Source: https://www.radioculturafoz.com.br/2...sos-de-dengue/
Paran? is the third state in Brazil with the highest number of dengue cases
The trend is that cases will increase considerably in the coming days. Historically, the number of patients has grown since March.
Joshua Caleb by Joshua Caleb
February 29, 2020
In the same month that Brazil confirmed its first case of a patient with a new type of coronavirus that emerged in China, an old acquaintance of Brazilians showed signs that it will infect even more people in 2020: the dengue virus, transmitted by the Aedes aegypti mosquito .
The latest epidemiological bulletin from the Ministry of Health with data on dengue shows that the number of probable cases of the disease - those that are notified to the folder by the States - grew 19% in the first five weeks of the year compared to the same period in 2019 .
94,149 probable cases were reported up to the fifth week of the year (more precisely from 12/29/2019 to 2/1/2020), compared to 79,131 in the same period last year.
At the beginning of 2020, there is confirmation that at least 14 people died from dengue in the country. The comparison of deaths with 2019 is still uncertain, as the numbers can still change significantly as the results of laboratory analyzes arrive and as states and municipalities send their reports to the ministry. The data in the current bulletin, for example, still does not compute the cases and deaths recorded at the local level in February.
But the ministry is already working with a scenario of increasing dengue cases for this year, and some municipalities and states across the country have declared an alert for a dengue epidemic - which is defined when there is a rate of 300 confirmed cases of disease for every 100 thousand population.
Today, the country has an average incidence of 44.8 probable cases for every 100 thousand inhabitants, a value that is also higher than that registered in the bulletin of the same period last year (26.3 cases per 100 thousand; the comparison between newsletters from different years should be done with caution, as there are many changes and updates to numbers after they are published).
The situation varies drastically within the country, and three states have already shot more than 200 cases per 100 thousand inhabitants: Acre (rate of 281.65 / 100 thousand); Mato Grosso do Sul (249.98 / 100 thousand) and Paran? (220.75 / 100 thousand).
However, the upward trend in dengue this year can only be confirmed in the coming months - historically, the number of patients grows from March.
Experts and government representatives interviewed by BBC News Brasil attribute the upward trend in dengue in 2020 to a combination of factors: first and perhaps more importantly, a powerful new circulation cycle for serotype 2 (there are 4 serotypes of the dengue virus, one classification that corresponds to the response of different antibodies in the infected); in addition to this, particular weather conditions in recent months and cultural and behavioral factors of the population.
Over 8 thousand patients in a week in Paran?
Maps of cases of the disease make the highlight in a part of the country that begins in Acre, passes through the Midwest and part of the Southeast, ending in Paran?. Northeastern states, such as Para?ba and Pernambuco, had few cases compared to units in other regions.
In Paran?, the data on the growth of dengue is impressive. In February last year, the Ministry of Health pointed out that the State had 14 patients per 100 thousand inhabitants; today, that number reaches 220.7 - an increase of 1,471% in the incidence when comparing bulletins for the two periods.
Since August, when the State started counting a new epidemiological period, almost 35 thousand cases of the disease have been confirmed. In the last week alone, there were 8,200 new patients. Also according to the state government, 14 people died of dengue this year - because they are provided by the state, these data are more up to date than those compiled by the Ministry of Health.
“At the moment, we have an upward curve of the disease. The trend is for an impacting worsening situation, as the period with the highest incidence is yet to start in March, ”says Ivana Belmonte, coordinator of environmental surveillance at the Paran? Department of Health.
According to her, the change in the type of circulating virus is one of the explanations for the increase in dengue in the State and in much of Brazil. From 2010 to last year, the vast majority of people who had dengue in Paran? were infected with type 1 of the disease. As of August 2019, serotype 2 was responsible for 83% of dengue infections in the state.
A person can have the four serotypes of the disease, but once infection with one of them has occurred, permanent immunity is acquired for this type.
“When you get type 1, you are immunized against it. That is why, after a discharge, the number of cases tends to decrease over a period. However, when the circulating serotype changes to 2, people are not immunized and end up contracting the disease. This is what is happening in Paran? and elsewhere ”, explains Belmonte.
