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FINLAY ALBARRAN
MEDICAL INSTITUTE
INFLUENZA (02): PAN AMERICAN HEALTH ORGANIZATION UPDATE
Date: 17 Aug 2010 Source: The Pan American Health Organization (PAHO) [edited] <http://new.paho.org/hq/index.php?option=com_content&task=view&id=2929&Itemid=2295&lang=en>
Weekly Summary
-- In the Southern Cone, RSV was the predominant virus circulating; however, influenza B and influenza A/H3 virus have also been detected. Paraguay reported high influenza-like illness (ILI) activity in 3 of 5 regions.
-- In the Andean sub-region, Peru reported an increasing trend in acute respiratory disease. Bolivia reported a steady increase of pandemic influenza A H1N1 cases in epidemiological week (EW) 26-31.
-- Circulation of respiratory viruses was variable in Central America. Influenza A/H3 virus was predominant in Panama, Honduras and Costa Rica. Influenza B was predominant in Nicaragua. El Salvador reported high intensity of acute respiratory disease and moderate impact of acute respiratory disease on the health care services.
-- The Caribbean reported low influenza activity, but increased circulation of influenza A/H3 virus in some countries (Cuba, Dominican Republic).
-- In North America, influenza activity remained low; mostly influenza A/H3 virus (United States) was detected.
I - Influenza surveillance
South America - Southern Cone
Influenza activity was reported as regional in Brazil and Chile. The trends in acute respiratory disease were reported as unchanged in both countries.
In Chile, in epidemiological week (EW) 31, nationally, influenza-like illness (ILI) activity continued to be low, and was similar to the previous week, remaining in the security zone of the endemic channel. At the regional level, the highest rates of ILI activity were in the regions of Tarapaca, Los Rios and Los Lagos. The proportion of consultations in emergency services for respiratory illness of the total number of consultations remained similar to the previous week, after 2 prior consecutive EW of decreasing trends.
In EW 31, Paraguay, nationally, reported a decrease of 6.2% percent in ILI outpatient consultations as compared to the previous EW. At the regional level, in 3 regions (North, Oriental Center and Chaco) the ILI activity was above their epidemic threshold, while in the remaining 2 regions, activity was within the epidemiological alert zone of the endemic channel. Severe acute respiratory infection (SARI) activity in children under 5 years of age remained lower as compared to the same week of 2009 and 2008.
Viral circulation: In EW 31 in Chile, 73 percent of positive specimens were respiratory syncytial virus (RSV) and 12 percent were parainfluenza virus. In Chile, influenza B (recently increasing), pandemic influenza A H1N1 2009 and seasonal influenza A/H3 were also identified. During EW 30-31 Paraguay reported circulation of influenza B, RSV, parainfluenza virus and the new circulation of seasonal influenza A/H3, which had not previously been identified during 2010.
South America - Andean
In EW 31, influenza activity was reported as widespread in Bolivia (6 of 9 departments reported positive influenza cases) and regional in Colombia and Peru. Peru reported increasing trends of acute respiratory disease, while Bolivia and Colombia reported decreasing and unchanged trends, respectively.
In EW 31, Bolivia3 reported, at the national level, a slight decrease in the number of acute respiratory illness (ARI) cases as compared to the previous week, remaining below the epidemic threshold. Regionally, in EWs 30-31, no departments were above their epidemic thresholds for ARI, while in EW 29, 2 departments were above the epidemic threshold.
Bolivia reported a steady increase in the number of pandemic influenza A H1N1 2009 cases between EWs 26-31; circulation of influenza B during the year 2010 has also been reported. Colombia continues to report a predominance of pandemic influenza and some seasonal influenza A/H3 activity.
Central America
Influenza activity was reported as regional in Panama, localized in El Salvador, and with no activity in Honduras. Honduras reported an unchanged trend in acute respiratory disease, while El Salvador and Panama reported decreasing trends this week. El Salvador reported high intensity of acute respiratory disease and moderate impact of acute respiratory disease on health care services.
In EW 31, Panama reported a decreasing trend of ILI activity in the national level.
Circulation of respiratory viruses is variable in Central America. In Costa Rica, in 2010, a mix of parainfluenza, adenovirus, RSV, and influenza have circulated. Until EW 28, in Costa Rica, the predominant influenza virus was the pandemic virus, however since then, it has been predominantly H3N2. In Honduras, in 2010, a mix of parainfluenza, adenovirus, RSV, and influenza have circulated. Until EW 26, in Honduras, among influenza viruses, a combination of influenza B and pandemic virus were circulating, since then, however, it has been predominantly H3N2. In Panama, until EW 22, very few respiratory viruses were detected. Since then, however, the predominant virus circulating has been influenza A/H3N2.
Caribbean
Influenza activity was reported as widespread in Jamaica, regional in Barbados and with no activity in Dominica and Dominican Republic. Trends of acute respiratory disease were reported as unchanged in all these countries. These countries reported low/moderate intensity of acute respiratory disease, and low impact of acute respiratory disease on health care services.
CAREC [Participating CAREC member countries, which include, Barbados, Dominica, Jamaica, St Vincent and the Grenadines, and Trinidad and Tobago, were assessed together], from EW 25-31, reported a continued decreasing trend in the proportion of admissions for SARI out of the total hospitalizations (59 and 11.5 SARI admissions per 1000 admissions, in EW 25 and 31, respectively).
The circulation of respiratory viruses is variable in the Caribbean. CAREC reported the predominance of influenza B virus since EW 18, but RSV and pandemic influenza have also been reported. In Cuba, in 2010, the predominant respiratory virus in circulation has been pandemic influenza. Since EW 30, some cases of influenza A/H3N2 have also been reported in Cuba. In Dominican Republic, in 2010, many respiratory viruses have co-circulated (adenovirus, RSV, parainfluenza, and influenza B), but since EW 27, influenza A/H3N2 has also been detected.
North America
Influenza activity remains low in this region. The trends in acute respiratory disease were reported as unchanged in the United States.
In the United States in epidemiologic week (EW) 31, the proportion of outpatient consultations for influenza-like illness (ILI) continued to remain below the national baseline. All the sub-national surveillance regions reported the proportion of ILI to be below their region-specific baselines. The proportion of deaths attributed to pneumonia and influenza was below the epidemic threshold. No influenza-associated pediatric deaths were reported this week.
The percentage of specimens testing positive for influenza in Mexico and the United States remained low. Seasonal influenza A/H3 was isolated in the United States. In Mexico, in 2010, until EW 13, the primary respiratory virus circulating was the pandemic virus. Since then, however, there has been little respiratory virus detection.
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