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Brazil - Outbreak of 'mysterious' disease that causes skin lesions in Pernambuco - from contact with Hylesia moths

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  • Brazil - Outbreak of 'mysterious' disease that causes skin lesions in Pernambuco - from contact with Hylesia moths

    Translation Google

    Outbreak of 'mysterious' disease that causes skin lesions affects Pernambuco

    Aliny Range
    Collaboration for UOL
    11/19/2021 22:39Updated on 11/19/2021 22:39

    The municipalities of Recife and Camaragibe, in the metropolitan region of the capital of Pernambuco, are investigating the outbreak of an unidentified disease that causes lesions and itchy skin.

    People who had the disease reported that they began to feel lumps on the skin followed by an itch, strong enough to make them seek medical care, but without residents who shared a house with them having the same problems, which raises questions about the means of transmission.

    The first case of the disease was registered on October 1 of this year, but so far the State Department of Health has not been able to name the cause of the problem.

    SES-PE also informed that the Cievs (Strategic Information Center for Health Surveillance) was notified and that it is monitoring the evolution of investigations initially carried out by the municipal secretariats, in addition to providing technical support in the investigations.

    Given the situation, an epidemiological alert was issued to public and private health units in the municipalities of Pernambuco to find out if there are cases in other cities. In Recife, according to data from Sesau (Secretariat of Health of the Municipality), 88 people showed symptoms of skin lesions and itching.

    The Municipal Health Department of Camaragibe reported that 60 people sought medical care with similar symptoms in the last 15 days.

    In all, so far, 148 cases have been registered in Pernambuco. In patient records are people aged between 2 and 96 years. The first occurrences were registered in five children living in the communities of Córrego da Fortuna and Sítio dos Macacos, in the North zone of Recife.

    The Health Surveillance of Recife informed that the investigations take place in a clinical, epidemiological and laboratory manner, with blood tests, skin sample collections and tests to detect arboviruses (dengue, zika and chikungunya), as well as covidence tests. -19.

    Only Recife had notified the state about the problem, until yesterday. After the epidemiological alert, the municipality of Camaragibe informed its records in the emergency room of the Aristeu Chaves hospital, belonging to the public health network.

    According to the Camaragibe city hall, the people who sought medical care live in the neighborhoods of Aldeia, Ostracil and Tabatinga.

    Até o momento, 148 casos da alergia desconhecida já foram registrados em duas cidades do estado, incluindo Recife; governo emitiu alerta epidemiológico
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
    Translation Google

    Paulista notifies three cases of skin lesions that cause itching

    The city is the third in the RMR to notify people with the same skin lesions without an identified cause

    By Portal Folha de Pernambuco
    11/22/21 at 20:00h updated on 11/23/21 at 07:15h

    Another city in Pernambuco registered cases of lesions that cause itchy skin. This time, three cases were identified in Paulista, in the Metropolitan Region of Recife. The same situation was reported in Recife , which currently has 105 cases, and in Camaragibe , which counts 60 cases.

    The cases registered in Paulista are of males, one with 17 years of age and two with 26 years. According to the Municipality of Paulista, the cases were notified last Friday (19), and residents showed initial symptoms between the 4th and 12th of November.

    The municipality also informed that two suspected cases of the same symptoms have been investigated since this Sunday (21). "On 11/21/2021, two more cases were referred by the same unit (PTG) and are being screened for notification to the CIEVS-PE. The patients are being monitored, being under observation by the municipal health team", informed the town hall.


    What is the cause of the itching outbreak in Recife? Doctor explains and discards problem relationship with covid vaccines

    Outbreak of itching has reached more than 100 people in Recife alone

    HEALTH 11/22/2021 AT 4:03 PM

    Updated at 5:41 pm

    Recife, Camaragibe and Paulista registered in recent weeks cases of people with symptoms of itching in the body . The head of the infectious diseases service at the Oswaldo Cruz University Hospital and infectologist at the Real Hospital Português, Demetrius Montenegro, in an interview with Rádio Jornal, this Monday (22), spoke about the outbreak of itching that has hit Pernambuco.

    So far, 105 cases have been reported in Recife, 62 in Camaragibe and three in Paulista. The latter were confirmed by the City of Paulista this Monday (22).

    What is causing the outbreak?

    Demetrius Montenegro explained that it is "difficult to find a cause of this disease because people have different manifestations."

