.8%) were positive for influenza and 1,512 (40.2%) for other respiratory viruses (RSV,
Parainfluenza and Adenovirus). Among the influenza-positive samples, 976 (43.4%) were due to
of influenza A (H1N1) pdm09, 318 (14.2%) of influenza B, 112 (5.0%) of influenza A not subtyped and 841
(37.4%) of influenza A (H3N2). Among the other respiratory viruses, there was a predominance of 933
(61.7%) of RSV (Figure 1).
The South, Southeast regions present respectively the largest amounts of positive samples,
with emphasis on the greater circulation of Influenza A (H3N2), A (H1N1) pdm09 and RSV. The Northeast region
presents a greater circulation of Influenza A (H1N1) pdm09 and the Midwest and North regions of RSV
(Annex 1 - B).
As for the distribution of viruses by age group, individuals over 10 years old predominate
circulation of Influenza A (H1N1) pdm09 and A (H3N2) viruses. Among individuals under 10 years of age,
increased circulation of RSV and Influenza A (H1N1) pdm09.
Figure 1. Distribution of the respiratory viruses identified in the sentinel units of Gripal Syndrome,
per epidemiological week of onset of symptoms. Brazil, 2018 until the SE 36.
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Severe Acute Respiratory Syndrome in ICU
Regarding the samples collected by the SRAG sentinel units in the ICU, 2,597
collections, with 2,213 (85.2%) presenting their results inserted into the system. Of these, 871 (39.4%)
were positive for respiratory viruses (Influenza, RSV, Parainfluenza and Adenovirus), of which
354 (40.6%) for influenza and 517 (59.4%) for other respiratory viruses (RSV, Parainfluenza and
Adenovirus). Of the influenza positive samples, 200 (56.5%) were detected for influenza
A (H1N1) pdm09, 20 (5.6%) for non-subtyped influenza A, 24 (6.8%) for influenza B and 110 (31.1%)
influenza A (H3N2). Among the other viruses, there is a predominance of 458 (88.2%) RSV (Figure 2).
Figure 2. Distribution of the respiratory viruses identified in the sentinel units of Syndrome
Severe Acute Respiratory Infection in the Intensive Care Unit, per epidemiological week from the beginning of
symptoms. Brazil, 2018 until the SE 36.
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UNIVERSAL SURVEILLANCE OF SERIOUS ACUTE RESPIRATORY SYNDROME
Epidemiological Profile of Cases
Up to SE 36 of 2018 29,137 cases of SARS were reported, of which 23,629 (81.1%) were sample
processed and with results entered into the system. Of these, 26.6% (6,274 / 23,629) were classified as
as SARS by influenza and 22.0% (5,210 / 23,629) as other respiratory viruses. Among the cases of
influenza 3,727 (59.4%) were influenza A (H1N1) pdm09, 627 (10.0%) influenza A, not subtyped, 432
(6.9%) influenza B and 1,488 (23.7%) influenza A (H3N2), (Figure 3 and Annex 2).
Figure 3. Distribution of Severe Acute Respiratory Syndrome cases according to etiologic agent and
of the onset of symptoms. Brazil, 2018 until the SE 36.
The SARS cases of influenza had a median age of 37 years, varying from 0 to
107 years. In relation to the geographical distribution (Annexes 2 to 4), the Southeast region registered the largest
of cases of SARS by influenza 46.6% (2,912 / 6,274).
Epidemiological Profile of Deaths
Up to SE 36 of 2018 4,290 deaths were reported by SARS, which corresponds to 14.7%
(4,290 / 29,137) of the total cases. Of the total reported deaths, 1,277 (29.8%) were confirmed for
Influenza A virus, 852 (66.7%) due to influenza A (H1N1) pdm09, 128 (10.0%) influenza A
67 (5.2%) for influenza B and 230 (18.0%) influenza A (H3N2) (Figure 4 and Annex 2). The state
with the highest number of deaths due to influenza is S?o Paulo, with 42.3% (540 / 1,277), in relation to the country
(Annex 4).
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Figure 4. Distribution of Acute Respiratory Syndrome Deaths according to etiologic agent and
of the onset of symptoms. Brazil, 2018 until the SE 36.
Among influenza deaths, the median age was 57 years, ranging from 0 to 107 years. The rate
of mortality from influenza in Brazil is at 0.61 / 100,000 inhabitants. Of the 1,277 individuals who were
964 (75.5%) had at least one risk factor for
adults ≥ 60 years, patients with heart disease, pneumopathies and diabetes mellitus. In addition, 997 (78.1%)
made use of antiviral, median of 4 days between the first symptoms and the beginning of the treatment,
ranging from 0 to 94 days (Table 1). It is recommended to start treatment preferentially in the first 48
hours.
http://portalarquivos2.saude.gov.br...forme-Epidemiologico-Influenza-2018-SE-36.pdf
