Influenza outbreak: H3N2 cases increased 1,380% in Salvador in 14 days

Allied to COVID-19, influenza syndromes worry Salvador’s Municipal Health Ministry. And one more than the others: influenza caused by H3N2, a type of influenza A virus, which has increased 1380% in cases in the capital, in the last 14 days. On December 1, five patients were registered in the city. This Tuesday (14), there were already 74, according to SMS. In just the last 24 hours, there have been 21 diagnostic confirmations.

For this reason, Mayor Bruno Reyes (Democratic), I had to reopen Bao Miodo flu To reduce pressure on care at Barris’ Emergency Care Unit (UPA), the only flu service operating so far that has tripled in demand in the past week.

According to researcher Marcelo Gomez, Infogripe coordinator at Fiocruz, a group that monitors data for severe acute respiratory syndrome (SRAG) notifications in Brazil, the outbreak in El Salvador comes from a new H3N2 mutation that appeared in the northern hemisphere at the end of last year that arrived in Rio de Janeiro, In the second semester, it spread to other states, such as Bahia and Amazonas.

“Today, we already know that H3N2 predominates, even without genetic sequencing, because in addition to Rio de Janeiro with an epidemic scenario, it ends up spraying in the capitals and large centers of the country, because of our air network. We have, daily, passengers going up from Rio to the main cities In the country and vice versa.. Gomez says this causes a very high incidence of cases in Rio, which is certainly the same type.

For the specialist, the rise in cases was supposed to be in early spring and not now, a week from the beginning of summer, and he believes that this is due to two factors: the lack of commitment of the population to the influenza vaccination campaign, and relaxation. COVID-19 restrictive measures. Only 58% of the expected public were vaccinated in the city of Salvador’s campaign against influenza, according to the SMS. Only 416 of the 720,000 expected have been vaccinated. The goal was 90% vaccination coverage.

All the measures we have taken to prevent corona virus have a brutal effect on the influenza virus, because the method of transmission is the same. So you need to use good masks, such as N95 and PFF2, especially if you are indoors, and avoid clumps. Last year, we were able to curb the flu because of these precautions, but we are starting to let our guard down,” explains the researcher.

He also says the risk of fatal influenza is very high: 12 to 15% among those admitted. In other words, out of every 10 people hospitalized with the flu, at least one does not survive. This lethal percentage, in corona viruses, almost doubles – 20-30%, since there is still no cure for the disease, as there is for influenza viruses.

influenza types

Andrea Mendonça Gusmão, professor of virology at the Federal University of Bahia (UFBA) and UniFTC, Andrea Mendonça Gusmão, explains that there are several types of influenza. “When we talk about influenza, we identify influenza virus A or B, which are two different types that can cause influenza. We have many strains, because they are RNA viruses and they have a high mutation rate,” he explains. H1N1 and H3N2 are two different types of influenza type A, which have a higher chance of causing epidemics, according to the virologist.

Due to the emergence of new strains, it is necessary to get vaccinated every year. “Even if the vaccination is done correctly, there is a new vaccine every year, because this virus has a high mutation rate. The vaccine we used in this year’s SUS vaccination campaign contains H3N2, but it is not the same strain that is circulating now, as last year. In other words. We are always late with the virus, which is why we can get the flu even when vaccinated,” says Andrea.

The vaccine protects against three types of influenza

Available in trivalent public health centers, the vaccine protects against three types of flu mutations, the most dangerous of which are: H1N1, H3N2 and a strain of influenza B. The symptoms are the same as those of the coronavirus, such as myalgia (muscle aches), headache pain, fever, Shortness of breath, fatigue and sometimes pneumonia. However, the treatment is with an antiviral.

Retired Vera Lucia was vaccinated against influenza this year, but fell ill, precisely because virologist Andrea Gusmão explained that the virus had mutated. She has been showing symptoms since Saturday. “Terrible headache with cold, runny nose and severe cough. Since Saturday, I’ve been taking Tylenol every eight hours and benefit every six hours. Thanks to God, I feel better today, I’ve already been able to leave the house,” Vera says. Besides her, her grandson, who lives in the same building, also contracted the flu.

However, infectious disease scientist Claudelson Bastos, technical director of the vaccination service at Sabin Medicina Diagnóstica in Salvador, recommends that the “best medicine” is still the vaccine. “Influenza A, from time to time, reappears, because there is viral seasonality. Therefore, we believe that influenza vaccination is effective in reducing infection and mortality rates from the disease,” he defends.

SMS alerts for arboviruses
Yesterday the Municipal Health Department of Salvador (SMS) issued a warning of lobster viruses such as dengue, zika and chikungunya. “The health system is the same for all diseases: coronavirus, influenza, dengue fever, Zika, chikungunya. What worries us now is that we have a number of patients with exacerbations who were afraid to go to units during the pandemic. Municipal Health Minister Leo Prates warned of All diseases that can and should be avoided alleviate the severity of the health system and improve the service for the population.

He says that although the index measuring Aedes aegypti prevalence in El Salvador has fallen compared to last year, some neighborhoods are far above normal. The historical rate of infection is 2.3, that is, for every 100 households, 2.3 of them are focused on mosquitoes. Now, this index is 2.1, which is classified as “on alert” by the Ministry of Health, however, the Itapuã index has 10.2. In Coutos 1 and Vista Alegre, the rate is 7.2 and in Fazenda Coutos, 6. The worst sanitary areas for mosquito infestation are Itapagipe (3.9) and Subúrbio (3.9).

We need people to fight mosquitoes inside their homes, and remove containers. We are doing our part, but the health system will not, at the same time, bear a new wave of COVID-19, an influenza outbreak, and an outbreak of dengue fever; In addition to those patients whose condition has worsened and who have not been treated in the pandemic,” pleads Leo Pratis. According to him, 80% of arbovirus outbreaks occur indoors and not on public roads. “This is very worrying, I would say that it was a previous outbreak of the virus. . I don’t know why it hasn’t exploded yet.”

As for SMS, the arbovirus of most concern is dengue, as there are four serotypes. In 2020, there were two deaths from dengue and three from chikungunya in the capital. In 2021, to date, there is one case of each disease under investigation. The file says that home inspections have been carried out at strategic points, and covers have been placed in tanks where water can accumulate, as well as special insecticides. “The advice is to try to eliminate what could store water and become a breeding site,” the department’s Center for Zoonoses Disease Control (CCZ) advises, citing buckets, plant dishes and litter.