Brazil: Dengue Outbreak

[Shiloh]

Wednesday, March 19, 2008
Direct Link: http://www.mercopress.com/vernoticia.do?id=12921&formato=html

Dengue panic in Brazil: 19.169 cases and 30 deaths in 2008
Six children have died of the mosquito transmitted disease in the last 24 hours reported Brazilian health authorities from Rio do Janeiro, totaling 30 fatal cases so far this year which is almost the 31registered in the twelve months of 2007.
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?Hospitals are on the verge of collapse as a ?dengue-panic? has extended to the city?, following on information that since the beginning of the year 19.169 cases of dengue have been officially confirmed said the Rio press quoting sanitary sources and illustrated by long queues of parents with children waiting for medical treatment.

Of the 30 deaths, 17 are children below the age of 11.

In the first fortnight of March the number of cases has soared to 2.275.

The situation has been considered so serious that the Rio do Janeiro state Health and Civil Defence office has requested help from the Armed Forces to help combat the focus of the outbreak plus supplying hospital beds.

The current rate of infestation means that in Rio there are 327 cases of dengue per 100.000 population which is rapidly approaching the 470 per 100.000 benchmark which describes an epidemic.

At the beginning of the year the Rio government declared a ?state of alert? given the 95% jump in cases in 2007 compared to 2006, 60.647 against 31.054.

Local authorities have requested aid from the federal government which apparently is working on an overall plan to prevent the disease from spreading.

According to the United States Center for Disease Control and Prevention Dengue (DF) and dengue hemorrhagic fever (DHF) are caused by one of four closely related, but antigenically distinct, virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4), of the genus Flavivirus. Infection with one of these serotypes provides immunity to only that serotype for life, so persons living in a dengue-endemic area can have more than one dengue infection during their lifetime.

DF and DHF are primarily diseases of tropical and sub tropical areas, and the four different dengue serotypes are maintained in a cycle that involves humans and the Aedes mosquito. However, Aedes Aegypti, a domestic, day-biting mosquito that prefers to feed on humans, is the most common Aedes species. Infections produce a spectrum of clinical illness ranging from a nonspecific viral syndrome to severe and fatal hemorrhagic disease.

Important risk factors for DHF include the strain of the infecting virus, as well as the age, and especially the prior dengue infection history of the patient.

Symptoms include sudden onset of fever, severe headache, myalgias and arthralgias, leucopenia, thrombocytopenia and hemorrhagic manifestations. Occasionally produces shock and hemorrhage, leading to death.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.theglobeandmail.com/servlet/story/RTGAM.20080320.wdengue0320/BNStory/International/home


Dengue epidemic hits Rio de Janeiro

MICHAEL ASTOR

The Associated Press

March 20, 2008 at 3:04 PM EDT

Rio de Janeiro ? An outburst of dengue has killed at least 47 people ? and perhaps twice that ? in Rio de Janeiro state this year, officials said Thursday, announcing a hot spot in a hemispheric outbreak that sickened nearly 1 million people in 2007.

State officials said 51 cases are being reported every hour as the outbreak strains public hospitals' capacity.

?What we see today in Rio de Janeiro is a catastrophe,? said Edmilson Migovski, a professor of infectious diseases at the Federal University of Rio de Janeiro. ?The death toll is rising because the virus is becoming more virulent, and at the same time people who were infected once are getting infected again.?

Brazil had more than half of the 900,782 cases of dengue in the Americas last year, according to the Pan American Health Organization. Of the hemisphere's 317 deaths, 158 came in Brazil, including 31 in Rio state.

But while federal officials say overall numbers were down in early 2008, they have jumped in Rio state. State officials say dengue has already killed 47 people, and is suspected of killing another 49 whose deaths are under investigation. The state, which has 16 million inhabitants, has seen more than 32,000 dengue cases this year, officials said.

?I am treating it as an epidemic because the number of cases is extremely high,? state Health Secretary Sergio Cortes said.

Mr. Migovski told the Associated Press that the problem may actually be worse: ?An emergency room doctor who has to attend 40 or 50 patients in a morning is not going to be able to inform officials about all the cases.?

Health officials across the Americas are trying to co-ordinate their fight against dengue, which has steadily gained strength since the early 1980s. Known as ?bonebreak fever,? dengue is spread by the Aegis aegypti mosquito and can incapacitate patients for over a week with severe headaches and joint pains.

A deadly hemorrhagic variant that causes internal and external bleeding accounts for fewer than 5 per cent of cases but has shown signs of growing ? often affecting people who have recovered from a less-severe form.

Experts fear the virus could grow deadlier and more widespread, in part because tourism and migration are circulating four different strains across the Americas.

Federal Health Minister Jose Gomes Temporao said Rio may be seeing more dengue cases because state and city officials have failed to heed warnings on a growing problem. Rio de Janeiro Doctor's Union this week urged prosecutors to charge city officials with criminal negligence.

Officials fight dengue by spraying insecticides and eliminating puddles of standing water where mosquitoes can breed ? in the crevices of old buildings, on rooftops, inside used tires, in vacant lots and garbage dumps.

 

[Gert van der Hoek]

Re: Brazil: Dengue Outbreak

Brazil takes action as dengue fever death toll hits 47


RIO DE JANEIRO (AFP) ? Brazilian authorities have started a crisis center to deal with a dengue fever outbreak in the state of Rio de Janeiro that has so far this year claimed 47 lives.

