Friday, Nov

Seasonal Diseases
18 2022 Newsletter IDEM Latam Insights:
Aline Bayon

Bi Weekly Newsletter – Nº 6
• Why is Brazil on the spotlight for COVID this week?
• Be aware for the “triple threat”
• What is a ‘tripledemic’?

PAHO
Countries must be
vigilant of “triple
threat” of COVID-19,
influenza and RSV as
holidays approach
November 16 2022

With an increase in COVID-19 infections in

the region, seasonal influenza on the rise,
November 11 : Influenza and COVID Sentinel Positivity Rate (line) and specimens positives (bar). Source: WHO
th

and a spike in cases of RSV, the Pan

American Health Organization Director,
Carissa F. Etienne, called on countries to
implement the tools proven to keep
communities safe, including vaccines,
surveillance, mask wearing and social
distancing, particularly in the run-up to the
festive period. “The rise of a single
respiratory infection is a cause for concern.
When two or three start impacting a
population concurrently, this should put us
all on alert,” she said during a media briefing
today.
Cases of COVID-19 have increased by 17%
in the region over the past week, and deaths
increased in South America and Central
America. A reduction in testing may be
hiding the true number of infections.
Meanwhile, cases of influenza in North
America are rising and an out-of-season
increase in cases in the Southern Cone is
also being seen, particularly in Argentina
and Uruguay, which is putting unexpected
stress on health systems.
RSV infections have also increased
significantly, burdening health systems in
Mexico, Brazil, Uruguay and the US, and
having a particular impact on children and
infants under the age of one.
Dr. Etienne highlighted that the strategies
used to limit the spread of COVID-19 also
apply to other respiratory diseases,
including RSV, for which there is currently
no vaccine. Countries must also strengthen
genomic surveillance of diseases and
continue to encourage vaccination against
COVID-19 and influenza.
As we head into the holiday season, people
must remain vigilant about all these health
threats and learn from the lessons of
COVID-19, Dr. Etienne said: “We have the
tools at our disposal to limit the impact of
severe respiratory diseases, and we must
continue to respond to these crises as a
region. Let’s not take these lessons for
granted.” Read full article: PAHO
WHO
Globally, influenza activity
increased and where subtyped,
influenza A(H3N2) viruses
predominated
An increasing trend of influenza activity was observed in
the northern hemisphere while a plateau was observed in
the southern hemisphere
NORTH AMERICA: Influenza activity is
low, but increasing in the subregion.
Influenza A(H3N2) predominated with the
co-circulation of influenza A(H1N1) and CENTRAL AMERICA: Influenza activity
influenza B. The SARS-CoV-2 activity was remained low but increased with
low overall, and RSV circulation continuedinfluenza A(H3N2) predominance and
to rise. In Mexico, influenza was at the co-circulation of influenza B. SARS-
moderate-intensity levels. In the United CoV-2 activity remained low in the
subregion overall. Influenza activity
States, influenza activity increased, with
A(H3N2) predominance. increased in Guatemala with A(H3N2)
predominance, and in Nicaragua
CARIBBEAN: Influenza activity remained increased with the circulation of
low across the subregion with A(H3N2) influenza B. RSV activity is increased in
virus predominance. Influenza activity is Costa Rica and El Salvador.
increasing in Jamaica and Puerto Rico.
The SARS-CoV-2 activity was raised in BRAZIL AND SOUTHERN CONE:
Dominica. Influenza activity increased in the
subregion, with influenza A(H3N2)
ANDEAN COUNTRIES: Influenza activity predominance and co-circulation of
remained low, with the predominance of influenza A(H1N1) and influenza B.
influenza A(H3N2) and co-circulation of SARS-CoV-2 activity has remained low
influenza B. Overall, SARS-CoV-2 and overall. Argentina, Chile, and Uruguay
RSV activity was low in the subregion. reported increased influenza activity,
However, Bolivia reported increased while RSV activity remains high in Brazil
influenza activity with co-circulation of and Uruguay.
A(H3N2) and B.

Page 1
 Friday, November 18, 2022 Seasonal Diseases IDEM Latam Insights

Percentage of respiratory specimens that tested

positive for influenza, by influenza transmission zone
October 11th 2022 Source: WHO

BBC
'Tripledemic': the 3 respiratory viruses that
crowd hospitals in the US and Latin
America
It is, according to experts, a much less serious This post is being occupied by the Influenza A virus, with two
phenomenon than the coronavirus pandemic, different variants that cause the so-called swine flu (which
which between December 2019 and this year generated its own pandemic in 2009-2010). The "triple combo" is
caused at least 6.5 million deaths worldwide, completed by the respiratory syncytial virus (RSV), one of the
according to the platform Our World In Data. most common infections in babies, which causes bronchiolitis and
Today, most people infected with covid have mild pneumonia.
symptoms, which do not require hospitalization.
All three viruses have similar symptoms: fever, congestion, cough,
However, the confluence of germs is generating headache, and sore throat.For most people, they pose a risk: just
what some call "tripledemic": three epidemics that a few days of bed rest and medication to treat the symptoms, if
coexist and have returned to crowding hospitals in necessary. But for those with more vulnerable immune systems
various parts of the American continent, especially — such as infants, the elderly, or those with risk factors — they
children's. According to the most recent can be dangerous. And when they all strike at the same time, they
epidemiological data from the Pan American can leave healthcare systems on the verge of collapse and create
Health Organization (PAHO), the most affected a problem of understaffing due to the number of people sick at the
countries in the region are the United States, in the same time. Read full article: BBC
northern hemisphere, and the southernmost
nations in the southern hemisphere — Argentina, When everything suggested that
Chile, Uruguay and Brazil. In these countries, there
is a combination of these three respiratory we could finally breathe a sigh of
diseases.
relief and leave behind the public
On the one hand, covid continues, with new
variants much less lethal than the original ones, but health crisis caused by covid-19, a
much more contagious. But the SARS-CoV-2
virus, which causes covid-19, is no longer the
new wave of respiratory viruses
predominant virus. returned to fill the pediatric wards
of hospitals in some countries.
On the News
Medscape Acumen Research News Medical
COVID POINT OF CARE COVID/TB
Paxlovid Cuts the Risk of Long COVID: VA Global POC testing market revenue is Study reveals neglected or late TB
Study estimated to reach USD 71.7 Bi by 2030 diagnoses related to COVID-19

