Risco de uma pandemia de influenza pelo vírus A (H1N1)

Abstract

On April 24, 2009, the World Health Organization (WHO) announced a public health emergency of international importance, in accordance with the International Health Regulations, caused by infection with the new influenza A (H1N1) virus. Its beginning is possibly associated with an epidemic of febrile respiratory illness that first struck Mexico in March 2009. The epidemic behaved unusually when compared to seasonal influenza, since it occurred outside of winter, predominantly in young adults, and initially with more severe cases (although the latter has since proven not to characterize the epidemic). The virus was first positively identified in the United States, through tests performed in two children in California on April 17 (MMWR Morb Mortal Wkly Rep 2009; 58:400-2). Since then, spread of the virus elsewhere in the United States has been detected, including community transmission. Subsequent to spread of the virus in Mexico and the United States, cases were detected in Canada, where community transmission was also reported. By mid-May, more than 40 countries had confirmed cases, Brazil included, and autochthonous transmission had also been reported outside of North America. This situation led the WHO to increase the pandemic alert to level 5 and adopt recommendations aimed at decreasing the epidemic's effects, by activating the national preparedness plans for the influenza H5N1 pandemic, with the appropriate adaptations to the current epidemic. The new epidemic shows a predominance of cases in children and young adults and low case-fatality (< 1%), with a majority of mild and moderate cases of a flu syndrome and higher case fatality in patients with an underlying chronic illness, while most cases have recovered without specific treatment. Transmission occurs through either direct person-to-person contact or respiratory secretions from infected individuals. The first estimates based on analysis of cases in Mexico indicated lower transmissibility than for previous influenza pandemics (Fraser et al. Science 2009; Epub 14 May) or the epidemic of severe acute respiratory syndrome (SARS). Assuming that these characteristics hold out over the course of the epidemic, three possible scenarios can be predicted: (a) this epidemic will follow a similar pattern to that of a seasonal influenza epidemic; this scenario is further consistent with sustained transmission in other regions, but with a self-limited tendency; (b) after waning during the hot months in the Northern Hemisphere, the epidemic will recrudesce, with more severe cases; or (c) the epidemic will continue to spread unchecked to other countries and regions, acquiring the characteristics of a pandemic. Due to the high degree of uncertainly and (unfortunately) the lack of available information from affected countries, it is necessary to maintain the pandemic alert and activate the preparedness plans, with the needed adaptations to the various possible scenarios. Furthermore, we should always remember the experience with SARS, which was only managed effectively by...

Relacionamento entre bases de dados para vigilância da pandemia de influenza A(H1N1)pdm09, Brasil, 2009-2010

“…Devido à circulação do novo subtipo do vírus influenza A, inicialmente denominado "gripe suína", com ocorrência de casos em humanos desde 18 de março de 2009, no México e Estados Unidos 5,6,7,8,9,10,11,12 , a Organização Mundial da Saúde (OMS) declarou, em 25 de abril daquele ano, Emergência em Saúde Pública de Importância Internacional (ESPII) e, no mesmo dia, o Ministério da Saúde instituiu o Gabinete Permanente de Emergências em Saúde Pública 5,7,8,9,10,11,13,14 .…”

“…Outro artigo brasileiro é um editorial, no qual o autor sintetizou a história da pandemia, desde a detecção do vírus em abril de 2009. Como foi publicado ainda na fase de contenção, fez uma projeção dos cenários da pandemia em um futuro próximo e a necessidade de estruturação dos serviços de saúde para responder a uma emergência em saúde pública 12 . O terceiro artigo relatou a experiência de um hospital público terciário, referência para atendimento dos casos de influenza pandêmica 26 .…”

“…O terceiro artigo relatou a experiência de um hospital público terciário, referência para atendimento dos casos de influenza pandêmica 26 . O perfil apresentado assemelhou-se ao relatado em artigo anterior 12 , sendo mulheres e pessoas com idade entre 0 e 29 anos as mais acometidas. Os pacientes diferenciaram-se dos atendidos fora desse serviço por apresentarem pelo menos uma comorbidade, como imunossupressão, doença respiratória crônica e doença cardiovascular 26 .…”

Dimensiones políticas de una epidemia: el caso de la gripe A (H1N1) en la prensa escrita de Argentina

“…Esta discusión adquiere escasa resonancia en Brasil 41,42,43,44,45,46,47 y en Argentina 37,48,49 , tanto a nivel de los medios masivos de comunicación, como de la producción científica.…”

Factors associated with vaccination against Influenza A (H1N1) in the elderly

“…In 2010, the World Health Organization (WHO) announced the post-pandemic phase, from which should be intensified and monitored preventive actions, especially in relation to vulnerable groups such as children, elderly, immune-compromised, cardiopathic and pneumopathic people, since the virus A (H1N1) has greater potential to cause morbidity and mortality in these groups (1,6) . WHO indicates vaccination as a primary prevention strategy for reducing infections, hospitalizations and deaths (7) .…”