Health Minister Jose Gomes Temporao said Thursday the army was being mobilized to cope with the problem, with 51 more people becoming infected every day.

"The dengue mosquito infection in Rio shows an alarming situation and more concrete action has to be taken," he said.

Most of the deaths have occurred in the city of Rio, and children account for 25 of the fatalities.

Dengue fever is a tropical virus transmitted by mosquitos. In extreme cases it can cause hemorrhage and death. No vaccine is yet commercially available.

Federal and Rio state officials are to meet in Brasilia on Monday to draft a strategy aimed at decimating the Aedes aegypti mosquitos responsible and providing better care for infected patients seeking treatment in overcrowded and understaffed hospitals.

The head of the Rio Doctors Association, Jorge Darze, on Wednesday said his organization was going to sue city, state and federal authorities for "negligence" and "putting the population in danger."

http://afp.google.com/article/ALeqM5hlG0YgL2p52p0Ey0wMFoig5OdkvQ

 

[Gert van der Hoek]

Re: Brazil: Dengue Outbreak

Reports on a dengue outbreak last year in Brasil:

http://www.flutrackers.com/forum/showthread.php?t=17506

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.bloomberg.com/apps/news?pid=20601086&sid=aaN6afDH3.YE&refer=latin_america

Rio de Janeiro Has 2,053 Dengue Cases in 24 Hours, Globo Says

By Jeb Blount

March 21 (Bloomberg) -- Rio de Janeiro health authorities recorded 2,053 new cases of dengue fever yesterday, double the previous day's number, the Globo daily newspaper reported. At least one victim, a seven-year-old girl, died.

The city has recommended that residents and visitors avoid wearing shorts, use insect repellent and cover their arms, wrists and ankles, to prevent bites from virus-carrying mosquitoes, Globo said.

The city may run out of platelets by March 23, Globo said. The blood product promotes clotting and is needed to save the lives of people with more advanced forms of the disease. So far this year, 23,555 people have contracted the disease in Rio de Janeiro and 30 people have died, the newspaper said, citing city health officials.

Dengue comes in several strains and is difficult to diagnose, Globo said. Known to some as ``bone-break fever,'' it often causes severe joint pain, elevated body temperature, diarrhea, vomiting and bruising. People who suffer repeat infections from different strains run the risk of potentially fatal internal bleeding.

To contact the reporter on this story: Jeb Blount in Rio de Janeiro at jblount@bloomberg.net
Last Updated: March 21, 2008 14:08 EDT

 

[sharon sanders]

Re: Brazil: Dengue Outbreak

Brazil minister says Rio dengue mortality too high

By Rodrigo Gaier

RIO DE JANEIRO, March 24 (Reuters) - The mortality rate from the hemorrhagic form of dengue fever in the Brazilian city of Rio de Janeiro far exceeds rates considered acceptable in the world, Health Minister Jose Temporao said on Monday.

A dengue fever epidemic has killed 48 people in Rio state this year, compared to 31 in all of last year, according to state health officials.

Visiting the famous beach city, Temporao said the situation was "grave and difficult" and that army doctors would fight the outbreak, possibly mounting field hospitals to help the infected.

He said the World Health Organization considers mortality rate of 1 percent of people infected with the hemorrhagic strain of dengue acceptable.

"Compared to WHO norms, here it's five time as much. Mortality is above 5 percent. ... The number of deaths is totally above expectations that could be considered reasonable," Temporao told reporters.

News reports had earlier put Rio's death toll from dengue fever this year at 49.

Some 32,000 cases of dengue, including hemorrhagic, have been reported since Jan. 1 in Rio state. Most deaths and cases are in Rio de Janeiro, Brazil's second-biggest city. Temporao did not provide the estimated number of hemorrhagic cases.

Dengue fever is a viral disease spread by the Aedes aegypti mosquito and there is no vaccine or drug to treat it. It has various strains, including the potentially lethal hemorrhagic form, which tends to affect people who had earlier contracted a weaker strain.

The minister said a combination of factors including wide circulation of at least two dengue strains in Rio, rains and heat that breed mosquitoes and a poor disease prevention network had contributed to the epidemic.

Authorities will deploy more cars equipped with powerful insecticide sprays and reinforce hospitals medical staff, Temporao said.

"Data show we're at the peak of the disease. A reversion should be possible in the coming weeks," he said.

Most affected areas are relatively far from the districts frequented by tourist, but as the disease is spread by mosquitoes, nobody is totally safe.

Public hospitals in the northern and western districts of the city were overwhelmed by the number of patients seeking treatment at the weekend. Treatment primarily involves increased fluid intake, orally and intravenously. (Writing by Andrei Khalip; editing by Mohammad Zargham)

http://www.reuters.com/article/latestCrisis/idUSN24343607

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.iht.com/articles/ap/2008/03/27/america/LA-GEN-Brazil-Dengue.php

Dengue death toll rises to at least 54 in Brazilian state
The Associated Press
Published: March 27, 2008

RIO DE JANEIRO, Brazil: A dengue epidemic has claimed at least 54 lives in Rio de Janeiro state since January, health officials said Thursday.

Hospitals have reported a total of 114 deaths, but 60 of those cases are still being investigated, the officials said.

The majority of the confirmed deaths, 31, have been in the city of Rio de Janeiro ? Brazil's biggest resort city ? which has seen a 25 percent drop in tourism as a result, the Brazilian Hotel Association said.