    According to the doctor, some patients have had lesions similar to those caused by scabies, but this diagnosis is not concrete. "Some people have lesions that are very similar to scabies, scabies, others lesions seem more allergic. We are working with all the possibilities, including arbovirus. However, this possibility of arbovirus is increasingly fragile because it seems to be a contact situation," he explained. "Over 90% of people only have symptoms of itching and lesions. Symptoms such as pain in the body, fever, which are also common in arboviruses, we see in a very small percentage. That's why practically the arbovirus situation was ruled out”, he added.

    He also points out that there is another hypothesis for the problem: insect. “As in Recife, this outbreak started in Dois Irmãos, in communities close to the forest, and continues through Camaragibe also in areas closer to the forest, so there is another possibility that some type of insect is causing this type of injury. This is also being investigated by the personnel of the Epidemiological Surveillance and Environmental Surveillance of these areas”, he said.

    Can vaccine be the cause of the itchiness outbreak?

    The infectious disease physician was emphatic in ruling out any relationship between the itching outbreak and the covid vaccine. “It has no relationship. The vaccine has already been applied in a very large amount, and if it were related to the vaccine, it would not be located in some areas of the city, much less located here in Pernambuco, Recife, Camaragibe. It would be the whole world. A large part of the world population was vaccinated and we do not see this in other people who received the vaccine. This is totally out of the question. Nobody should fail to complete the vaccination for fear of this itch. It has nothing to do with it”, he stressed.

    What to do if you have symptoms?

    The doctor explains what to do if symptoms appear. “The main thing is to look for a doctor because he will assess and treat as needed. Some people are being advised to undergo treatment for scabies because the lesions are very characteristic of some people. But we have not yet come to the conclusion that scabies is the cause of this outbreak. The recommendation is to look for a health unit”, concluded the infectious disease specialist.

    City halls demonstrate

    Through a statement, the municipalities of Camaragibe and Paulista expressed their views on the situation.

    See the note from the Camaragibe City Hall:

    "The Municipality of Camaragibe, through the Department of Health, is investigating the notification of 62 cases of skin lesions to be clarified, registered by residents who sought care at Hospital Aristeu Chaves, the main emergency in the municipality. The Health Surveillance of Camaragibe is carrying out a survey epidemiological clinical study with the collection of information about the diagnoses, case by case, of the patients treated at the unit.In addition, the Surveillance carries out an entomological study to identify possible insects or arthropods that are causing the complications. in homes, it is also being collected for analysis. We emphasize that our basic health units carry out Covid-19 and serological tests for arboviruses."

    See the note from the City Hall of Paulista:

    "On 11/19/2021, 03 notifications were made to the Health Surveillance Strategic Information Center (CIEVS-PE) from Prontoclínica Torres Galvão.

    There are three cases of males, aged between 17 (one case) and 26 (two cases) years old. The signals started in mid 11/4, 11/09 and 11/12/2021, respectively.

    Signs of itching and skin lesions stand out, with no nocturnal worsening and no other signs and symptoms.

    On 11/21/2021, two more cases were referred by the same unit (PTG) and are being screened for notification to CIEVS-PE. Patients are being monitored, being under observation by the city's health team."


    Infectologist discards relationship between outbreak of skin lesions and arboviruses

    Physician Demetrius Montenegro stated that the hypothesis is remote

    By Jaqueline Fraga
    11/23/21 at 6:15 am updated on 11/23/21 at 9:01 am

    The hypothesis that the outbreak of skin lesions that has affected residents of the Metropolitan Region of Recife is related to arboviruses is practically discarded. That's what the infectious disease doctor Demetrius Montenegro said this Monday (22), in an interview with Folha de Pernambuco. He is part of the team leading the studies, made up of experts and representatives from the State Health Department (SES-PE) and the Executive Secretariat for Health Surveillance of Recife.

    “Apparently the injuries look a lot like contact injuries. Initially, the possibility of arboviruses was raised, but this possibility is very remote because in arboviruses you expect the person to have a fever, to have pain in the body, to have these symptoms. Of course, there are some people who have arboviruses without fever, but not the majority. Most will have fever, most will have pain in the body. And these people, most will not have fever, most will not have pain in the body, it's just the lesions and the itching”, he explained.

    According to the doctor, water samples are also being analyzed and, on Monday, a search for mites on the skin of people who presented the lesion was started. “Including, among these mites, scabies, which is scabies, is also being investigated. So, there are a number of possibilities that could happen causing this. But there is still no definition of exactly what it is”.

