Tiago Queiroz/Estadão

Dengue fever: high incidence and mortality in Brazil; Climate change makes viruses spread even in winter – Side – Estadao

Regardless of the season of the year, measures to fight dengue fever It must be maintained on an ongoing basis. Although the period known to have the highest transmission rate is between November and May, climate change has increased the risks of vector mosquitoes even in other seasons of the year. Between January 2 and June 18, 2022, according to the latest epidemiological bulletin of Ministry of Healthwas registered 1,172,882 cases in dengue fever In Brazil, the number of registered notifications has doubled over the entire past year: 534,743.

Until the last balance is confirmed 585 deaths – More than 130% increase compared to 246 deaths It was counted in 2021. Among the states that provided the highest number are: Sao Paulo (200), Santa Catarina (66), Parana (60), Rio Grande do Sul (57) and Goiás (55).

“Dengue cases are exploding. We already have more deaths, in just six months, than those recorded throughout the whole of last year. We are witnessing one of the worst epidemics of the disease. And there are fears of a worse scenario than those recorded in 2015, when there was One of the worst epidemics of the disease, with 986 deaths,” assesses infectious disease doctor Alexander Nayemi Barbosa, Vice President Brazilian Society of Infectious Diseases (SBI) and Professor at São Paulo State University (Unesp).

although Aedes aegypti They do not live long in low temperatures – unlike summer, when the life cycle reaches 60 days – eggs and larvae deposited in the water remain alive, able to grow and form new mosquitoes with arrival. Of the hot weeks, at any time of the year.

to me Ministry of Health, the period of the year with the highest transmission rate occurs in the wettest months in each region, usually from November to May. The accumulation of stagnant water contributes to the spread of mosquitoes, thus increasing the spread of disease. However, in years when it is rainy like 2022, the number of cases also tends to increase if control measures are not maintained.

“We had two factors. The whole issue is rain, but at the beginning of winter, in the southeast and south, for example, it was very hot. Weeks with temperatures. That is, Climate change is increasing temperature and increasing precipitation, providing an ideal condition for the spread of disease vectorsBarbosa notes.

The emergence of other diseases such as COVID-19tends to reduce the number of awareness campaigns, as well as provoke a relaxation of preventive measures by the population themselves.

“People end up relaxing more in terms of control measures to combat the disease. This lack of continuous awareness measures by the authorities and mitigating the impact of the population on the increase in cases. It should be resumed as soon as possible. . Genotype 2, which has not been circulated for a while. , which is different from the 2015 epidemic, in this way people are more susceptible to contracting the virus,” adds an infectious disease doctor at Universidade Estadual Paulista (Unesp). ).

São Paulo is the state with the highest number of deaths in Brazil

The number of deaths due to dengue fever in the country is the highest State of Sao Paulo It records 292,100 dengue cases and 250 deaths as of August 2022, which is a really high number compared to the data recorded up to June by the Ministry of Health. In 2021, there were 145,800 cases and 71 deaths throughout the year.

According to the Arizona Department of Health Sao PauloThe five cities with the highest number of deaths from the disease so far are: Araraquara (17), Franca (14), Santa Bárbara d’Oeste (13), São José do Rio Preto (7) and Americana (7).

To help fight the disease, the Sao Paulo government is investing R$10.7 million to support municipalities in the fight against dengue fever, Zika virus and chikungunya. “291 beneficiary municipalities were selected based on epidemiological and entomological indicators. The resources will be used in measures to control the spread of vector mosquitoes and to monitor reported cases,” he said in a note.

The secretary adds that the fight against mosquitoes Aedes aegypti It is an ongoing and collective task, and it is up to the municipalities to do field work to combat the dengue vector.

The dangers in the Cerrado

as shown stadiuma study by scientists from Universidade Estadual Paulista (Unesp), published in the scientific journal PlusProve That The progress of the destruction of the Cerrado is directly related to the increase in the number of dengue cases in the region. The work shows that if the pace of deforestation continues similar to the current one, without specific and rational public policy, in 2030 the entire Cerrado region will experience a significant increase in cases of mosquito-borne disease.

a Minas Gerais is the state of greatest concern. From 2,200 cases per 100,000 inhabitants, disease records will rise to 4,000 per 100,000 inhabitants. Scientists warn that to prevent deforestation, the country will have to control deforestation and adopt new environmental and public health policies.