About half of the victims were children under the age of 13.

More than 43,000 people have contracted the mosquito-borne disease since January in Rio de Janeiro state ? nearly double the 25,107 cases reported in all of 2007. The state is home to 16 million people.


State health official Victor Berbara said the outbreak highlights the importance of fighting the dengue-carrying Aedes aegypti mosquito all year ? not just between November and May when most infections occur.

"If nothing is done ... next year is going to be much worse," he told reporters.

Earlier this week, federal officials sent hundreds of health workers to Rio de Janeiro state to help care for victims in the state's overcrowded emergency rooms, and set up special tents with extra hospital beds in the city.

Other agents were being deployed to spray insecticide and help root out standing puddles of water where the mosquitoes breed.

The army also is being called in to help, officials said. Local media reported Thursday that 500 federal troops would be deployed next week to set up three field hospitals around the city and to help combat mosquitoes.

On Wednesday, Rio de Janeiro state Gov. Sergio Cabral ordered health officials to break into homes suspected of containing standing bodies of water if the owners could not be found.

Dengue, which has no vaccine, can incapacitate patients for over a week with severe headaches and joint pains, but is not usually fatal.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.economist.com/world/la/displaystory.cfm?story_id=10925811

Feverish in Rio

Mar 27th 2008 | RIO DE JANEIRO
From The Economist print edition
The dengue mosquito exposes public-health laxity
A failure of prevention, followed by panic

THE ?hydration tents? for rousing the stricken have been pitched. Hundreds of doctors, nurses and health inspectors have been deployed. The armed forces are on the way. To anyone arriving in Rio de Janeiro, the hum in the streets might seem impressive. To cariocas, as the city's natives are called, the scene is sadly familiar. Sure as summer, mosquito-borne dengue fever is back. But this time the outbreak is Brazil's worst-ever, according to some public-health specialists.

Dengue causes high fever and excruciating aches (it's known as break-bone fever) that can send patients to bed for days. It can also be fatal. Officials point out that far fewer Brazilians have fallen ill with dengue this year than last. But while the infection rate is down 40% nationwide this year, in Rio de Janeiro the disease is out of control. Some 27,000 people in the city of Rio have been stricken so far, double last year's toll. Hundreds have succumbed to a deadly haemorrhagic variety: 49 people have died, more than half the death toll from the disease for the whole of 2002, Rio's deadliest year on record. As summer starts to turn to rainy, warm, mosquito-friendly South American autumn, the epidemic is far from over.

Before 1980, dengue was fairly rare in Latin America, and the lethal haemorrhagic strain was almost unheard of. Public-health workers armed with pesticides had all but wiped out aedes aegypti, the mosquito which carries both dengue and yellow fever. But victory was declared prematurely: commitment and budgets dried up, while cities continued to grow. The felling of Brazil's Atlantic forest freed a host of bugs, some of which found new homes in ill-drained, jerry-built urban favelas (slums). Old tyres and neglected swimming pools, septic tanks or potted plants?the mosquito has many incubators.

With every fresh outbreak, the virus grows stronger. By 2003, 24 countries in Latin America and the Caribbean were reporting haemorrhagic dengue, according to the Centres for Disease Control, an American government agency. Most health authorities despair of eradicating aedes agypti. A vaccine is said to be still five to ten years away.

Brazil accounts for 70% of cases in the region. Pest control is especially difficult in crime-ridden Rio suburbs, where residents are loth to open their doors to strangers. Half the new cases of dengue are in the city's west end, where favela drug lords often bar anyone in uniform, whether police or mosquito killers. City officials report that neighbourhood dengue patrols were turned away, or found nobody in, at four out of ten city homes.

A year ago, experts from the health minister down said that dengue risked getting out of control. They worried about the proliferation of mosquitoes, and the return after a long absence of type-2 dengue, a strain to which many younger Brazilians have no immunity. But officials have quibbled over whether the dengue mosquito is ?municipal, state, or federal?, as a bitter joke has it. Only on March 24th, with the body count rising and emergency rooms strewn like flophouses with prostrate patients, did national and local officials convene a ?crisis cabinet?. Sadly, inflamed rhetoric and listless bureaucracy are not new symptoms for Brazil's body politic. It will take more to crush the mosquito.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://news.bbc.co.uk/2/hi/americas/7320036.stm


Rio accused of neglecting dengue
By Gary Duffy
BBC News, Sao Paulo

A mother with her son, who is suffering from dengue-like symptoms, waits for treatment in Jacarepagua, in Rio de Janeiro, on 27 March
Many of the sufferers are children

A Brazilian judge has ordered Rio de Janeiro state and city to start using private hospitals to help cope with a surge in cases of dengue fever.

At least 54 people have died across Rio state since the start of the year while the number of people infected is now said to have passed 43,000.

The judge accused the authorities of neglect and indifference to sufferers of the mosquito-borne fever.

They had failed to act to prevent and contain the epidemic, she said.

For weeks, hospitals in Rio have been struggling to cope with the latest outbreak of dengue, a disease which is spread by one type of mosquito and which in extreme cases can be fatal.

Agony

On Friday at just one hospital in the city people said they had been waiting around five hours to receive attention, and a long queue stretched out of the emergency room into the street outside.

A short time afterwards, a woman waiting in the hot sun for attention fainted and had to be carried away.

Judge Patricia Cogliatti de Carvalho has now ruled that the state and city have to send patients with dengue to private hospitals and clinics when demand exceeds the capacity of public hospitals.