    Another hypothesis raised by the infectologist is that of environmental imbalance. “The cases started in two communities in the Dois Irmãos neighborhood, close to the forest. So, we are also working with the possibility of some environmental imbalance, because the people who are most affected are close to the Dois Irmãos forest. And there are the residents of Camaragibe, because the city also has an area that is close to the forest”, he analyzed.

    The doctor even ruled out the possibility that the outbreak was related to Covid-19 or the vaccination. "It's not possible. Covid is not just happening in Recife, it happens all over the world, the vaccine happens all over the world. Covid skin changes are known but this outbreak is very localized. So, it is not justified. If it were skin alteration by Covid, other regions in the world would also be going through the same problem”.

    Dermatologist Maiara Bastos reinforces that, if the person presents symptoms, the recommendation is to seek medical attention. “It is still a disease with no defined cause and notification is required. The treatment is symptomatic, that is, the doctor will prescribe medication to combat the symptoms presented, such as anti-allergic drugs for itching or antipyretics for fever," he said. Despite not being one of the main symptoms, fever can occur in some cases.

    According to the doctor, to relieve symptoms, patients can use soaps and moisturizing creams, in addition to cold compresses, and should avoid scratching the region. "When we scratch the skin too hard, we can cause wounds that can later become infected", he warned.

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela


    • #3
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      • #4

        The prevalence of itchy skin lesions affects at least six cities in Greater Recife
        by Ursula Curtis
        November 25, 2021

        At least six cities in Greater Recife are reporting cases Mysterious itchy skin lesions. This Wednesday (24), Total notifications in the capital of Pernambuco reached 149, in 23 counties. While the cause of the outbreak remains unknown, doctors advise people with symptoms to exercise caution and avoid close contact with other individuals....


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          • #6
            Translation Google

            Outbreak of skin disease reaches new municipalities

            Published: 25/11/2021 21:05

            The mysterious outbreak of the new skin disease that affects Pernambuco has affected more and more people. This Thursday, five more cities in the state (Cabo de Santo Agostinho, Igarassu, Ipojuca, Itapissuma and Nazaré da Mata) registered cases of residents who showed symptoms such as itching and skin lesions. Altogether, there are 11 municipalities affected with the disease, accounting for about 300 cases according to city halls. In Recife, the first cases were registered in early October.

            Symptoms include itchiness, lump-shaped lesions, and redness. So far, the cause of the disease is unknown, however investigations have been carried out by city halls and the Health Department of Pernambuco to find the cause of the outbreak.


            After sending, last Friday (19) a technical note to the health services advising that all cases of skin diseases with the respective symptoms were notified, in order to map the action of the disease, SES-PE, with the support of city halls has sought to find the cause of the outbreak.

            According to the Secretariat, the investigation has had the participation of the technical team from SES-PE itself, from the Central Laboratory of Pernambuco (Lacen-PE) and other specialists. So far, the cause of the disease is not known, however the hypotheses include scabies (popularly known as scabies), arboviruses (Dengue, Zica virus and Chikungunya), allergic reactions and even environmental imbalances.

            The cases have been investigated in clinical, epidemiological and laboratory investigations, as stated on the 19th of the last day by the Executive Secretary for Health Surveillance, Marcella Abath, in a meeting with the State Health Department and the Aggeu Magalhães Institute. In a press conference this Thursday (25), Health Secretary André Longo assured that biopsies have been performed in order to find the cause of the disease.

            R. Edmond.

            O misterioso surto da nova doença de pele que atinge Pernambuco tem afetado cada vez mais pessoas. Nesta quinta-feira, mais cinco cidades do estado (Cab


            Environmental imbalance has already caused cases of itching in Rio Grande do Sul

            by Laura Machado
            11/26/21 at 3:30 pm updated on 11/26/21 at 8:00 pm

            The team of specialists and representatives of the State Health Department (SES-PE) and the Recife Executive Secretariat for Surveillance and Health, which investigates the causes of skin lesions found in several municipalities in Pernambuco, assess the possibility that the disease is linked to a environmental imbalance . A similar problem happened five years ago, in the interior of Rio Grande do Sul.

            In Recife, the neighborhoods of Dois Irmãos and Guabiraba concentrate more than 80% of the cases and, therefore, possibilities that the skin lesions are caused by insects or substances present in the forest, such as pollen from leaves or flowers, are some of the perspectives. studied.