Acute febrile infectious disease caused by a virus belongs to the family flaviveredifrom a kind of flavivirusDengue virus has four serotypes, which are generally called DENV-1And the DENV-2And the DENV-3 And the DENV-4. In general, symptoms of dengue fever appear from the third day after the insect bite with an average of five to six days.

It is transmitted by female mosquitoes Aedes aegypti (when infected with the virus) and can cause both the classic appearance of the disease and the form that is considered hemorrhagic, according to the Oswaldo Cruz Foundation (Vocruz).

Dengue fever symptoms

The disease can be asymptomatic or it can progress to more serious conditions, such as bleeding and shock. In classic dengue, the first manifestation is a high fever (39° to 40°C) and sudden onset, usually followed by headache or eye pain, musculoskeletal fatigue or aches, decreased appetite, nausea, dizziness, and vomiting, and a rash (similar to German measles). The disease lasts from five to seven days (maximum 10 days), but the recovery period may be accompanied by significant physical weakness and may last for several weeks.

Main symptoms:

  • A high temperature above 39 degrees
  • Body and joint pain
  • Pain behind the eyes
  • malaise
  • lack of appetite
  • Headache
  • Red spots on the body
  • Gradual increase in hematocrit (a measure of the percentage of red blood cells in the blood)

Regarding the most dangerous form of the disease known as Dengue Hemorrhagic FeverThe initial symptoms are similar, but the condition worsens on the third or fourth day of development, with hemorrhagic manifestations and circulatory collapse.

“In severe cases, shock usually occurs between the third and seventh day of illness, and is usually preceded by abdominal pain. Shock results from increased vascular permeability, followed by hemoconcentration and circulatory failure. Some patients may also have neurological manifestations, such as convulsions and irritability. ‘ Vucruz warns.

When a person is infected with one of the four serotypes, they become immune to all types of viruses for a few months and then remain immune for the rest of their life from the type they contracted.

However, if you catch dengue fever again, one of the three other types of viruses you haven’t had yet, It may or may not present a more serious form. Most cases of dengue hemorrhagic fever occur in people previously infected with one of the four types of viruses.

Pregnant women, children and the elderly are more likely to develop complications from the disease. The risk increases when an individual has a chronic disease such as bronchial asthma, diabetes, sickle cell anemia and high blood pressure, in addition to previous infections with other serotypes of dengue fever, according to the Ministry of Health.

The dengue fever It is the most common arthropod virus in urban areas of the Americas, especially in Brazil.

Warning signs of illness

  • Severe and persistent abdominal pain
  • continuous vomiting
  • Fluid buildup (ascites, pleural effusion, pericardial effusion)
  • Postural hypotension and/or hypotriglyceridemia (loss of consciousness)
  • Lethargy and/or irritability
  • mucous membrane bleeding

To date, there is no effective treatment against the dengue virus. Treatment is based on analgesics and antipyretics and can be done at home with guidance to return to the health service. Comfort must be maintained. Dengue hemorrhagic fever is treated from admission to hospital.

Dengue fever vaccine

A quadrivalent vaccine, that is, a vaccine that immunizes the population against the four types of dengue virus, is not yet available for widespread application.

In the private network, only the vaccine is available DengvaxiaMade by a French laboratory Sanofi Pasteur. Despite protection from the four dengue serotypes and prevention of severe cases of the disease, Dengvaxia is not prescribed to people who have never had contact with the dengue virus.

“Clinical trials have shown that people who have never been exposed to dengue virus, after vaccination, have a higher chance of complications and hospitalization for traditional forms of dengue, and for this reason, the recommendation is only for those who have had contact or exposure to dengue virus in the age group between 9 and 45 years old,” says Carolina Barreto Marinho, member of the scientific division of immunization at the Brazilian Society of Allergy and Immunology (Asbai).

In addition, since it is an attenuated vaccine, consisting of four live dengue virus serotypes, it is also contraindicated for pregnant and lactating women, people with severe allergic reactions to the components of the vaccination, and people with immunodeficiency.

Check out some prevention tips

  • Fill the plant pot with sand to the edge.
  • Change the water and wash the hydroponic plant pot with a brush, soapy water at least once a week
  • Change the water of your pets and wash their bowls frequently
  • Put trash in plastic bags and always keep trash closed
  • Water tanks should also remain closed and all objects in which water has accumulated, such as used containers, should be thrown into the trash; Cleaning must also be done regularly.
  • Leaves and anything that might prevent water from flowing into the gutters should also be removed.
  • Bottles and containers containing water should always be turned upside down.
  • Keep recycling materials in a closed bag and in a covered place


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