The state would then have to pay for the treatment within 20 days.

In her ruling, the judge spoke of the "neglect and indifference" shown by the authorities in relation to dengue.

This had meant patients, including old people and children, passing through indescribable agony and embarrassment as they waited hours for treatment, as well as running the risk of losing their lives.

Brazil's Health Minister, Jose Gomes Temporao, has acknowledged that incomplete information means the death toll and the number of cases reported are almost certainly much higher.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.alertnet.org/thenews/newsdesk/N31402843.htm

Fever-hit Rio residents flock to military hospitals
31 Mar 2008 19:38:33 GMT
Source: Reuters
By Pedro Fonseca

RIO DE JANEIRO, March 31 (Reuters) - The Brazilian military opened three field hospitals on Monday in Rio de Janeiro to help prevent more deaths from a dengue fever epidemic that has overwhelmed public clinics.

The outbreak has killed 54 people since January and infected more than 43,500 in Rio de Janeiro state, according to official figures.

About 1,200 military doctors and staff will work in the hospitals, which have a total of 140 beds. They will stay open around the clock.

In addition, 500 more troops will be deployed in the streets to help eradicate the dengue mosquito.

Among those turning up at a field hospital on Monday was Jorge Luiz Carvalho Alves. He had taken his 6-year-old daughter to four public hospitals only to find long lines. Over the weekend, a private clinic diagnosed her with the potentially lethal hemorrhagic form of dengue.

Alves said he had to borrow money to pay for the private consultation but it did not include treatment so he brought her to the field hospital's intensive care unit.

"Apparently she is in bad shape and will be hospitalized," he said, tears in his eyes, outside the camouflaged tents of an air force field hospital in Barra da Tijuca neighborhood. "Many people, many children will die still if it's left to public hospitals."

Dengue is a viral disease spread by the Aedes aegypti mosquito and there is no vaccine or drug for it. Treatment primarily involves increased fluid intake, administered orally and intravenously.

It has various strains, including one that causes the hemorrhagic form. It tends to affect people who previously have contracted a weaker strain.

'HERE IT'S WONDERFUL'

The waiting lists at military hospitals were short on the first day and triage efficient.

"In the hospital you wait and wait and people have no respect for you. Here it's wonderful," said Ana da Silva Henrique, a 29-year-old cleaning maid who took a bus for 90 minutes to get to a field hospital on Monday morning.

She was put on an intravenous drip an hour after coming. At a public hospital near where she lives, she had waited in line for four hours and been sent home with pains and fever after a quick consultation.

Authorities have deployed cars equipped with powerful insecticide sprays and were checking areas with pools of stagnant water where mosquitoes can breed.

Last week, Health Minister Jose Temporao blamed a poor disease prevention network and fragile public health system for the crisis.

In 2005, the military also set up field hospitals in Rio after a breakdown in the state public health system led to long lines at hospitals.

Authorities hope the outbreak will ease in the coming weeks with the arrival of cooler weather after a hot, wet summer.

Most of the affected areas are relatively far from tourist districts, but no one is completely safe from the mosquito-borne disease. (Writing by Andrei Khalip; Editing by Angus MacSwan and Xavier Briand)

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://news.bbc.co.uk/2/hi/americas/7324000.stm

Brazil army aids Rio dengue fight

The Brazilian military has opened three new field clinics in Rio de Janeiro to help officials tackle a surge in dengue fever that has overwhelmed hospitals.

Officials say 13 people have died since Friday, bringing the number of deaths this year in Rio de Janeiro state to 67, with some 45,000 people infected.

The mosquito-borne disease causes high temperature, headaches and muscle pain and, in extreme cases, can be fatal.

President Lula has said all levels of government have mishandled the crisis.

"It's the responsibility of the president, the governor, the mayor and each resident of this country," he said on Monday night.

"If we don't clean up the water in our home, our street, our city, our state, we will all be victims of irresponsibility."

Stagnant water

Brazilian Health Minister Jose Gomes Temporao last week said Rio's municipal authorities bore much of the blame, by failing to spray against mosquitoes early enough to control the outbreak.

A judge also ordered Rio authorities to begin using private hospitals to cope with the surge in cases, accusing officials of neglect and indifference.

Nationwide, the number of dengue cases is 27% down on the same period last year, according to the health ministry.

But the mayor of Rio, Cesar Maia, has said that the city was not warned early enough by the federal authorities of the scale of the problem.

Rio state officials said the three new military field hospitals should help to ease the pressure on emergency rooms packed with people suffering from dengue.

"We have to enter into combat like we're fighting a war, to minimise the suffering of the population," Major Robert Tury told the Associated Press.

The authorities have also been spraying areas with powerful insecticides and inspecting areas with pools of stagnant water where mosquitoes can breed.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.washingtonpost.com/wp-dyn/content/article/2008/04/02/AR2008040203244.html

Brazil's Military Mobilizes Against Dengue
Outbreak Leaves 67 Dead, Sickens Tens of Thousands

By Monte Reel
Washington Post Foreign Service
Thursday, April 3, 2008; Page A08

RIO DE JANEIRO -- Brazilian military troops joined public health workers this week to battle the deadliest outbreak of dengue fever to hit this city, which in recent years has been the epicenter of the disease's resurgence throughout Latin America.

Officials on Tuesday confirmed that 67 people have died from the mosquito-borne virus so far. Tens of thousands of people here have been sickened, and many of the most serious cases -- including the majority of the fatalities -- have been children.