Paxlovid, the antiviral drug designed to
reduce the risk of death and hospitalization
from COVID-19, may also help cut the
chances a person will develop long COVID, a
study by the U.S. Department of Veterans
Affairs shows. Read more
The Global Point of Care Testing Market
Size accounted for USD 33.7 Billion in
2021 and is projected to occupy a market
size of USD 71.7 Billion by 2030 growing
at a CAGR of 8.8% from 2022 to 2030.
Read more
In a recent study, researchers
modeled changing patterns in sex-
and age-stratified new and relapse
tuberculosis (TB) case notifications
reported to WHO for nations with high
TB, TB/HIV and MDR-TB burden
between 2013 and 2019 due to
SARS-CoV-2 infections. Read more

Page 2
 Friday, November 18, 2022 Seasonal Diseases
Folha, John Hopkin & Our World in Data
Fiocruz identifies new According to Felipe
researcher in public health at
Naveca,
variant of the Fiocruz and responsible for
sequencing and identifying the variant,
coronavirus in the BE.9 already corresponds to 94% of
samples sequenced in the region.
Amazon "What we saw was an increase in real
cases in the state and at the same time
the presence of a lineage with
mutations that increase the power of
transmission and escape of the
immune response, and which is
already in 94% of the samples . So we
are quite sure to say that it is
responsible for what is happening", he
said.
Like BQ.1, BE.9 carries a mutation
that can help it escape the action of
antibodies , which would make the so-
Fiocruz Amazônia has identified a new called vaccine escape cases
variant of the coronavirus that descends – infections in fully vaccinated
from omicron in the region, according to a individuals – more common.
note released last Saturday (12).
"We still don't know what the
As a result of the increase of Covid cases in magnitude of the new wave will be, if it
the state, especially in the capital, Fiocruz will be a 'wall', as it was with the
researchers analyzed more than 200 omicron at the beginning of the year,
samples of the virus between September or if it will be a smaller rise. But we will
and October and found the new strain , certainly have an effect in the coming
according to a note from the institute. weeks, and that's why we are closely
monitoring the scenario with
A new lineage of Sars-CoV-2 , BA.5.3.1, surveillance" he said.
had already been detected by researchers
at the institute since June of this year. The The researchers emphasize the
BE.9 variant regionally evolved from this importance of updating with the
lineage, as did another available booster and appeal to the
subvariant, BQ.1 . Differently, it has at least population to get vaccinated. "I am in
three mutations in the gene that encodes favor of a booster dose now, even if it
the S protein (from spike, the molecular is not with the updated vaccines that
hook used by the coronavirus to connect to contain the sublines, for this new
human cells). One of these alterations is in stimulated immunity that the vaccine
the so-called receptor-binding region – offers to protect against serious
something of concern because it is cases", says Naveca.
directly associated with the entry of the
virus into cells . For the time being, it is still not possible
to know whether BE.9 will reach
In the last month, the state of Amazonas the other regions of the country and
had a significant increase in the weekly how it will behave with BQ.1, its
moving average of cases, rising from 232, competitor, but the low reinforcement
between October 9th and 15th, to 1,258 coverage is worrying. "It's a different
until last Saturday. scenario, post-vaccine, we have that in
our favor, we don't expect a significant
increase in serious cases, but
obviously if there is an increase in
cases, we have to issue alerts", he
adds.
Read full article: Folha
Page 3
IDEM Latam Insights
John Hopkins
Region Update
LATAM: New cases rose 76%. New
cases rose in almost all of South
America including a 347% increase in
Brazil and 53% in Peru. Brazil cases are
surging in at least 4 states and
hospitalizations in Sao Paulo tripled last
week. South American countries are
preparing for COVID-19 to have multiple
peaks a year, and not a single peak like
flu.
US: New cases rose 2%. Daily new
cases rose 16% in 26 states plus Puerto
Rico, and fell in the remain 24 states.
The BQ.1 and BQ.1.1 subvariants are
now dominant at ~44% of US cases,
BA.5 fell to 29.7% of cases. Combined
Flu, COVID-19, and RSV cases are
straining ERs and pediatric hospital
capacity, some hospitals are delaying
non-urgent pediatric procedures.
EUROPE: Cases fell 4% in W Europe
(WE) and fell 17% in Central and
Eastern Europe (CEE). New cases
rose 63% in Italy. Cases rose in most
northern European countries for a
second straight week, potentially
signaling a winter wave. The ECDC
forecasts European cases to rise over
the next two weeks driven by Italy and
Spain. CEE health officials still expect a
winter wave starting by early December,
so far the wave has not yet developed.
ASIA: Infections rose 16% in Asia ex
China and rose 152% in China. New
cases rose in 11 of 15 countries that
reported over 100 new cases/day.
Japan had over 100,000 new cases on
November 15th after averaging
~30K/day a month ago. South Korea
cases rose 18% as the current wave
reached 5 weeks. New cases rose 89%
in India but from very low levels.