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Five States and Federal District in Brazil Get Dengue Epidemic

Dengue in Brazil Brazil’s Ministry of Health confirmed Thursday, February 18, that at least five states – Acre, Mato Grosso, Mato Grosso do Sul, Goiás and Rondônia – have presented a considerable increase of dengue cases since December. The Federal District has also recorded more cases since last month.

Some health departments are already using the term “epidemic” to describe the situation they are in in their epidemiological bulletins made public.

In Rondônia, for example, the Health Secretariat reported that the state is facing its largest outbreak of dengue ever. The increase in the number of cases in the first week of 2010, compared to the same period last year reached 2182%. In the second week, the increase was 1164%.

In the capital Porto Velho alone there were 2210 cases from a total of 5306 across the state. The city also recorded the highest number of severe cases of the disease – 70 – and three deaths.

In Mato Grosso, the Health Secretariat up to February 10 had already reported 12,666 cases of dengue – 344 considered serious – and 16 deaths from the disease. When compared to the same period last year, the numbers represents an increase of 804% of the notifications. In 2009, the state faced a dengue epidemic, with 60,000 cases reported.

So far, five deaths were confirmed in Mato Grosso. The capital, Cuiabá, had 802 reported cases and one death. In addition, the health authority is investigating if four additional deaths were caused by the disease. In Várzea Grande, five people have died from the disease and  notifications of cases already number 802.

In Mato Grosso do Sul, seven towns concentrate 53.4% of state population and 69.6% of suspected cases of dengue in the first five weeks of the year – Bonito, Campo Grande, Corumbá, Coxim, Dourados, Ponta Porã and Três Lagoas. Across the state, 7991 cases have been reported and two deaths are under investigation. Although it has confirmed 996 cases, the Secretariat of Health warns that extra official information indicate that the numbers of cases may reach 14,566.

In Goiás, 49 municipalities have a high risk of dengue infection. The capital, Goiânia, leads in reports of cases in the first five weeks of 2010 (10,862), followed by Aparecida de Goiânia (2.712) and Senador Canedo (674). According to the Health Secretariat, 50 cities have medium risk of infection and 68 low risk.

Through a spokesperson, Brazil’s Health Minister said the five states have been receiving federal help against dengue, including insecticide and drugs. They also informed that they expect the numbers of cases will be going down from now on.

The main foci of the disease are places where stagnant water accumulates like tanks and barrels, flower pots, pools, ponds, tires and gardens.

“The risk that Carnaval celebrations might change the behavior of the epidemic always exists,” said Giovanini Evelim Coelho, coordinator of the National Program for Control of Dengue.

Dengue which is transmitted by the Aedes Aegypti mosquito becomes an epidemic when the number of confirmed cases reaches 300 per 100.000 of population.

Dengue is considered one of the most extended diseases in the world and is endemic in the heartland of South America which includes northern Argentina, Brazil, Paraguay and Bolivia.

At the beginning of the month the Brazilian government alerted about the epidemic risk following the reappearance of the DEN-1 strain, with no cases registered in Brazil for the last ten years. Since January Brazilian sanitary officials have confirmed 12.666 cases in the country, five of them causing death.

Although dengue cases have fallen overall 34.2% compared to last year, 298 Brazilian residents died of the most acute strain, and the Brazilian government has launched a massive information and prevention campaign.

In related news sanitary authorities from the Argentine northern province of Misiones, next to Paraguay, have confirmed 424 dengue cases since mid December. Most of the affected are back home and only 70 remain in hospitals or clinics.

However officials are on the alert because in the city of Port Iguazú, where the three countries meet (Paraguay, Argentina and Brazil) next to the world famous falls, a daily average of 60 people visits medical centers with possible symptoms of the disease.

Misiones was put on “yellow alert” last year following the epidemic in Paraguay.

Dengue is caused by four closely virus serotypes of the genus Flavivirus transmitted by mosquitoes. The disease manifests as a sudden onset of severe headache, muscle and joint pains, sever pains that gives it the nickname of break-bone fever or “bone-crusher”, plus fever and rash. There may also be gastritis with some combination of associated abdominal pain, nausea, vomiting or diarrhea.

The more dangerous strain is the dengue hemorrhagic fever which causes abdominal pain, hemorrhage and circulatory collapse. DHF starts abruptly with high continuous fever and headache plus respiratory and intestinal symptoms with sore throat, cough, nausea, vomiting, and abdominal pain.

Shock occurs after 2 to 6 days with sudden collapse, cool clammy extremities, weak pulse, and blueness around the mouth (cyanosis). Pneumonia and heart inflammation may be present. The mortality is appreciable ranging from 6 to 30%.

ABr/MP

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