More than 1,200 military personnel arrived in Rio this week to spray insecticide in hard-hit neighborhoods and erect emergency hospital tents. At some of those tents, Brazilians were expressing anger over the government's failure to take preventive action sooner.

"I think that the state and municipal governments here were irresponsible in the way they handled this, because they didn't do anything until the problem was already out of control," said Isabel Belo, 35, whose ill 11-year-old daughter was hooked up to an IV bag. "Now, everyone is just trying to pass the blame around to someone else."

According to dengue experts, the outbreak can be largely attributed to the rise of hundreds of unplanned, densely populated shantytowns in Rio.

Wellington Sun, chief of the dengue branch for the Centers for Disease Control and Prevention, said the demographic shifts that turned Latin America from mostly rural to predominantly urban in recent decades have given the dengue-carrying mosquito a perfect environment in which to thrive. The mosquito needs only a tiny amount of standing water to breed -- even a piece of crumpled plastic garbage is enough, Sun said. Eliminating breeding pools is very difficult in areas where trash collection is infrequent and where water and sewer services are lax.

"The mosquito -- Aedes aegypti-- has found a very favorable environment in cities where there has been fast growth without the corresponding infrastructure," said Jarbas Barbosa, a Brazilian doctor who is the head of health surveillance and disease management for the Pan-American Health Organization. "In a lot of neighborhoods in Rio, for example, they store water on their houses because they don't have 24-hour, seven-days-a-week water service."

Between the 1950s and the 1980s, dengue was practically unknown throughout the Americas, as it had been successfully eradicated in many tropical countries through intensive insecticide efforts. But after those efforts were relaxed, the mosquito that carries dengue and yellow fever reappeared in most of the countries where it had been eliminated.

Rio de Janeiro has emerged as a main breeding ground. Serious dengue outbreaks hit the city in 1986, 1995 and 2002, but this year's has proved more lethal.

Children between the ages of 5 and 12 are showing the most severe symptoms. They have accounted for about 40 of the deaths confirmed so far, according to officials.

At one emergency tent in a southern neighborhood of this city, about 500 people -- many of whom had been referred to the tent by overwhelmed hospitals -- arrived Sunday for blood count tests that can help detect the likelihood of dengue exposure. Maj. Wilson Braz, a fire department medic overseeing the tent, said most were children.

Like Belo, many of the parents of those children have been criticizing public officials for inaction until the fatalities began to multiply in recent weeks. Now the city is covered with advertisements reminding people to use repellent and eliminate standing water, and health officials are aggressively spraying neighborhoods and standing water pools.

Brazilian President Luiz In�cio Lula da Silva on Monday night said all Brazilians -- not just the local officials who are catching most of the criticism -- share responsibility for the situation.

"It's the responsibility of the president, the governor, the mayor and each resident of this country," Lula said. "If we don't clean up the water in our home, our street, our city, our state, we will all be victims of irresponsibility."

 

[Treyfish]

Re: Brazil: Dengue Outbreak

<TABLE cellSpacing=0 cellPadding=10 width="98%" align=center border=0><TBODY><TR><TD><TABLE height=30 cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD align=left>Brazil Rio dengue fever rampant sustained nearly 60,000 people were infected
</TD><TD width=120>

2008/04/08 06:42:37​

2008/04/08 06:42:37​

</TD></TR></TBODY></TABLE></TD></TR><TR><TD class=gray16CN vAlign=top align=left> (CNA Tang Ya-ling on the 7th Sao Paulo) - Brazil integrated media reported that the outbreak of dengue fever in Rio de Janeiro sustained serious public hospitals and the military set up temporary medical stations have been overcrowded.

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Although states mobilized doctors from the Ministry of Health to the Rio, or the lack of child care is a pediatrician doctor.

According to the "Globe" that, in addition to requisition doctors from the field, the Rio municipal government also began to leave with neighbouring cities. Health Office will blame the doctors, they said that after graduating from the Faculty of Medicine is not public hospital services, would like to gain access to private hospitals and clinics to make money. Medical Association argued that the salaries of public hospitals is too low and therefore unable to recruit doctors.

Rio governor Cabral is also seeking help to Cuba to assess the possibility of the Minister of Health Tamboux Long was opposition to derision as "Minister of dengue fever." The face of this chaotic situation, but officials would make an issue of the paper, claims to the court banned hospitals can not have long queues of patients with the situation, but could not see the implementation of specific measures to improve the epidemic.

The problem is that the Rio epidemic may spread to the whole of Brazil, the city of Sao Paulo have been killed in a case of the other 30 cities may also face similar Rio dengue fever outbreak, including维洛Hong Kong, pagoda Leisha, El Salvador, Momashi such as Belem and the capital. These cities have shown Rio dengue fever outbreak of the epidemic before the symptoms, such as rampant mosquito vectors Egypt spot virus and the flow of the increase.

In addition, a four-Manaoshi virus is worrisome. This type of virus has not spread in Brazil, but the disease may cause more serious now, because the majority of the people of the virus has not been immune.

