Investigation of an outbreak of acute respiratory disease in an indigenous village in Brazil: Contribution of Influenza A(H1N1) pdm09 and human respiratory syncytial viruses
Investigation of an outbreak of acute respiratory disease in an indigenous village in Brazil: Contribution of Influenza A(H1N1) pdm09 and human respiratory syncytial viruses
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DOI：
10.1371/journal.pone.0218925
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发表时间：
2019-07-08
期刊：
影响因子：
3.7
通讯作者：
Siqueira, Marilda M.
中科院分区：
文献类型：
--
作者：
Cardoso, Andrey Moreira;Resende, Paola Cristina;Siqueira, Marilda M.
对2009年H1N1流感大流行和大流行后年份的分析表明，土著人口的发病率和严重性都很高。这项研究介绍了2016年3月30日至4月14日在巴西东南部地区瓜拉尼村爆发的第一起有记录的巴西土著人民流感疫情的特点。对急性呼吸道感染进行前瞻性调查。73例中以流感样疾病(ILI)(63.0%)或严重急性呼吸道感染(SAI)(20.5%)居多。ILI+SARI发病率(35.9%)随年龄增长而下降。流感疫苗接种率较高(86.3%)，但重症与非重症之间的疫苗接种率差异无统计学意义(p=0.334)。对19.2%的病例进行的分子分析显示，甲型H1N1流感病毒pdm09和/或HRSV 100%阳性。甲型H1N1流感病毒pdm09属于6B.1基因群，这是一个独特的簇，具有A/California/07/2009-like的13个氨基酸替换。HRSV均聚在类BA遗传群中。流感季节的提前到来与通常的HRSV季节重叠，疫苗未覆盖的漂移流感病毒的传播，以及该村感染危险因素和严重程度的高流行，共同解释了即使接种流感疫苗的比率很高，ARI的发病率也很高。这些结果加强了监测呼吸道病毒、及时接种疫苗和控制土著人口感染风险因素和严重程度的重要性，以预防疾病和相关死亡，特别是儿童。
Analyses of the 2009 H1N1 influenza pandemic and post-pandemic years showed high attack rates and severity among indigenous populations. This study presents the characteristics of the first documented influenza outbreak in indigenous peoples in Brazil, that occurred from 30th March to 14th April 2016 in a Guarani village in Southeast Region. Acute respiratory infections were prospectively investigated. The majority of the 73 cases were influenza-like illness (ILI) (63.0%) or severe acute respiratory infection (SARI) (20.5%). The ILI+SARI attack rate (35.9%) decreased with increasing age. There was a high influenza vaccination rate (86.3%), but no statistically significant difference in vaccination rates between severe and non-severe cases was seen (p = 0.334). Molecular analyses of 19.2% of the cases showed 100% positivity for influenza A(H1N1)pdm09 and/or hRSV. Influenza A (H1N1)pdm09 was included in the 6B.1 genetic group, a distinct cluster with 13 amino acid substitutions of A/California/07/2009-like. The hRSV were clustered in the BA-like genetic group. The early arrival of the influenza season overlapping usual hRSV season, the circulation of a drifted influenza virus not covered by vaccine and the high prevalence of risk factors for infection and severity in the village jointly can explain the high attack rate of ARI, even with a high rate of influenza vaccination. The results reinforce the importance of surveillance of respiratory viruses, timely vaccination and controlling risk factors for infection and severity of in the indigenous populations in order to preventing disease and related deaths, particularly in children.