Achievements and Future
Challenges in the surveillance of
Respiratory Viruses
San Jose, Costa Rica, 29-30th Jan,2013
• RSV Surveillance in Brazil
•
Marilda M Siqueira –NIC/FIOCRUZ/Rio de Janeiro
OUTLINE
RSV DATA from Research Studies in Brazil
RSV DATA from Influenza Surveillance-20012012
IMPROVING INFLUENZA AND OTHER
RESPIRATORY VIRUSES SURVEILLANCE
RSV DATA from Research Studies in Brazil
Rio Grande do Sul State(South)
Straliotto, et al Rev Soc Bras Med Trop. 2002 Jul-Aug;35(4):283-91.
Straliotto, et al Rev Soc Bras Med Trop. 2002 Jul-Aug;35(4):283-91.
Rio de Janeiro City (Southeasthern)
Peak at weeks 15 and 35 (from autumn to winter)
Nascimento JP et al., Rev Inst Med Trop Sao Paulo. 1991 Jul-Aug;33(4):287-96.
Ribeirão Preto, SP (Southeasthern)
Cintra et a., J Med Virol. 2001 Oct;65(2):408-12.
Salvador, BA (Northeastern)
Moura et al. Mem Inst Oswaldo Cruz. 2003 Sep;98(6):739-43.
Fortaleza, CE (Northeasthern)
Moura et al., 2006,
Am J Trop Med Hyg. 2006 Jan;74(1):165-7.
RSV DATA from Influenza Surveillance
Background
1999-introduction of Flu Vaccine by MoH
Sentinel surveillance - ILI
Implemented in 2000- LabNet: IFAT
• 2000 to 2011 – 59 sentinel units-
Influenza Surveillance
UNTIL 2011
Restricted to viral circulation
Irregular and heterogeneous
Provided restricted information for Surveillance and
Control Measures for Influenza and other respiratory
viruses.
We needed
More samples, representativeness, virulence, subtyping
Guide antiviral treatment
Capacity to identify new viral subtype
IMPROVING INFLUENZA AND OTHER
RESPIRATORY VIRUSES SURVEILLANCE
New organization - influenza surveillance system in Brazil
Sentinels Units (SU) - 79 Municipalities
319 SU (ILI + SARI)
150 SU SARI
INFLUENZA LAB NET BRAZIL
2000-2009-IFAT
2009-2012- 13 StateLabs:rtPCR
REGIONAL REFERENCE LABORATORY
INSTITUTO EVANDRO CHAGAS- IEC/PA
: AP, AC, RR, AM,CE,PA,PB,PE,RN, MA e MS
NATIONAL REFERENCE LABORATORY
FUNDAÇÃO OSWALDO CRUZ -FIOCRUZ/RJ
AL, BA, ES, PR,RJ, RS, SC ,SE,MG
REGIONAL REFERENCE LABORATORY
INSTITUTO ADOLFO LUTZ – IAL/SP
:GO, DF, MT, PI, SP, RO e TO
State Central Laboratories - LACEN
New organization - influenza surveillance system in Brazil
 Training
 Health
Professionals
surveillance
 1,000 health professionals
 Methodoly – ONLINE
 Nationwide
about
influenza
SIVEP_GRIPE (ILI)
Distribuition the Positive Samples by IIF for age in Sentinels
Units. Brazil, EW -1 - 52/ 2012.
N = 1,391
AGE
60 +
34,4
25 - 59
0,04,9
37,7
15 - 24
8,2
9,3
44,5
5 - 14
10,0
0,0
7,2
2,2 5,1 1,2 7,5
10,0
20,0
23,0
5,1 4,5 3,9
13,3
35,9
0-4
4,9
22,6
2,92,3 5,2
6,5 2,0 3,9
16,9
19,1
28,8
19,5
30,0
24,6
12,7
15,7
54,5
40,0
50,0
60,0
70,0
80,0
90,0
% CASES POSITIVES SAMPLES
Influenza A
Fonte: SIVEP Gripe/SVS/MS.
Influenza B
Parainfluenza 1
Parainfluenza 2
Parainfluenza 3
Adenovírus
VRS
100,0
SIVEP_GRIPE (ILI)
Distribution the Positive Samples for Respiratory Viruses
(Sentinels Units) Brazil, EW 01- 52/ 2012.