So far, Brazil recorded in the whole country this year, dengue fever cases have been more than 134,000 cases and 87 deaths; only Rio on the number of areas affected nearly 60,000, and 67 people were killed.:tiphat: </TD></TR></TBODY></TABLE>
http://209.85.135.104/translate_c?h...trSearchDate=&strNewsID=200804080031&strType=

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://afp.google.com/article/ALeqM5hfb4qMCLyMRRKrfAI4_kSooPiMug

Dengue fever kills 12 more people in Brazil

1 hour ago

RIO DE JANEIRO (AFP) ? Twelve more people died from dengue fever in Rio de Janeiro state, raising to 79 the death toll from the start of the year and to 75,399 the infections by the mosquito-borne disease, health authorities said Wednesday.

In the past week, 12 people died and more than 18,000 new infections were reported throughout the eastern state, Rio's Health Ministry said.

Another 80 deaths are being investigated to see if they were caused by dengue fever, whose symptoms are high temperatures and muscle aches. In extreme cases, hemorrhage and death can follow.

The tourist city of Rio was worst hit by dengue, with 44 reported deaths since Wednesday last week, with another 33 reported elsewhere in the state. The city also has the highest infection rate of the region.

Rio Governor Sergio Cabral recently said he may appeal to Cuba for doctors to help treat patients, many of whom have been sent to tent hospitals set up by the army to cope with the large number of people affected.

Around 1,200 military personnel have joined health service staff in fumigating areas that may contain mosquito colonies.

Children are especially at risk from dengue fever. No vaccine is yet commercially available.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.pr-inside.com/neglect-political-squabbling-hamper-brazil-s-r530961.htm

Neglect, political squabbling hamper Brazil's fight against increasingly deadly dengue fever
? AP

2008-04-10 20:36:41 -

RIO DE JANEIRO, Brazil (AP) - The shantytowns clinging to Rio's lush jungle hillsides are fertile breeding ground for a tiny black mosquito whose bites are causing an increasingly deadly dengue fever epidemic.
Crevices in dilapidated hovels, old tires and trash piles collect standing water where the insect breeds, while kids toting automatic weapons scare
away the few public health agents who might teach slum dwellers how to protect themselves.
Successfully fighting dengue requires tedious, labor-intensive and well-organized efforts to persuade people to remove trash and standing water and accept the spraying of insecticides. Add government neglect and political infighting to the mix, and the result can be devastating.
Since January, dengue has killed at least 79 people and sickened over 75,000 in the surrounding Rio state, home to 40 percent of all of Brazil's cases of the disease. Another 80 deaths have been reported but are awaiting blood tests, the state health secretariat said Thursday. If confirmed as dengue, Rio's death toll this year would be higher than all of Brazil last year.
Nearly half of this year's fatalities have been children under age 14.
?They can't just fight the disease in the streets of Copacabana and Leblon,? said 48-year-old Gloria Mendonca, referring to two fashionable beach neighborhoods. ?They have to come to the poor communities. They have to see the children dying.
Mendonca and her 5-year-old son, who live in the Salgueiro Hill shantytown, are still recovering from the disease, which causes high fever, severe headaches and flu-like symptoms, nausea, rashes and joint pains for more than a week.
A neighbor's son was not so lucky _dying days after contracting a more virulent, hemorrhagic dengue that causes internal and external bleeding.
?Imagine the pain of a mother raising a child and losing it to tiny mosquito,? said Mendonca, who took pains to eliminate puddles of standing water at home _ but still came up short.
There is no vaccine for dengue _ also known as ?bonebreak fever? _ which is spread only by mosquito bites. Treatment includes pain relievers, rest and fluids. In Rio, the army has set up special ?hydration tents? where patients are fed sterile saline solution intravenously to avoid severe dehydration.
Unfortunately, the more mosquitoes go unchecked, the deadlier the disease becomes. Mosquitoes carry four different strains of dengue, and there is good evidence that people who survive one or two infections will be more likely to contract the more deadly form of dengue if infected with another strain, according the U.S. Centers for Disease Control and Prevention.
Such neglect isn't unique _ Rio's shantytowns are at the leading edge of a dangerous global trend, with hemorrhagic dengue rising sharply, particularly among children, according to the Pan American Health Organization.
Mendonca's one-room shack abuts a thick patch of rain forest where puddles are all but impossible to root out. Just up the hill, hundreds of black larvae of the Aedes aegypti mosquito could be found seething inside an abandoned cistern. Residents in these shantytowns behind the famous mountaintop Christ the Redeemer statue also store drinking water in piles of capless plastic soda bottles.
?It's a perfect breeding ground for mosquitoes. They like clean water and don't need very much of it to breed,? said Josh Ruxin, founder of the Neglected Tropical Disease Control Project.
The job of helping some 5,000 families in Salgueiro Hill eradicate mosquitoes falls to two environmental agents employed by the mayor's office who haven't been paid since January.
They're also charged with keeping the hovels from expanding into the Tijuca National Forest above, limiting the local rat population and keeping tabs on pigs that roam about freely.
?The pump breaks for 10 days, two weeks at a time,? said Denise Silva da Sousa,32, a Salgueiro Hill resident. ?People have to go down and carry the water up the hill on their heads. If they find a larvae in the water, they're not going to throw the water out.
The agents try to teach residents not to let garbage pile up, which is difficult in slums without enough trash bins, Sousa says.
Failure to fight the disease, however, is not limited to the city's shantytowns.
Jorge Darze, president of the Rio de Janeiro doctors' union, has accused the government of criminal negligence in the epidemic. While the virus infected 900,782 people across the Americas last year, killing 317, more than half of the cases were in Brazil.
After an intense eradication effort in the months leading up to the July 2007 Pan American Games, health agents and insecticide campaigns all but disappeared from Rio's streets afterward, Darze said.
?The threat of an epidemic was already apparent since last year and the city did nothing. And neither the state or federal government pressured them to do anything,? he said. ?The mayor can't run for re-election, so he left it all to luck and the Lord.
Political rivalries caused the mayor to turn down a federal offer of 3,200 health agents, said Sandro Cezar, president of the Rio de Janeiro state health workers' union.
?That's a lie,? responded Rio de Janeiro Mayor Cesar Maia in an e-mail to The Associated Press, blaming political agitators ?who don't want to work? for spreading false accusations.
The mayor claims the worst is over. Dengue outbreaks usually peak around April, then taper off as the Southern hemisphere's winter approaches and the weather gets too cold for mosquitoes.
Federal health officials declined to comment on the alleged infighting. But in March, Health Minister Jose Gomes Temporao noted that while dengue cases were down 40 percent across Brazil, the number of cases in Rio had exploded.
That suggests adequate preventive measures were not in place, said Jarbas Barbosa da Silva, area manager for Health Surveillance and Disease Management at the Pan American Health Organization.
?Policy makers need to think about dengue control like HIV/AIDS. We need to inform people and encourage them to make some changes in behavior to prevent the mosquito,? Silva said.
Scrambling to catch up, authorities have established military field hospitals and pleaded for pediatricians to come help treat the victims. On Tuesday, 500 army soldiers were finally deployed to help spray insecticide.
State Health Secretary Sergio Cortes says the battle is far from over.
?I don't have the slightest doubt that we could have a new epidemic,? Cortes said. ?We will have to change a lot of things and mobilize society.

