Ceará has not recorded cases of H1N1 flu this year; Understanding the cause and the expected scenario for 2022 – Badalu

Go to school or work with the flu, cough without covering your mouth, come home and throw yourself on the couch without showering. What seemed “normal” before the pandemic is now out of the question, and this change has been useful in preventing diseases beyond Covid-19, such as influenza A H1N1.

In 2021, Ciara did not record cases of the virus, also known as “swine flu,” responsible for causing the 2009 pandemic. That year, the first confirmation of the disease in the state occurred in June, and more than 200 serious cases were identified.

Since then, 2021 is considered, to date, the first year without cases. In a statement, the state Department of Health (Sesa) reported that the “Sentinel Influenza Syndrome (SG) Surveillance Network is working to search for multiple pathogens, and has expanded the identification of respiratory viruses,” after it resumed activities in April of this year.

The Ministry confirms that until the first week of December, no cases of influenza A H1N1 were recorded. He explains that “the spread of viruses has decreased due to the preventive measures for respiratory diseases that were adopted during the Covid-19 pandemic.”

Also, according to the secretariat, Ciara had 244 cases of H1N1 in 2019, and only 37 were confirmed in 2020, the state’s first year of the epidemic.

On the other hand, the Ministry of Health takes note of disease records in cases of severe acute respiratory syndrome (SRAG) since 2009, the epidemiological year. Data tabulated by Diário do Nordeste shows that Ceará has had, on average, 225 cases per year since the pandemic.

Records have been more accurate since 2018, the year the causative agent – the type of virus that causes the disease – was identified. From then to 2020, 432 people from Ceará contracted the severe form of influenza A H1N1, and 80 people died of the disease.

Why were there no cases

Epidemiologist Daniel Queiroz notes that the decline in H1N1 cases has occurred worldwide, but that influenza A H3N2 and influenza B-Victoria viruses are “spreading more aggressively.”

“Covid and influenza surveillance are integrated. If no cases of influenza have been recorded, it is because the virus has not spread. But it is important to add that respiratory syncytial virus, which is also dangerous, is the one that is most detected,” highlights Danieli.

The specialist also adds that it is necessary to be careful and maintain sanitary measures, because when there is a low circulation of the virus in one period, the trend is that, in the next period, more people are more susceptible to it.

Paulo Magalhães, family and community physician and master of public health, estimates that other respiratory illnesses, such as influenza, should intervene in the health scenario in Fortaleza and the state in the coming months.

“Brazil has excellent vaccination campaigns, with a lot of capillary capacity, but with all the energy directed at vaccinating against Covid, there has been a failure to cover influenza vaccination, for both children, adolescents, adults and the elderly,” he said.

“mixed infection”

Caroline Gorgel, a virologist, epidemiologist and professor at the Federal University of Ceará School of Medicine (UFC), believes that the virus has already spread in Ceará this year, but the focus on COVID-19 surveillance has prevented identification.

“If there is no sentinel network working to capture other respiratory viruses, there is information suppression. It is circulating, but there is no test to confirm it. It is impossible to determine a respiratory infection agent solely by symptoms,” assesses the virologist.

Caroline recalls another point that may have contributed to the potential underreporting, which is that many patients who thought they had Covid had not been tested, “and may in fact have had another agent, such as influenza.”

“The focus on Covid,” the epidemiologist cites, creates another problem. There is a call to get vaccinated annually, but people are not looking, because the focus is now on Covid. But the flu can also be dangerous, you need to be immunized,” he warns.

In 2020, according to Sesa, Ceará has reached 97% vaccination coverage against influenza among priority groups. By 2019, 95% of the immunization target has been achieved.

This year, the first phase of vaccination (April to May) reached 62% of coverage for children (6 months to less than 6 years), pregnant women, postpartum women, indigenous peoples and health workers. In the second phase (May to June), 43% of the target was achieved for seniors and teachers.

Why does the flu not stop spreading even with a vaccine?

Infectious disease expert Kenny Colaris also stresses the importance of vaccination against influenza, which has intensified in Ceará since the pandemic, in 2009. “At the moment, the vaccine is not available, because it arrives in April and ends in August, September. So, it is necessary to strengthen the care that We already know it,” he points out.

The doctor also advises that “if they develop any respiratory symptoms, the person should not go to work, study or come into contact with others: they should get tested for Covid. We need to be prepared for the possible increase in cases.”

In 2022, cases of influenza (SG) and Severe Acute Respiratory Syndrome (SRAG) caused by the influenza virus should grow across the country, predicts Marcelo Gomez, InfoGripe Coordinator, of the Oswaldo Cruz (Fiocruz) Foundation.

These measures are those already in place since March 2020 in Ceará. Continue to use the mask, preferably PFF2; Avoid crowds, reduce the number of people in meetings, and avoid being indoors. We have this clear because of Covid, but the way to prevent it is exactly the same as the flu”, confirms Marcelo.

With information from Diário do Nordeste