N = 1,391
70
100
80
50
60
40
30
40
20
20
10
0
0
1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031323334353637383940414243444546474849505152
EW
Influenza A
Fonte: SIVEP Gripe/SVS/MS.
Influenza B
Parainfluenza 1
Parainfluenza 2
Parainfluenza 3
Adenovírus
VRS
% amostras positivas
%
Number Positive Samples
60
RSV in SARI cases-RS State,South
500
48
45
450
42
400
39
Número de vírus
36
350
33
30
300
27
250
24
21
200
18
15
150
12
100
9
6
50
3
0
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
VSR
Total de amostras/S.E.
20
20
100
100
90
90
80
80
15
15
N of RSV
70
70
% Positividade
N de VRS
RSV identified by IFAT in Sentinel Units
NORTH Region 2008 - 2012
%
Positividty
60
60
10
10
50
50
40
40
30
30
55
20
20
10
10
00
00
13 19
19 25
25 31
31 37
37 43
43 49
49 22 88 14
14 20
20 26
2632
32 38
3844
44 50
50 44 10
10 16
1622
22 28
28 34
34 40
4046
46 52
52 66 12
12 18
1824
24 30
3036
36 42
42 48
48 22 88 14
14 20
2026
26 32
3238
3844
44 50
50
11 77 13
2008
2008
2009
2009
RSV
VRS
Sivep_Gripe/CGDT/DEVEP/SVS/MS
Source
Fonte: Sivep_Gripe/CGDT/DEVEP/SVS/MS
2010
2010
2011
2011
%Positividade
Positivity for
RV vírus respiratório
%
praany
qualquer
2012
2012
Yeare and
Ano
SE EW
RSV identified by IFAT in Sentinel Units
NORTHEAST Region 2008 - 2012
20
100
90
%
80 Positivity
15
70
N of RSV
60
10
50
40
30
5
20
10
0
0
1 7 13 19 25 31 37 43 49 2 8 14 20 26 32 38 44 50 4 10 16 22 28 34 40 46 52 6 12 18 24 30 36 42 48 2 8 14 20 26 32 38 44 50
2008
2009
2010
2011
2012
Ano e SE
VRS
Fonte:Sivep_Gripe/CGDT/DEVEP/SVS/MS
% Positividades para qaulquer vírus respiratório
25
100
90
20
80
70
15
60
50
10
40
30
5
20
10
0
0
1 7 13 19 25 31 37 43 49 2 8 14 20 26 32 38 44 50 4 10 16 22 28 34 40 46 52 6 12 18 24 30 36 42 48 2 8 14 20 26 32 38 44 50
2008
2009
2010
2011
2012
Ano e SE
VRS
Fonte: Sivep_Gripe/CGDT/DEVEP/SVS/MS
% Positividade para qualuqer vírus respiratório
% Positividade
N de VRS
RSV identified by IFAT in Sentinel Units
SOUTHEAST Region 2008 - 2012
PILOT SURVEILLANCE in Belo Horizonte City
Respiratory Viruses by age Group
Belo Horizonte,2012
150
150
150
140
140
140
130
130
130
120
120
120
110
110
100110
100
100
90
90
90
80
80
80
70
70
6070
60
60
50
50
50
40
40
40
30
30
2030
20
20
10
10
010
00
n = 364
nn = 364
364
menor 1
<menor
1
1
1a4
11 a 4
4a
5a9
55aa 99
10 a 14
15 a 19
20 a 39
40 a 59
mais 60
10
15
60
10aa 14
14
15aa 19
19 20
20aa 39
39 40
40aa 59
59 mais
mais 60
Faixa Etária
Faixa Etária
Age
Group
A não subtipado
AAnot
não typed
subtipado
A(H1N1)2009
A(H1N1)2009
A(H1N1)2009
A(H3N2)
A(H3N2)
A(H3N2)
Flu B
Flu
Flu B
B
Adeno
Adeno
Adeno
Para 1
Para
Para11
Para2
Para2
Para2
Para3
Para3
Para3
VSR
VSR
VSR
Acknowledgements
•
•
•
•
•
•
Walquíria Almeida-MoH Brazil
Líbia O Souza- MoH Brazil
Thiago Moreno Souza- NIC/FIOCRUZ
Sirlene Pereira-MoH Brazil
Tatiana Gregianini- LACEN RS
Maria do Carmo Debur-LACEN PR