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.nytimes.com/2008/04/15/w...em&ex=1208318400&en=1845bee384aa9626&ei=5087

Dengue Outbreak Sweeps Through Rio
By MERY GALANTERNICK and ALEXEI BARRIONUEVO
Published: April 15, 2008

RIO DE JANEIRO ? Heavy rains over the past month have created a fertile breeding ground for mosquitoes carrying the dengue fever virus, deepening a crisis that has claimed at least 80 lives in Rio state.

The dengue strain ravaging this tropical city is now considered stronger and more lethal than the virus responsible for an epidemic in 2002, considered the worst in recent history in Brazil, according to Rio?s health secretary.

The spreading epidemic has shown no signs of slowing. Since January, 75,399 people have been infected in Rio state, health officials say. The mortality rate is now more than three times as high as it was during the epidemic in 2002, which claimed 91 lives.

There is no vaccine for dengue, also known as ?bonebreak fever,? which is spread by bites from the Aedes aegypti mosquito. Dengue produces high fever, a rash, nausea, vomiting and severe headaches and joint and muscle pains. The treatment includes pain relievers, rest and fluids. The disease usually lasts about one week.

Children younger than 15, who have little immunity, are the most susceptible to being infected. At least 35 children have now died from the disease in Rio state.

As the death toll has mounted, public officials have been slow to react, in part because no one could decide if the mosquito was a city, state or federal issue. In recent days physicians have been brought in from other states, and the federal government has sent in 1,700 members of the armed forces to help efforts against the disease.

Last week army and navy service members trained by health officials began a 30-day tour on the streets of Rio state, visiting 95,000 homes in an effort to identify breeding grounds for the mosquito and to teach residents how to help prevent the disease. The service members are also feeding patients intravenous saline solution to avoid severe dehydration.

The latest outbreak was set off by heavy rains over the past few months. The mosquito breeds in uncovered water tanks, in pools of stagnant water and in discarded tires that accumulate water. The shantytowns built along jungle hillsides here provide a fertile breeding grounds for the mosquitoes.

The dengue outbreak is taking a toll on tourism. The embassies of several countries, including the United States, Portugal and Italy, issued alerts on their Web sites warning about the epidemic in Rio, the main gateway into Brazil for foreign tourists. Two Portuguese tourists were infected in Rio, Portuguese newspapers reported. Officials recommend that visitors wear trousers and long-sleeve shirts, and that they spray insect repellent on uncovered skin three times a day.

When two children died from dengue here last November, the local authorities determined that a second type of dengue virus was present that could cause more casualties among children than the 2002 epidemic. In its more severe form, the dengue hemorrhagic fever causes internal bleeding and can eventually kill. According to the city of Rio?s health secretary, 50 people who have died were infected with hemorrhagic dengue, half of them children younger than 12. The death toll in the city is now more than half of the 91 casualties reported in 2002 for all of Rio de Janeiro state.

In Jacarepagu?, one of the most-afflicted neighborhoods in the city, the air force put up 15 barracks with space to attend to up to 400 patients a day. ?There were many more people needing assistance than we could handle,? said Col. Henry Munhoz, a spokesman for the air force.

Last week 4,000 former guides to the Pan American Games were called back to help fight the disease. The governor of Rio state, S?rgio Cabral, unveiled a package of dengue-related measures, including an educational campaign for public transportation, schools and police stations.

But those efforts are meant to avoid an epidemic next year. The governor has expressed frustration at the lack of effort by city officials in preventing the disease. ?But right now we are facing a crisis; we don?t have time to debate whose responsibility it is,? he told reporters late last month. ?It?s useless to cry over spilled milk. There are people dying.?

