Recently, the brunt of the current influenza pandemic has been felt in the southern hemisphere. We report an analysis of the first 34,506 cases of influenza-like illness with severe acute respiratory infection (SARI) notified in Brazil during the epidemiological weeks 16 to 33. The 5,747 confirmed cases of pandemic H1N1 influenza showed two incidence peaks across the age span: one in children up to the age of five years (3.8/100,000) and one in individuals aged 20 to 29 years (4.6/100,000). People over the age of 60 had the lowest incidence (1.1/100,000 inhabitants). The epidemic peaked rapidly. Ninety-four percent of cases were concentrated in two of Brazil s five geographic regions - the south and southeast, regions that have a more temperate climate and thus colder winters. Case-fatality of pandemic influenza presenting with SARI was 11.2% (95% confidence interval (CI): 10.4%-12.1%). People with a reported comorbidity had approximately twice the risk of those without (relative risk=1.89; 95%CI: 1.64-2.18).