In Pernambuco, influenza surveillance ‘sleeps’ and only confirms new H3N2 influenza case eight days after positive patient diagnosis

December started with thousands of influenza A cases in Rio de Janeiro and this is an epidemic pain It surprises specialists because it began in the middle of spring and is already spreading to other states on the eve of summer. Even with the recognition of health surveillance for the work of detecting problems that pose risks to the population, Pernambuco confirmed and released the first case of influenza A (the type responsible for the current epidemic in some Brazilian states, plus Rio de Janeiro) in 2021 eight days after a private laboratory announced the positive result of the patient.. Another important detail is that the investigation only started because his wife called the Strategic Information Center for Health Surveillance of Pernambuco (Cievs/PE) to report flu-like symptoms and diagnose her husband.

The State Department of Health (SES) reported that the private lab had not contacted Cievs/PE about the patient’s result, which should have happened, even though the test was being done on a private service. On the other hand, even under the current scenario of influenza pandemic in some Brazilian states, caused by a new strain (H3N2 Darwin), the Secretariat has not issued a technical note to health units, in order to alert the need for services to notify Cievs/PE of the occurrence of cases.

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Cievs began analyzing the events after the 48-year-old woman called the center. She stated that her husband, the 48-year-old man, had been in contact with two workers from São Paulo who had developed flu-like symptoms. Symptoms on December 7 ), after an examination in a private laboratory. The result, released on December 10, was positive for influenza A not of the subtype and negative for covid-19,” which was released, in a note, by the Ministry of Health of Pernambuco (SES) Last Saturday (18), eight days after the positive test.

Since December 9, at a press conference, a GC SES questions the incidence of influenza in the state. On that date, the Minister of Health of Pernambuco, André Longo, confirmed that epidemiological surveillance is not taking the results of respiratory virus samples out of sight.. “We did very important sampling, as all of the SERA (Severe Acute Respiratory Syndrome) tests and in our testing centers have taken into account the entire viral panel, which also includes an analysis for influenza. We haven’t really seen the flu happen here in the state,” he said. Secretary on that occasion.

Last Friday (17), the day before SES revealed the first cases of H3N2 in the state, it was The report questioned the state again about possible cases of the flu, after doctors reported an increase in the number of people with flu-like symptoms compatible with the H3N2 Darwin strain, in health units, who did not test positive for covid-19.. “We are still not detecting influenza,” said SES Health Surveillance Executive Secretary, Patricia Ismail. However, on Saturday (18), SES announced the first three cases of H3N2, days after the virus had already spread in Pernambuco.

What would have happened? Monitor failure? interrogated by GC, informed the secretariat that “confirmation of certain diseases must be done in a laboratory recognized by the Ministry of Health (MS), and influenza is one of them – in the reported case, the positive result of the 48-year-old girl. The man was due to a non-subunit influenza of Type A is in a special unit, which MS did not recognize, which required an investigation by Cievs Pernambuco and Recife.” In addition, the SES asserts that it “maintains an open channel with health services, health professionals and the general population to receive information of health importance and conduct due verification. Finally, it certifies that, upon being informed of this event by a woman whose 48-year-old health professional, In partnership with the Patients’ Residence Municipality, which is responsible for the investigation, take all steps to investigate the situation and provide an appropriate response to the community in the shortest possible time.”

The SES statement is strange because confirmation of influenza, according to Vol., cannot be done by a private laboratory. In other words, are there other cases observed in the special units that may have escaped the eyes of the observer? For medical epidemiologist Anna Brito, a researcher at Vicruz Pernambuco, it does not have to be confirmed by a public laboratory. “On the contrary: all units, all research institutes, whether private or public, are obliged to register the diagnosis of the disease with obligatory notification. It is clear that there is a clear negligence on the part of state and municipal administrators in the face of the disease that has already been announced, where there is a link Global. Influenza was not expected at this time in the Southern Hemisphere, but given the prevalence of cases in the Northern Hemisphere, it would be inevitable that influenza did not arrive,” highlights Anna Brito.

And the epidemiologist stresses that health surveillance is the first service that must be alert and ready to identify cases, in order to try to prevent the spread of diseases, such as influenza, with health barriers. “It’s the same discussion we had on covid-19. We will never prevent a respiratory virus from entering, but it is possible to delay the spread and reduce transmission between people significantly if there is rapid detection. It is possible to direct, in a timely manner, whatever Those who have developed symptoms, regarding care and measures such as physical distance, use of a mask, and hygiene of hands and face”, confirms.

Cases of H3N2 influenza have been reported in Pernambuco

On Saturday (18), the Ministry of Health of Pernambuco (SES) confirmed three cases of influenza A (H3N2). The events involved a 38-year-old woman, who works in Recife and lives in Itampe, and another 48, from the capital of Pernambuco, who had laboratory results for the virus, as well as a 48-year-old man as well. from Recife, and confirmed by clinical and epidemiological standards. All had mild symptoms such as fever, cough, sore throat, headache, weakness and joint pain, and did not require hospitalization. “The investigation of the cases was carried out by the Strategic Information Centers for Health Surveillance in Pernambuco (Cievs/PE) and Recife,” says SES.

According to the secretariat, the Cievs began analyzing the events after the 48-year-old called the center. She stated that her husband, a 48-year-old man, had been in contact with two workers from São Paulo who had developed flu-like symptoms. Symptoms began to appear on him on December 7, after he was examined in a special laboratory. The result, released on December 10, was positive for non-subtype A influenza and negative for covid-19.

The 38-year-old woman, who is the couple’s employee and has not been vaccinated against the flu, started showing symptoms on December 11, and the 48-year-old woman, who confirms she had the vaccination, on December 14. Both deny travel. Biological materials were collected on December 16, and the analysis was carried out by the Central Public Health Laboratory of Pernambuco (Lacen-PE). Since both had positive laboratory results for influenza A (H3N2), the case of men with the disease could have been closed as well, based on clinical and epidemiological criteria.

“Pernambuco has an active epidemiological investigation system that constantly analyzes the viruses circulating in the state. Upon receiving this report, all necessary measures were taken to understand what happened. This discovery only reinforces the importance of using the virus. Mask and hand hygiene, postures that help prevent disease different types, such as influenza and covid-19. Anyone with respiratory symptoms should also try to get tested for covid-19, in addition to remaining in isolation during the period when symptoms appear”, says Minister of State for Health Andre Longo.