            The infectious disease physician Demetrius Montenegro, a member of the research group, stated that this scenario is a possibility. “It is also a line of research, to assess whether the injuries are not related to some environmental imbalance. [In Recife] the people who are most affected are close to the Dois Irmãos forest. And there are the residents of Camaragibe, because the city also has an area that is close to the forest,” he said.

            A equipe de especialistas e representantes da Secretaria Estadual de Saúde (SES-PE) e da Secretaria Executiva de Vigilância e Saúde do Recife que investiga as causas das lesões na...


            Ufal study associates scabies outbreak with the use of ivermectin

            Research can help in the investigation of the causes of more than 400 cases of skin lesions reported in Pernambuco. In Alagoas, there are no records.

            By g1 AL

            11/26/2021 7:40 PM Updated 45 minutes ago

            A survey by the Center for Studies in Pharmacotherapy (NEF) at the Federal University of Alagoas (Ufal), released this Friday (26), relates scabies (human scabies) to the indiscriminate use of ivermectin. According to the researchers, this study can help in the investigation of the outbreak registered in Pernambuco.

            Until this Wednesday (24), at least 413 cases were reported in three cities in Pernambuco . Skin lesions cause itching. The outbreak has not yet been defined and the health authorities in Pernambuco continue to investigate.

            Researchers from the Institute of Pharmaceutical Sciences (ICF), Alfredo Oliveira-Filho and Sabrina Neves, and students Lucas Bezerra and Natália Alves, based their observations on previously reported cases of resistance to ivermectin, isolated outbreaks and data on increased consumption of the drug because of the Covid-19 pandemic. The article was published in August.

            “Our article hypothesizes that we could have problems with resistant scabies outbreaks, due to the irrational use of ivermectin. The outbreak is set, as there is a rapid increase in cases of itchy skin lesions and other symptoms," explained Sabrina

            Some tests and the discarding of other hypotheses about what is happening in Pernambuco are necessary to confirm the questions raised in the article.

            Patients complain of a strong itching, which intensifies at night, and which evolves into wounds, even with the use of anti-allergic drugs. Epidemiological surveillance has issued an alert with symptoms to health services, so everyone must notify the care of patients with symptoms of the disease.

            “The hypothesis of the article is that it is possible that Sarcoptes scabiei, the mite that causes scabies, may have developed resistance to ivermectin. If this hypothesis is confirmed, we have a huge problem, as the disease could affect any population, and what's worse, with difficult treatment”, evaluated Sabrina.

            Increased Ivermectin Consumption in Covid's Pandemic

            With the Covid pandemic, the consumption of the drug, which is an antiparasitic, increased almost 10 times in Brazil. Even with opinions from the Ministry of Health and the pharmaceutical industry, added to scientific evidence, prescription and self-medication based on this drug continued to happen.

            “The irrational use of medications is a public health problem, however, in the case of antibiotics, antiparasitic and antifungal drugs, this problem takes on greater proportions.When we use drugs irrationally/incorrectly, such as ivermectin, we run the risk of inducing the parasite's resistance to the drug that should treat the disease caused by it”, reinforces the professor.

            Pesquisa pode ajudar nas investigações das causas de mais de 400 casos de lesões na pele notificados em Pernambuco. Em Alagoas, não há registros.
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela


            • #7
              Translation Google

              Outbreak of skin disease in Pernambuco was caused by moths, says SBD

              According to the Brazilian Society of Dermatology, a condition characterized by skin lesions and itching is triggered by the insect's bristles that penetrate the skin

              3 min of reading
              GALILEO NEWSROOM
              08 DEC 2021 - 16:29 UPDATED 08 DEC 2021 - 16:29

              This Wednesday (8), doctors from the Brazilian Society of Dermatology (SBD) released a technical note in which they clarify the reason behind the outbreak of a skin disease that has affected the population of Pernambuco in recent months. Although it was hypothesized that it was an outbreak of scabies (scabies) , the main indication is that the problem is actually related to moths of the genus Hylesia .

              The first notifications of the condition began to appear on October 1st and continued to increase in the following weeks, drawing the attention of residents and authorities in the Metropolitan Region of Recife . As reported by the G1 portal , an epidemiological alert was issued for health facilities to report suspected cases to the Strategic Information Center on Health Surveillance (Cievs) in the capital of Pernambuco.

