Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations

Freitas, André Ricardo Ribas; Donalísio, Maria Rita

doi:10.1590/0074-02760150341

Cited by 29 publications

(35 citation statements)

References 31 publications

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“…All-cause mortality exceeded the upper limit of the confidence interval (95%) a week before the first laboratory-confirmed death in the cities of São Paulo and Rio de Janeiro, this suggests that there should already be many deaths that would not have been captured by conventional epidemiological surveillance system, based on individual notification of cases. COVID-19 is characterized by a majority of mild cases that can be confused clinically with influenza, or even with respiratory syncytial virus that occurs at this time of year in these two Brazilian cities [18]. Therefore, it is plausible to believe that SARS-CoV-2 has circulated widely and this circulation was not identified at the beginning of the Brazilian epidemic.…”

Section: Discussionmentioning

confidence: 99%

Use of excess mortality associated with the COVID-19 epidemic as an epidemiological surveillance strategy - preliminary results of the evaluation of six Brazilian capitals

Freitas

Medeiros

Frutuoso

et al. 2020

Preprint

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In early 2020, the World Health Organization (WHO) recognized the pandemic situation of the new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2), which causes Coronavirus Disease-2019 (COVID-19). In Brazil by the end of April 2020, another 110 thousand cases and 5,000 deaths had been confirmed. The scarcity of laboratory resources and overload of the care network, added to the broad clinical spectrum of the disease, can make it difficult to capture all mortality from this disease through epidemiological surveillance based on individual notification of cases. The aim of this study was to evaluate the excess of deaths in Brazilian capitals with the highest incidence of COVID-19, as a way of validating the method, we also evaluated a capital with low incidence. We assessed weekly mortality from all causes during the year 2020, up to the epidemiological week 17, compared with the previous year. The data were obtained through the National Civil Registry Information Center (CNIRC, acronym in Portuguese). We estimate the expected mortality and the 95% confidence interval by projecting the observed mortality in 2019 for the population of 2020. In the five capitals with the highest incidences it was possible to identify excess deaths in the pandemic period, the age group most affected were those over 60 years old, 31% of the excess deaths occurred in the population between 20 and 59 years old. There was a strong correlation (r = 0.94) between the excess of deaths in each city and the number of deaths confirmed by epidemiological surveillance. There was no excess of deaths in the capital with the lowest incidence, nor among the population under 20 years old. We estimate that epidemiological surveillance managed to capture only 52% of all mortality associated with the COVID-19 pandemic in the cities studied. Considering the simplicity of the method, its low cost and reliability for assessing the real burden of the disease, we believe that the assessment of excess mortality associated with the COVID-19 pandemic should be widely used as a complementary tool to regular epidemiological surveillance and its use should be encouraged by WHO.

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Section: Discussionmentioning

confidence: 99%

Use of excess mortality associated with the COVID-19 epidemic as an epidemiological surveillance strategy - preliminary results of the evaluation of six Brazilian capitals

Freitas

Medeiros

Frutuoso

et al. 2020

Preprint

Self Cite

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“…These results agreed with ours. Understanding the seasonality associated with these pathogens is fundamental for developing seasonal strategies for prevention and treatment . Currently, there are few available antiviral medications for the treatment of CAP; and only vaccines are available against influenza and ADV …”

Section: Discussionmentioning

confidence: 99%

High incidence of rhinovirus infection in children with community‐acquired pneumonia from a city in the Brazilian pre‐Amazon region

