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The number of cases of respiratory infections in Latin America this season seems to be a sign that the COVID-19 pandemic is definitely ending. These infections are on the rise and have reached pre-pandemic levels, which has prompted the Pan American Health Organization (PAHO) to to issue an alert for countries to closely monitor this increase and act to prevent them.

The end of lockdown policies and the reduced use of facemasks, two measures that suppressed not only the coronavirus but other germs as well, has caused these viruses to return to pre-pandemic levels of circulation, experts say.

However, while COVID-19 circulation levels remain low, circulation levels of influenza and respiratory syncytial virus (RSV) have risen once again, especially in the southern part of the region. This health situation mirrors what has happened in the northern hemisphere, where there have been more cases of influenza and more hospitalizations due to RSV.

Every year in Latin America and the Caribbean, there are some 36,500 deaths and 400,000 hospitalizations due to seasonal influenza.

Since the 2009 influenza A (H1N1) outbreak, countries in the region have significantly improved their control and prevention of seasonal influenza. However, PAHO emphasized in its alert that governments must now reinforce their monitoring systems and vaccination campaigns to curb this increased circulation.

The region has one of the highest overall immunization rates in the world, but there are major differences between countries and even within countries, between large cities and remote rural areas.

The challenge for governments is to find the ideal time to launch a vaccination campaign, against a virus that mutates every year and whose impact lasts several months (from November to February in the northern hemisphere and from May to October in the southern hemisphere).

The Centers for Disease Control and Prevention (CDC) recommends influenza vaccination starting at six months of age. The CDC notes that some children between that age and eight years old may need two doses for greater protection.

Beyond this, there are still key barriers to overcome, depending on the area:

• Vaccine mismatch with circulating strains. 
• Misconceptions about the efficacy of the influenza vaccine. 
• Lack of awareness of the disease and the vaccine among the public. 
• In the case of RSV, there were more child cases with hospitalizations in the south of the continent, especially in Chile.

The United States has just approved the first vaccine against this virus for older adults; RSV causes the death of more than 6,000 people aged 60 years and older in the U.S.

Among adults, the incidence of illness and death associated with this virus increases with advancing age and the prevalence of coexisting conditions. The epidemiological evidence indicates that the impact of RSV in older adults may be similar to that of non-pandemic influenza.

In January, the CDC reported the risk of intense circulation of five families of respiratory viruses on the continent: coronavirus, human metapneumovirus, human parainfluenza virus, respiratory syncytial virus (RSV), and respiratory adenovirus. 

This story was produced using content from original studies and reports and from other medical research, as well as healthcare and public health sources, highlighted in related links throughout the article.