Dengue serotype 2 advances in the country
In fact, according to information sent by the Ministry of Health to BBC News Brasil, the participation of serotype 2 in the number of dengue cases has grown in the last five years in the country, reaching the highest percentage in 2019: 65.6% of cases, followed by serotype 1 (30.4%) and serotype 4 (3.9%). Data for 2019 are preliminary and, for 2020, are not yet available.
"At the end of 2018, type 2 of the dengue virus returned to circulation after 10 years and has been finding populations susceptible to the disease since then," explained the ministry in a note sent to the report.
Creator of the '10 minutes against Aedes' campaign recalls that most mosquito breeding sites are inside people's homes
CARLOS BASSAN / MUNICIPALITY OF CAMPINAS
Biologist Denise Valle, a researcher at the Flavivirus Molecular Biology Laboratory at the Oswaldo Cruz Institute (IOC / Fiocruz) and creator of the “10 minutes against Aedes” campaign, explains that, in 2019, serotype 2 has already pushed the number up dengue cases in several states. However, for several other places, the arrival of this type of virus is a novelty and, therefore, the numbers for 2020 must be high as well.
“In 2019, serotype 2 circulated a lot, but it did not circulate in all regions of Brazil. In addition, we are having a very wet summer, with a lot of rain - which also helps to increase the number of breeding sites ”, he points out.
Valle explains that the country is “hyper endemic for dengue, with epidemic periods” - which means, with “endemic”, that infections occur all year round, despite growing in the summer; and, with “hyper”, that there is more than one serotype circulating. The researcher also points out that, due to its continental dimensions, the country has different patterns of contamination by state and even within the same city.
But, for the biologist, it is worth noting what has been observed in the South in recent years, symbolized in this 2020 with the presence of Paran? among the Brazilian states with the most cases.
“Brazil has dengue all the time, but the South, with a colder climate, a higher Human Development Index (HDI) and better structured cities, was delaying the installation of Aedes aegypti. Today we see a consolidation of the installation of dengue in the South as well ”, points out Valle.
'You can't wait for the government to clean your yard'
Despite pointing to the importance of sanitation and urbanization in controlling the Aedes aegypti mosquito - which also transmits zika and chicungunha -, Valle draws attention to the role of people in combating dengue and other diseases.
“Aedes is a domestic mosquito. Of every 10 breeding sites, 8 are inside people's homes ”, he highlights.
Ivana Belmonte also mentions climate issues, such as increased rainfall in certain regions, in addition to cultural issues to explain the progress of dengue in Paran? this year.
“The culture of eliminating mosquito breeding sites is still small in Brazil. It is necessary to make the population even more aware that the risk is real, that you or a relative may die of dengue, ”he explains.
According to her, municipalities in Paran? have been working together to verify and eliminate breeding sites for Aedes aegypti, but even so, the contagion data has gone up.
“The servers do house checks every two months, but that needs to come from people too. You can't wait for the government to clean your yard ”, he says.
Santa Catarina, although it has not yet had a significant increase in dengue cases in 2020, already projects a rise in the coming months. The number of outbreaks of the mosquito - when cities identify Aedes aegypti breeding sites - grew 54% until February 15, reaching more than 7,600 points. The latest epidemiological bulletin also points out that 100 of the 295 municipalities in Santa Catarina face an “infestation” of Aedes aegypti.
“Due to the proximity to Paran? and the circulation of tourists, we see a scenario of dengue growth,” says Tharine Dal Cim, a biologist at the Santa Catarina Department of Health. “We have had hotter summers and less severe winters. Typically, the colder winter controls mosquito proliferation. But the milder temperatures, and the fact that Aedes is adapting to these conditions, have increased the focus on the State ”.
For the biologist, part of the South region is not yet used to facing dengue, as, in the population's imagination, colder states are free of the disease - high temperature is indeed an important factor in the proliferation of mosquitoes, but this does not shield the southern region of the country.
“People think that there is no dengue here, that it only affects the Southeast and Northeast. So, there is an oversight with the mosquito proliferation ”, says Dal Cim.