Ferreira

Costa

Cariolano

et al. 2019

Journal of Medical Virology

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Community‐acquired pneumonia (CAP) is the leading cause of child death worldwide. Viruses are the most common pathogens associated with CAP in children, but their incidence varies greatly. This study investigated the presence of respiratory syncytial virus (RSV), adenovirus, human rhinovirus (HRV), human metapneumovirus (HMPV), human coronavirus (HCoV‐OC43 and HCoV‐NL63), and influenza A virus (FluA) in children with CAP and the contributing risk factors. Here, children with acute respiratory infections were screened by pediatrics; and a total of 150 radiographically‐confirmed CAP patients (aged 3 months to 10 years) from two clinical centers in Sao Luis, Brazil were recruited. Patient's clinical and epidemiological data were recorded. Nasopharyngeal swab and tracheal aspirate samples were collected to extract viral nucleic acid. RSV, adenovirus, rhinovirus, FluA, HMPV, HCoV‐OC43, and HCoV‐NL63 were detected by real‐time polymerase chain reaction. The severe CAP was associated with ages between 3 and 12 months. Viruses were detected in 43% of CAP patients. Rhinovirus infections were the most frequently identified (68%). RSV, adenovirus, FluA, and coinfections were identified in 14%, 14%, 5%, and 15% of children with viral infection, respectively. Rhinovirus was associated with nonsevere CAP (P = .014); RSV, FluA, and coinfections were associated with severe CAP (P < .05). New strategies for prevention and treatment of viral respiratory infections, mainly rhinovirus and RSV infections, are necessary.

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“…Viral detection is also concentrated in the beginning of those colder months, and influenza is indeed the most sampled virus during this period. In contrast, in the equatorial regionswhich lacks a cold season and where respiratory infections are concentrated in the rainy season (Alonso et al 2007, Freitas & Donalisio 2016, Moura et al 2006, Moura 2010, Paynter et al 2015, Tamerius et al 2013, Yu et al 2013)-the predominant virus is RSV during the periods when P&I attributed hospitalizations and deaths peak. Influenza, parainfluenza and adenoviruses are detected in those regions in the months of lower P&I attributed hospitalizations and deaths.…”

Section: Discussionmentioning

confidence: 99%

Respiratory syncytial virus causes more hospitalizations and deaths in equatorial Brazil than influenza (including during the 2009 pandemic)

Alonso

Tamerius

Freitas

2020

An. Acad. Bras. Ciênc.

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Despite numerous studies evaluating infl uenza and Respiratory Syncytial Virus (RSV), there is still a lack of knowledge about them, especially in tropical countries. We compared the relative importance of respiratory viruses by examining their spatiotemporal patterns, age-specifi c hospitalization data and mortality data for 2007-2012 obtained from offi cial sources. The data were aggregated into "respiratory infection seasonal zones" formed combining states that had similar seasonal patterns of pneumonia and infl uenza (P&I). Equatorial-North where P&I peaks in the middle of the year, Equatorial-South where P&I peaks in the fi rst semester and coincides with the rainy-season, Subtropical where P&I peaks are clearly concentrated in the winter season, and Tropical Midwest and South-East where P&I peaks are a transition between the South-Equatorial and the Sub-tropical. Our analyses indicate that RSV has higher impact than infl uenza in equatorial region of Brazil, which was particularly evident during the circulation of the 2009pdm strain, and suggests that seasonal infl uenza may have a lower impact in Equatorial Brazil (and perhaps in other tropical regions of the world)than previously considered. Accordingly, we suggest that the broad assumption that infl uenza is the main cause of viral respiratory hospitalizations and death in equatorial regions be questioned with greater emphasis in future studies.

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Respiratory syncytial virus seasonality in Brazil: implications for the immunisation policy for at-risk populations

Cited by 29 publications

References 31 publications

Use of excess mortality associated with the COVID-19 epidemic as an epidemiological surveillance strategy - preliminary results of the evaluation of six Brazilian capitals

Use of excess mortality associated with the COVID-19 epidemic as an epidemiological surveillance strategy - preliminary results of the evaluation of six Brazilian capitals

High incidence of rhinovirus infection in children with community‐acquired pneumonia from a city in the Brazilian pre‐Amazon region

Respiratory syncytial virus causes more hospitalizations and deaths in equatorial Brazil than influenza (including during the 2009 pandemic)

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