Global Influenza Hospital-based Surveillance Network (GIHSN): results of surveillance of influenza and other respiratory viruses in hospitalised patients in Brazil, 2015

BMJ Open. 2018 Feb 15;8(2):e017603. doi: 10.1136/bmjopen-2017-017603.

Abstract

Background: Influenza-like illness occurs annually worldwide, with peak timing and severity varying seasonally, resulting in significant annual mortality.

Objectives: There were three objectives: (1) to describe the epidemiological and clinical features of hospitalised patients with severe acute respiratory infection caused by influenza and other respiratory viruses (ORVs); (2) to report the influenza seasonality in the region and (3) to correlate findings of influenza circulation and immunisation time in Brazil.

Patients/methods: This study took place in three Brazilian hospitals located in cities with different climatic conditions (Curitiba (south), Rio de Janeiro (south-east) and Fortaleza (north-east)). Patients presenting with an acute process with indication for admission consisting of a predefined set of conditions potentially associated with recent influenza infection were enrolled.

Results: We screened 1666 patients, with 595 meeting the inclusion criteria. Influenza viruses and ORVs were detected in 6.5% and 59% of patients, respectively. Influenza-positive cases fell into the severe spectrum as compared with those with ORVs (30% vs 11%), but without any difference in mortality rates. Epidemiological results revealed variations in the peak time of influenza infections between north-east (Fortaleza) and south (Curitiba) Brazil, basically following the rain period of each region. In north-east Brazil, viral circulation was prevalent in the first 4 months of the year, indicating that the vaccination campaign occurred in a postseasonal period, possibly explaining the low effectiveness.

Conclusions: The active-surveillance model is a valuable tool for investigating respiratory virus impact on hospitalised patients, with influenza-infection monitoring enabling implementation of adequate preventive measures.

Keywords: hospital admissions; influenza; seasonality; severe acute respiratory infection; vaccination; viral respiratory infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Cities
  • Climate*
  • Female
  • Hospitalization*
  • Hospitals*
  • Humans
  • Immunization Programs
  • Infant
  • Influenza Vaccines*
  • Influenza, Human / epidemiology*
  • Influenza, Human / prevention & control
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Population Surveillance / methods
  • Prevalence
  • Respiratory Tract Infections
  • Seasons*
  • Vaccination*
  • Young Adult

Substances

  • Influenza Vaccines