              Patients had skin lesions and itching. So far, 21 cities across the state have identified people with similar symptoms. In addition to the Metropolitan Region, occurrences are investigated in Zona da Mata, Agreste and Sertão. Faced with this scenario, a team of professionals conducted actions to investigate the cause of hundreds of cases of dermatitis already registered.

              Dermatologist Cláudia Ferraz conducted a survey of the epidemiological history and described the lesions. Vidal Haddad Junior, who has experiences with other outbreaks , clarified the etiology of the eruption. From this work, it was possible to discard previously raised hypotheses without scientific proof, such as intoxication by ivermectin, scabies and insect bites.

              “The hypothesis of scabies was absurd, as the type of transmission is different, the distribution and appearance of the skin lesions were different and no mite was found in many samples of direct examination and histopathological exams”, explain the doctors. Marcella Abath, executive secretary of Health Surveillance in Recife, notes that similar diseases are also being registered in this context. "Without a doubt, has the case of diseases such as scabies and arbovirus in the middle," says in publishing the G1 .

              According to specialists from the SBD, the outbreak of “ppuloerythematous-pruritic dermatitis with urticarial appearance” is the result of the wings of the Hylesia moths , which reproduce at this time of year and generate epidemics in various regions of Brazil . Insects enter domestic environments and, when struggling against light sources, release small body bristles capable of penetrating human skin.

              Severe dermatitis can persist for days or weeks. During treatment, the focus is on inflammation , and topical corticosteroids and antihistamines are generally used. “With proof of the bristles in the direct examination, extremely compatible clinical and epidemiological history and a report of moths on the spot made by the residents, we conclude that the mystery is solved and we hope that the correct treatments are given”, state Cláudia Ferraz and Vidal Haddad Júnior.

              Marcella Abath advises people not to kill moths . The ideal is to put screens on the windows and keep the house closed, especially in the late afternoon. "It is also recommended to reduce external lights, do not leave clothes on a clothesline at dusk, wipe the furniture with a cloth with water to avoid spreading bristles if they are there, and keep your hands always clean to avoid a secondary infection ", he says.

              Also according to Abath, the Hylesia moths are the main explanation considered by the Executive Secretariat for Health Surveillance of Recife. "The cases are bordering on the Atlantic Forest , which tends to have a greater concentration of moths", she highlights. Even so, other possibilities are still being evaluated by the authorities. "This is the main hypothesis considered today, it is the most strengthened, but it has not yet been defined."

              Segundo Sociedade Brasileira de Dermatologia, quadro caracterizado por lesões cutâneas e coceira é desencadeado pelas cerdas do inseto que penetram na pele


              Epidemic pruritus in Recife: cause unveiled.

              An outbreak of pruritic papular erythematous dermatitis, with an urticarial appearance,
              challenged the city's medical services. The cases took place in two communities
              bordering the forest, located in an Atlantic forest reserve area of ​​the Park
              State of Dois Irmãos, in Recife (PE).

              Several hypotheses were raised for the outbreak and included ivermectin poisoning,
              scabies, insect bites and others, but without any proof. the hypothesis of
              scabies was absurd, as the type of transmission is different, the distribution and appearance of
              skin lesions were distinct and no mites were found in many examination samples.
              direct and histopathological exams.

              A joint work by Dr. Cláudia Ferraz, who researched the epidemiological history
              correct and adequately described the lesions, in addition to suspecting the probable etiology, and
              by Dr. Vidal Haddad Junior, who had witnessed and published other outbreaks, clarified
              the etiology of the eruption.

              Hylesia moths reproduce at this time of year and cause epidemics of
              dermatitis in various parts of the country, as they penetrate domestic environments and when
              debate against spotlights, release tiny body bristles that penetrate
              deep into human skin and cause the intense dermatitis observed.

              In addition to the initial inflammation, described in histopathology as a lymphocytic infiltrate,
              there is a likelihood of granuloma formation at later stages. dermatitis
              remains for days and even weeks, due to the permanence of the bristles ("flechettes") in the
              skin. These bristles can be seen on the skin and examinations showed them with

              Treatment focuses on inflammation with topical corticosteroids and antihistamines
              and sometimes, depending on the extent of the lesions, the use of systemic corticosteroids can
              be necessary.

              With proof of the bristles on direct examination, clinical and epidemiological history
              extremely compatible and locals' report of moths at the site,
              we conclude that the mystery is solved and we hope that the correct treatments are
              given to the population.

              Claudia Ferraz
              Vidal Haddad Junior
              Brazilian Society of Dermatology

              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela


              • #8
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