Patterns of influenza B circulation in Brazil and its relevance to seasonal vaccine composition

Abstract

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.

Public health impact and economic benefits of quadrivalent influenza vaccine in Latin America

“…First, to date, there are no published studies assessing quantitatively the impact of the introduction of QIV in Latin America. Recently, 2 studies, Barros et al 7 . and Arlant and Bricks, 55 summarized evidence corroborating our data collection on the circulation of B lineage.…”

“…The World Health Organization (WHO) annually issues recommendations about the strains to be included in the TIV vaccine in the next season in the northern and southern hemispheres based on the reports provided by influenza surveillance networks worldwide. However, over the past years, 2 distinct lineages of influenza B (Yamagata and Victoria) have been co-circulating worldwide with one lineage dominating the other in many of the seasons 7,8 . But, predicting which lineage will predominate in the next season has been revealed to be challenging, with frequent mismatches occurring between the lineage included in the TIV and the circulating lineage 9 .…”

Influenza A and B in a cohort of outpatient children and adolescent with influenza like-illness during two consecutive influenza seasons

“…27 In Brazil, previous studies have demonstrated the mismatch between vaccine and circulating lineages of influenza B. 28 We observed a higher proportion of the B/Yamagata lineage circulating in the city of Araraquara during the study period. As this lineage was not included in the TIV provided by the Brazilian Ministry of Health, protection against INF B infections was certainly lower than expected.…”

Serious acute respiratory syndrome: a case series in a municipality region of central Brazil

“…Denominated as Myxovirus influenza, it is variable RNA virus, split into types A, B and C (FORLEO-NETO et al, 2003;MARTINEZ, 2009;BARROS et al, 2016). The influenza B virus, of which human beings are the principal host is more stable than influenza A, with less antigenic drift and consequent immunologic stability, and does not undergo the process of antigenic shift.…”

“…The influenza B virus attacks more frequently in places like schools and kindergartens, but can also be found in asylums, hostels and others (KASPER;FAUCI, 2015). Commonly affecting children, it can cause death if not treated swiftly and properly (BARROS et al, 2016;GLEZEN, 2014).…”