Re: Brazil: 2010 dengue cases
Re: Brazil: 2010 dengue cases
MINISTRY OF HEALTH
DEPARTMENT OF HEALTH SURVEILLANCE
Department of Epidemiological Surveillance
Esplanada dos Ministerios, Headquarters Building, 1st floor
70058-900 Brasilia-DF Tel 3315 2755 / 2812
TECHNICAL NOTE CGPNCD / DEVEP / SVS / MS
CGVS / SES-RR
SVS / SMS-BV
Updated on 18/08/2010
Subject: Isolation of DENV serotype 4 in Roraima / Brazil
On July 30, 2010, the Secretary of Health of Roraima (SES / RR) has notified the Secretariat of Surveillance in Health / SVS a suspected case of dengue virus serotype by DENV 4. The case is indigenous to Boa Vista, the capital of state, and was detected in a sentinel monitoring viral. The initial diagnosis was made by RT-PCR and Virus Isolation, processed at the Central Laboratory of Roraima and confirmed by retest the Institute Evandro Chagas - IEC-PA.
19 samples were later sent to the IEC-PA were identified where two more confirmed cases and one suspected of DENV 4, all indigenous Boa Vista / RR. On August 11, as a result of the search for cases of fever performed in health services, 30additional samples were sent for processing. Could perform RT-PCR in 19 samples, which were identified over eight suspected cases of DENV 4, and 6 Boa Vista and two of the cities of Normandy and Sing. Epidemiological research conducted in these two counties will set the probable site of infection, whether coming from Boa Vista or another municipality of Roraima. In all Samples will be held in cells culture for virus isolation.
In summary, to date have been three confirmed cases in Boa Vista and nine suspects are in research, as autochthony, 7 residents of Boa Vista and two of the municipalities and Sing Normandy.
I. EPIDEMIOLOGICAL SITUATION
In 2010, to the epidemiological week 31 (1-7 August), were 8342 reported cases of dengue 61 classical records Dengue Hemorrhagic Fever (DHF) and Dengue with 160 complications (CHD). In over the same period in 2009 shows an increase of 44.5% when 4631 cases were reported. At Boa Vista-RR, 5171 cases were reported which equates to 62% of cases in the state of Roraima.
It is noteworthy that despite the increase in cases in Boa Vista, there is a
downward trend in notifications from the epidemiological week 22 (June) as shown in Chart 01.
Chart 01. Number of dengue cases in Boa Vista-RR second month and year of onset, 2010 *.
*See link for chart*
Circulating in the State since the beginning of the year, DENV 1 and DENV serotypes 2 and was recently detected serotypeDENV 4. Figure 2 shows the distribution of suspected and confirmed cases of DENV 4 by start date of
symptoms. Figure 01 illustrates the municipality of residence of suspected cases of DENV 4 in Roraima, the figure 02 todistribution of suspected cases by home district of Boa Vista, and figure 03 the distribution of cases
confirmed by district of residence in Boa Vista.Chart 02. Distribution of suspected and confirmed cases of DENV April 2 date of onset of symptoms, Roraima, 2010
*See link for Chart & Maps*
Two laboratory techniques were used in all samples: the first survey of dengue virus genome by RT-PCR complemented by conducting research of virus inoculated into C6/36 cells, and latter technique considered the gold standard for confirmation of serotype DENV 4.
II - Summary of confirmed cases of DENV 4 with a positive result by the technique of cell isolation C3/36
The epidemiological investigation of the trajectory of the three confirmed cases of DENV 4 autochthony confirmed infection in Boa Vista. The median age of cases was 43 years (15-44), all being classified clinically as dengue fever. The evolution was to cure without any admission of cases. For the period of occurrence of cases, the date of onset of symptoms in the first case was 26.06.2010 and the last case was detected on 07/21/2010.
III - Summary of suspected cases with four DENV positive by RT-PCR
The epidemiological investigation of the trajectory of the nine suspected cases confirmed the four DENV autochthony Infection 7 cases in Boa Vista. Investigations to define autochthony infection and Sing in the towns of
Normandy is underway. The median age of cases was 23 years (10-55), all being classified clinically as dengue fever. The evolution was to cure without any admission of cases. For the period of occurrence of cases, the date of onset of symptoms in the first case was 20.07.2010 and 08.08.2010 in the latter case.
IV. SUMMARY OF ACTIVITIES DEVELOPED
Ø Health education
Talks in the public schools in the neighborhoods: Buritis Pricumã and Santa Teresa; Recommendation for the collection of debris and garbage in the vicinity of schools;
Ø Combating Vector
Performed the following activities in the neighborhoods of Santa Teresa, Buritis City Satellite and Pricumã
§ Visits to 10 358 households to eliminate breeding and health education to
residents;
§ 18 305 Elimination of breeding sites;
§ Visit at strategic points (where properties are found with great frequency
numbers of reservoirs suitable for breeding of Aedes aegypti) with elimination of focus and collection of larvae;
§ Held fogging operation space for equipment engaged in the vehicle
affected areas;
§ Held costal fog within a radius of 150m cases of DENV 4;
§ Installation of 284 ovitraps around the neighborhood for evaluation of control;
§ Held entomological assessment;
§ Conducted training of 80 community health agents to guide the population
prevention and control of Aedes aegypti in the domestic environment;
§ Start of vector control activities in neighborhoods and Caimbé Carano.
Ø Epidemiological surveillance
Installation of the situation room to monitor the actions of surveillance and control at the Registry State Health, with participation of the Ministry of Health and State Health Departments Municipal
o Realizado busca ativa em 157 residências no entorno dos três casos confirmados, com participação
dos agentes comunitários de saúde.
o Realizada entrevista em 58 moradores e coletados 22 amostras de sangue. As demais coletas de
sangue estão agendadas.
o Busca ativa em serviços de saúde de casos febris, com coleta de material para exame.
o Investigação epidemiológica no município de Cantá e orientação de medidas de controle, incluindo o
município de Normandia.
http://portal.saude.gov.br/portal/arquivos/pdf/nt_denv_4reveduardo2.pdf
