Influenza outbreak in Rio is close to becoming epidemic, experts say

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Amid the increase in the number of cases of Influenza A occurring in Rio de Janeiro, specialists understand that the situation of an outbreak in the city is on its way to becoming an epidemic. According to the Municipal Health Department, 23 thousand cases have already been registered in the state capital in the last four weeks.

Since then, the demand of patients for care in Emergency Care Units (UPAs) has increased by more than 400% in the network located in the city, according to the State Health Department. The outbreak of Influenza A occurs at an unexpected time by the researchers of health: the virus tends to spread during the winter.

For the epidemiologist Diego Xavier, from the Institute of Scientific and Technological Communication and Information in Health (ICICT/Fiocruz), the current scenario already has conditions to be defined as an epidemic.

“We can say that an epidemic is already taking place, because it happens outside the expected period, it lasts more than two weeks and the phenomenon is spread throughout the city. As we were isolated, some viruses did not spread so much in the population and, when we return, there is greater contact with these viruses that have been trapped. The important thing is to test more, to find out if there are no cases of mild Covid-19, because the symptoms are confused”, he assesses.

Former director of the National School of Public Health (ENSP/Fiocruz), health doctor Hermano Castro partially agrees with Xavier’s perception, but understands that there is still no ongoing epidemic due to the territorial dimension of the phenomenon, concentrated in the capital. According to him, the evolution of the phenomenon needs to be closely monitored in the coming weeks, to assess the potential for expansion and the direction of an eventual spread.

“Today, everything is still very concentrated in the capital, with lesser effects on the Metropolitan Region, in cities like São Gonçalo. It’s hard to talk about a municipal epidemic, it’s not a common concept. So, I would say that we are still at the stage of an epidemic outbreak. But, yes, depending on how it evolves in the coming weeks, it could actually turn into an epidemic”, he says.

The latest InfoGripe Bulletin, released by Fiocruz on Thursday (2), indicated that 13 of the 27 states showed signs of growth in the number of cases of Severe Acute Respiratory Syndrome (SRAG) in all age groups under 60 years. Three states drew attention for the increase and, among them, is Rio de Janeiro.

However, this data comes from the Severe Acute Respiratory Syndromes Notification System (SIVEP-Influenza), which only reflects cases of flu-like illness that evolved into the most acute form. Although there is an increase in the number of Influenza cases, the proportion of Covid-19 is still higher among them. The milder form is accompanied by a platform that, according to experts, has not been properly updated.

Coordinator of the InfoGripe Bulletin, Marcelo Gomes, from the Scientific Computing Program (PROCC/Fiocruz) also misses more detailed data to carry out a precise analysis, and explains that the border between an outbreak and an epidemic is subtle.

“This line is very fine. As we have an outbreak across the city, with sustained growth, it can characterize the beginning of an epidemic outbreak. Unfortunately there is no information for fine analysis. Some states also reported some cases, but nothing at the level reported in Rio de Janeiro. In the SRAG data, there was already an increase in admissions among young adults. It may be a reflection of this, but it still lacked laboratory confirmation and was restricted to children and young adults”, he ponders.

Amid the outbreak, vaccination against Influenza A has been suspended in the city of Rio de Janeiro since Friday (3), due to lack of doses. According to the panel of the Ministry of Health, 2.7 million cariocas need to be immunized, but vaccination coverage is 54.9%. This Wednesday (8), the governor of São Paulo, João Dória (PSDB) announced the donation of 400,000 doses to the City of Rio de Janeiro, which hopes to resume the application this week.

For Hermano Castro, the campaign is delayed because of the restrictions that existed at the beginning of vaccination, when the recommended was that the public wait 15 days to receive the immunizing agent, after having been vaccinated against Covid-19. Currently, both can be applied in the same visit to the vaccination post, which has been recommended for those who will receive the second application or the booster dose.

“This has been encouraged. There is still a misperception that vaccination against Influenza A is intended only for the elderly, due to the dissemination work done in the first years of the vaccine. They form part of the priority group, but the vaccine is also important for children from six months to six years of age, and it is available to the entire population”, he concludes.

In addition to being able to prevent the disease with the vaccine, prevention measures are similar to those used to combat the coronavirus, such as using masks and hand hygiene.

Reference: CNN Brasil

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