Data on the burden of disease and circulation patterns of influenza B lineages for Brazil are limited. This review aims to describe the pattern of influenza B occurrence in Brazil to have a better understanding of its epidemiology and its relevance when considering seasonal influenza vaccine composition. A review of the data including analysis of international and local surveillance data as well as information from online search of databases using Medical Subject Headings terms in conjunction with screening of abstracts from scientific events was performed. Based on international epidemiologic surveillance data, moderate levels of influenza B disease (19%; 2006-2014) were observed. Of these nine years, it was possible to compare data from three years (2007, 2008 and 2013) which have information on the circulating influenza B lineage. Co-circulation of influenza B lineages was observed in all these three influenza seasons, of which, during one season, a high degree of mismatch between the vaccine lineage and the predominant circulating lineage (91.4% [2013]) was observed. Local surveillance data reveal a distinct and dynamic distribution of respiratory viruses over the years. Data from published literature and abstracts show that influenza B is a significant cause of disease with an unpredictable circulation pattern and showing trends indicating reemergence of the B/Victoria lineage. The abstracts report notable levels of co-circulation of both influenza B lineages (2000-2013). Mismatch between the Southern hemisphere vaccine and the most prevalent circulating viruses in Brazil were observed in five influenza seasons. The evidence on co-circulation of two influenza B lineages and mismatched seasons in Brazil indicates the benefit of quadrivalent influenza vaccines in conferring broader seasonal influenza protection. Additionally, improving influenza surveillance platforms in Brazil is important for monitoring disease trends and the impact of introducing seasonal influenza vaccination.

Resumo: O objetivo deste estudo foi o de descrever, com base no relacionamento entre os sistemas de informação SINAN (Sistema de Informação de Agravos de Notificação) e SIM (Sistema de Informações sobre Mortalidade), o perfil epidemiológico dos casos notificados de influenza por novo subtipo viral que evoluíram para óbito, durante a pandemia da doença. Foram utilizados dados secundários de ambos os sistemas referentes aos anos de 2009 e 2010. O relacionamento identificou 5.973 óbitos de casos notificados como influenza pandêmica. Destes, 2.170 (36,33%) haviam sido classificados no SINAN como confirmados para a enfermidade; 215 (3,6%), como infecção por outro agente infeccioso; e 3.340 (55,92%), como descartados. Após o relacionamento, alguns casos, que, no SINAN, foram encerrados com evolução para óbito por influenza (n = 658) ou óbito por outras causas (n = 847), não foram encontrados no SIM. O relacionamento entre os bancos de dados pode aprimorar o sistema de vigilância e o dimensionamento da morbimortalidade. Recomendamos o fortalecimento da vigilância da influenza no país com o uso do relacionamento entre os sistemas de informação do Ministério da Saúde.

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Objective:To describe the clinical aspects of cases of influenza A(H1N1)pdm09 in Brazil.Methods:A descriptive study of cases reported in Sistema de Informação de Agravos de Notificação (SINAN), 2009-2010.Results:As the final classification, we obtained 53,797 (56.79%) reported cases confirmed as a new influenza virus subtype, and 40,926 (43.21%) cases discarded. Fever was the most common sign, recorded in 99.74% of the confirmed and 98.92% of the discarded cases. Among the confirmed cases, the presence of comorbidities was reported in 32.53%, and in 38.29% of the discarded cases. The case fatality rate was 4.04%; 3,267 pregnant women were confirmed positive for influenza A new viral subtype and 2,730 of them were cured. The case fatality rate of pregnant women was 6.88%.Conclusion:The findings suggested concern of the health system with pregnant women, and patients with comorbidities and quality of care may have favored a lower mortality. We recommend that, when caring for patients with severe respiratory symptoms, with comorbidities, or pregnant women, health professionals should consider the need for hospital care, as these factors make up a worse prognosis of infection by the pandemic influenza virus.

Since the announcement of the coronavirus disease (COVID-19) pandemic in January 30 th 2020, 68 countries reported to the World Health Organization that they were experiencing disruptions in malaria diagnosis and treatment. This situation had the potential to lead to delays in diagnosis and treatment, which could result in an increase in severe cases and deaths. This analysis was based on findings from a field visit, carried out between June 30 th and July 1 st , 2020, to a warehouse, to two health facilities, and a meeting with a community health worker, and an descriptive epidemiologic data analysis of health information system (HIS) to evaluate trends of the number of people tested for malaria and number of malaria cases reported, by comparing data from 2018, 2019 and 2020 for the period between January and May. The two health facilities and the warehouse had about two months of stock of antimalarial drugs, and patients with malaria symptoms were being tested for malaria at the COVID-19 screening site. The HIS data showed that the number of reported malaria cases decreased by 3.0% (177.646/172.246) in April, and 7.0% (173.188/161.812) in May, when comparing 2019 and 2020 data. People tested for malaria in community increased by 39.0% (190.370/264.730), between 2019 and 2020. The COVID-19 may have had a negative impact on the diagnosis and treatment of malaria in health facility (HF). The decrease in people tested for malaria in the health facilities may have overwhelmed the activities of the community.