Source: BBC Brasil
Paran? is the third state in Brazil with the highest number of dengue cases
The trend is that cases will increase considerably in the coming days. Historically, the number of patients has grown since March.
Joshua Caleb by Joshua Caleb
February 29, 2020
In the same month that Brazil confirmed its first case of a patient with a new type of coronavirus that emerged in China, an old acquaintance of Brazilians showed signs that it will infect even more people in 2020: the dengue virus, transmitted by the Aedes aegypti mosquito .
The latest epidemiological bulletin from the Ministry of Health with data on dengue shows that the number of probable cases of the disease - those that are notified to the folder by the States - grew 19% in the first five weeks of the year compared to the same period in 2019 .
94,149 probable cases were reported up to the fifth week of the year (more precisely from 12/29/2019 to 2/1/2020), compared to 79,131 in the same period last year.
At the beginning of 2020, there is confirmation that at least 14 people died from dengue in the country. The comparison of deaths with 2019 is still uncertain, as the numbers can still change significantly as the results of laboratory analyzes arrive and as states and municipalities send their reports to the ministry. The data in the current bulletin, for example, still does not compute the cases and deaths recorded at the local level in February.
But the ministry is already working with a scenario of increasing dengue cases for this year, and some municipalities and states across the country have declared an alert for a dengue epidemic - which is defined when there is a rate of 300 confirmed cases of disease for every 100 thousand population.
Today, the country has an average incidence of 44.8 probable cases for every 100 thousand inhabitants, a value that is also higher than that registered in the bulletin of the same period last year (26.3 cases per 100 thousand; the comparison between newsletters from different years should be done with caution, as there are many changes and updates to numbers after they are published).
The situation varies drastically within the country, and three states have already shot more than 200 cases per 100 thousand inhabitants: Acre (rate of 281.65 / 100 thousand); Mato Grosso do Sul (249.98 / 100 thousand) and Paran? (220.75 / 100 thousand).
However, the upward trend in dengue this year can only be confirmed in the coming months - historically, the number of patients grows from March.
Experts and government representatives interviewed by BBC News Brasil attribute the upward trend in dengue in 2020 to a combination of factors: first and perhaps more importantly, a powerful new circulation cycle for serotype 2 (there are 4 serotypes of the dengue virus, one classification that corresponds to the response of different antibodies in the infected); in addition to this, particular weather conditions in recent months and cultural and behavioral factors of the population.
Over 8 thousand patients in a week in Paran?
Maps of cases of the disease make the highlight in a part of the country that begins in Acre, passes through the Midwest and part of the Southeast, ending in Paran?. Northeastern states, such as Para?ba and Pernambuco, had few cases compared to units in other regions.
In Paran?, the data on the growth of dengue is impressive. In February last year, the Ministry of Health pointed out that the State had 14 patients per 100 thousand inhabitants; today, that number reaches 220.7 - an increase of 1,471% in the incidence when comparing bulletins for the two periods.
Since August, when the State started counting a new epidemiological period, almost 35 thousand cases of the disease have been confirmed. In the last week alone, there were 8,200 new patients. Also according to the state government, 14 people died of dengue this year - because they are provided by the state, these data are more up to date than those compiled by the Ministry of Health.
“At the moment, we have an upward curve of the disease. The trend is for an impacting worsening situation, as the period with the highest incidence is yet to start in March, ”says Ivana Belmonte, coordinator of environmental surveillance at the Paran? Department of Health.
According to her, the change in the type of circulating virus is one of the explanations for the increase in dengue in the State and in much of Brazil. From 2010 to last year, the vast majority of people who had dengue in Paran? were infected with type 1 of the disease. As of August 2019, serotype 2 was responsible for 83% of dengue infections in the state.
A person can have the four serotypes of the disease, but once infection with one of them has occurred, permanent immunity is acquired for this type.
“When you get type 1, you are immunized against it. That is why, after a discharge, the number of cases tends to decrease over a period. However, when the circulating serotype changes to 2, people are not immunized and end up contracting the disease. This is what is happening in Paran? and elsewhere ”, explains Belmonte.
