Brazil has first death from swine flu in the year – 06/23/2023 – Health

The first death from swine flu in Brazil in 2023 was confirmed by Fiocruz (Oswaldo Cruz Foundation) on Wednesday (21).

Swine flu is caused by the influenza A (H1N1) virus, which normally circulates among pigs and occasionally can infect humans.

The victim, a 42-year-old woman, was a resident of Toledo, Paraná, and according to information released by Fiocruz, had been diagnosed with cancer —which contributes to lower immunity and more susceptible to the effects of the virus— and lived close to a pig farm.

In a technical note, the WHO (World Health Organization) describes that, at the moment, there is no reason for the condition to represent a risk of an outbreak of the disease.

“Based on currently available information, WHO considers this a sporadic case with no evidence of person-to-person transmission. The likelihood of human-to-human community spread and/or human-to-human spread of the disease is low.”

The WHO note also points out that, although the victim had no direct contact with the animals, two of his close contacts of the victim worked at the pig farm.

“The two contacts did not develop respiratory illness and tested negative for influenza. To date, no human-to-human transmission associated with this case has been identified.”

In a note sent to the American CNN, Kathleen Conley, spokesperson for the CDC (United States Center for Disease Control and Prevention), said that the agency will test samples from the Brazilian to confirm the infection and to verify if there were mutations in relation to previous cases that may have made the virus more transmissible or dangerous.

“The CDC’s #1 priority is to confirm that the patient has been infected with the influenza A (H1N1) virus,” Conley told CNN. “If virus isolation is successful, further virological detailing can be conducted.”

The victim’s clinical condition

Fiocruz reports that, on May 1, the resident of Toledo had a fever, headache, sore throat and abdominal pain. Two days later, the condition evolved into a severe acute respiratory infection and she had to be hospitalized.

On day 4, the patient was transferred to an Intensive Care Unit (ICU), but could not resist and died the next day.

Diagnosis was confirmed through a nasopharyngeal swab sample collected during hospitalization. The exam, carried out by LACEN (Central Public Health Laboratory) of Paraná, detected that it was an influenza A/H1 virus.

It was then confirmed that it was an influenza A(H1N1) virus with a high rate of identity with viruses collected from pigs in Brazil in 2015.

Celso Granato, infectologist and clinical director of Grupo Fleury, explains that women’s health characteristics make them more susceptible to the effects of the virus.

“The mere fact of being an oncology patient already indicates weakness in the immune system. If this same virus would cause serious effects in a person who is immunocompetent [sem doenças que prejudicam a imunidade]is something we don’t know.”

The forms of transmission of swine flu and its effects on the body

When humans are infected with influenza viruses that normally circulate among pigs, this virus is called a “variant virus” and is designated by the letter “v”. In the case in question, influenza A(H1N1)v.

H1N1, H1N2, and H3N2 viruses of porcine origin occasionally infect humans, usually after direct or indirect exposure to contaminated swine or environments.

According to Fiocruz, this is the first human infection caused by the influenza A(H1N1)v virus reported in 2023 in Brazil, and the third human infection reported in the state of Paraná (the first was in 2021 and the second in 2022) .

As Granato explains, the fact that human beings are part of the mammalian group — just like pigs — contributes to direct transmission.

“This virus can be transmitted to humans quite easily, unlike avian flu, which is much more difficult because it is a species with biological characteristics that are more different from ours.”

Transmission, explains the doctor, is done mainly through infected droplets released into the air, and eventually through contact with animal feces.

“But pork, cooked or fried, no longer has an active virus. The biggest risk is for the caretakers of these pigs, who have direct contact.”

The symptoms of the infection resemble those caused by other respiratory infections: they include a runny nose, sore throat, cough, difficulty breathing.

“The porcine variant, by the way, usually results in milder symptoms for humans. However, people from risk groups, such as the elderly, small children [nas quais o sistema ainda não está totalmente completo]and people with comorbidities, as was the case of the patient who died, are more likely to have serious conditions”, explains Vanessa Strelow, an infectologist at Hospital São Vicente, in Curitiba, Paraná.

For an accurate diagnosis, Strelow reinforces the importance of the PCR test (done by nasal swab), which is capable of determining which virus the person was infected with.

“This care taken by health professionals when noticing symptoms is essential, as a quick test would not detect them. We have good surveillance in Brazil, which constantly monitors the behavior and presence of viruses in the territories and allows us to know what it is when there is a case outside the curve, like this one with the swine flu.”

There is no specific vaccine that protects against swine flu. The trivalent Influenza vaccine, offered free of charge at health units, is updated every year considering the most prevalent strains.

The 2023 version is composed of two influenza A virus strains (H1N1 and H3N2) and one type B strain (Victoria lineage).

“It won’t protect against all swine flu, but being immunized against the viruses that we are most at risk of coming into contact with is already a big step”, says Granato.

In a confirmed case of swine flu infection, explains the doctor, it is best to start treating it soon, before the virus spreads through the body.

“The good news is that strains of the flu virus have been fought with relative ease with a generic drug that appeared in 2009 and changed the picture of the disease – oseltamivir phosphate [disponível na farmácia popular].”