Dengue serotype 2 advances in the country
In fact, according to information sent by the Ministry of Health to BBC News Brasil, the participation of serotype 2 in the number of dengue cases has grown in the last five years in the country, reaching the highest percentage in 2019: 65.6% of cases, followed by serotype 1 (30.4%) and serotype 4 (3.9%). Data for 2019 are preliminary and, for 2020, are not yet available.
"At the end of 2018, type 2 of the dengue virus returned to circulation after 10 years and has been finding populations susceptible to the disease since then," explained the ministry in a note sent to the report.
Creator of the '10 minutes against Aedes' campaign recalls that most mosquito breeding sites are inside people's homes
CARLOS BASSAN / MUNICIPALITY OF CAMPINAS
Biologist Denise Valle, a researcher at the Flavivirus Molecular Biology Laboratory at the Oswaldo Cruz Institute (IOC / Fiocruz) and creator of the “10 minutes against Aedes” campaign, explains that, in 2019, serotype 2 has already pushed the number up dengue cases in several states. However, for several other places, the arrival of this type of virus is a novelty and, therefore, the numbers for 2020 must be high as well.
“In 2019, serotype 2 circulated a lot, but it did not circulate in all regions of Brazil. In addition, we are having a very wet summer, with a lot of rain - which also helps to increase the number of breeding sites ”, he points out.
Valle explains that the country is “hyper endemic for dengue, with epidemic periods” - which means, with “endemic”, that infections occur all year round, despite growing in the summer; and, with “hyper”, that there is more than one serotype circulating. The researcher also points out that, due to its continental dimensions, the country has different patterns of contamination by state and even within the same city.
But, for the biologist, it is worth noting what has been observed in the South in recent years, symbolized in this 2020 with the presence of Paran? among the Brazilian states with the most cases.
“Brazil has dengue all the time, but the South, with a colder climate, a higher Human Development Index (HDI) and better structured cities, was delaying the installation of Aedes aegypti. Today we see a consolidation of the installation of dengue in the South as well ”, points out Valle.
'You can't wait for the government to clean your yard'
Despite pointing to the importance of sanitation and urbanization in controlling the Aedes aegypti mosquito - which also transmits zika and chicungunha -, Valle draws attention to the role of people in combating dengue and other diseases.
“Aedes is a domestic mosquito. Of every 10 breeding sites, 8 are inside people's homes ”, he highlights.
Ivana Belmonte also mentions climate issues, such as increased rainfall in certain regions, in addition to cultural issues to explain the progress of dengue in Paran? this year.
“The culture of eliminating mosquito breeding sites is still small in Brazil. It is necessary to make the population even more aware that the risk is real, that you or a relative may die of dengue, ”he explains.
According to her, municipalities in Paran? have been working together to verify and eliminate breeding sites for Aedes aegypti, but even so, the contagion data has gone up.
“The servers do house checks every two months, but that needs to come from people too. You can't wait for the government to clean your yard ”, he says.
Santa Catarina, although it has not yet had a significant increase in dengue cases in 2020, already projects a rise in the coming months. The number of outbreaks of the mosquito - when cities identify Aedes aegypti breeding sites - grew 54% until February 15, reaching more than 7,600 points. The latest epidemiological bulletin also points out that 100 of the 295 municipalities in Santa Catarina face an “infestation” of Aedes aegypti.
“Due to the proximity to Paran? and the circulation of tourists, we see a scenario of dengue growth,” says Tharine Dal Cim, a biologist at the Santa Catarina Department of Health. “We have had hotter summers and less severe winters. Typically, the colder winter controls mosquito proliferation. But the milder temperatures, and the fact that Aedes is adapting to these conditions, have increased the focus on the State ”.
For the biologist, part of the South region is not yet used to facing dengue, as, in the population's imagination, colder states are free of the disease - high temperature is indeed an important factor in the proliferation of mosquitoes, but this does not shield the southern region of the country.
“People think that there is no dengue here, that it only affects the Southeast and Northeast. So, there is an oversight with the mosquito proliferation ”, says Dal Cim.
Source: BBC Brasil
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