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.sciam.com/article.cfm?id=rio-officials-meet-foreig
April 18, 2008 spacer

Rio officials meet foreign envoys on dengue alarm

RIO DE JANEIRO (Reuters) - Brazilian officials met representatives of 35 countries on Friday to answer their concerns over a dengue fever outbreak in Rio de Janeiro, saying the disease was at its peak but may not yet be under control.

Rio state officials called the meeting with envoys from the United States, Japan and France among other countries over the mosquito-borne disease that has killed at least 87 people in the region and sickened more than 93,000 this year.

"We are at the peak of the epidemic with a trend towards a decline, but this isn't a reason to celebrate yet," Sergio Cortes, the state health secretary, said after the meeting.

He said that smaller lines of sufferers at hospitals in recent days were not necessarily a sign the outbreak was in retreat because many people were going to new hydration centers set up to treat dengue victims.

Brazil's worst dengue outbreak in years has highlighted the stark difference between rich and poor in the picturesque beach-side city.

Unsanitary conditions and a lack of medical centers in the city's hundreds of slums have worsened its impact among the poor, while tourist areas like Copacabana and Ipanema have been largely unscathed.

The Globo newspaper reported that occupancy rates in Rio's hotels were down 15 percent from the year before for the coming long holiday weekend due to dengue fears.

Two Portuguese tourists fell ill with dengue while on vacation here, but most foreign visitors appear undeterred.

Hugues Goisbault, the French consul-general in Rio, said that his consulate had been receiving calls from concerned tourists but that flights from France to Rio "had never been so full."

(Reporting by Pedro Fonseca; writing by Stuart Grudgings; Editing by Andrei Khalip and Vicki Allen)
Reuters



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[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.latimes.com/news/nationworld/world/la-fg-dengue21apr21,1,5024694.story

Dengue Outbreak Shows Dark Side of Rio de Janiero

The mosquito-borne fever has killed nearly 90, hitting children and the poor the hardest, and prompted outrage at city officials.

By Andr?s D'Alessandro and Patrick J. McDonnell, Los Angeles Times Staff Writers
April 21, 2008

RIO DE JANEIRO -- Brazil is booming. The currency is soaring, people are buying houses and cars at a record pace, and global financiers are keen to invest. The country seems poised to acquire official First World status.

But residents of this self-proclaimed city of wonders are worried and angry about a Third World affliction -- dengue fever, the tropical disease spreading in epidemic fashion here.

As of Friday, health officials reported that dengue had killed at least 87 people in the state of Rio de Janeiro this year and sickened more than 93,000. Most cases occurred here in the city, Brazil's principal tourist attraction. Children 15 and younger have been especially hard hit, accounting for almost half of the dead, officials said.

Dengue has become an annual scourge in a swath of tropical Brazil, but this year's epidemic seems likely to be Rio's deadliest in recent history.

Rather than blame the stripe-bellied Aedes aegypti mosquito that spreads the ailment, many Cariocas, as Rio residents are known, are lashing out at what they call a confused and belated government response. Critics say officials were slow to fumigate and take other action during the Southern Hemisphere summer, when heavy rains created optimum mosquito breeding grounds.

"This epidemic is purely the responsibility of local and national authorities," said Edna Rollin, 58, a history teacher who expressed the sentiment of many interviewed in the bustling Cinelandia plaza downtown. "They stopped fumigating in summer, and now we are paying the consequences."

Lawmakers have pointed fingers at each other in a blame game reminiscent of what happened in New Orleans with Hurricane Katrina -- which also hit the poor hardest and exposed a dark underside of an international tourist mecca.

With the number of cases soaring and clinics overwhelmed, officials this month belatedly directed more than 1,000 soldiers to join firefighters, volunteers and others in patrolling streets and inspecting tens of thousands of homes in a much-publicized offensive. The teams fumigate and destroy stands of still water, where mosquitoes breed.

Anti-dengue squads are focusing on the poor hillside favelas where many live in close quarters amid substandard sanitary conditions. Declared Rio Gov. Sergio Cabral, "We must fight dengue in the same way we cannot tolerate the occupation of favelas by drug traffickers."

The dengue epidemic, like the gun battles pitting police against traffickers in the favelas, has become a nasty blemish on Rio's glam image. Some accuse the government of trying to keep a lid on dengue to avoid scaring off tourists.

There have been scattered reports of reduced hotel occupancy rates, but no mass cancellations. At major hotels, the international airport or at approaches to tourist icons such as Corcovado and Sugar Loaf mountains, few signs warn visitors of the dengue threat.

But word is out. The U.S. and other embassies have advised visitors to take precautions, such as wearing long-sleeved shirts and avoiding short pants.

The heated dengue debate has again bared the deep divisions between Rio's haves and have-nots in a nation famous for income inequality. Residents of poor neighborhoods complain they have been ignored, until recently.

"I'm terrified that my baby will get sick," said Graciela Kauan, 16, her 8-month-old son in her arms at the Cinelandia plaza. "I cover my boy with insect repellent each night and he sleeps under a mosquito net."

Dengue fever, a viral disease transmitted by mosquitoes, is a flu-like ailment that is usually not fatal. However, physicians worry that a deadlier variant may be spreading here and in neighboring Paraguay, which also faces a dengue crisis.

There is no vaccine for dengue. Treatment usually involves rest and increased intake of fluids.

According to the Pan American Health Organization, dengue-infected mosquitoes have spread in the tropics worldwide thanks to factors such as rapid urbanization, lack of sanitation, and the heightened use of containers and tarpaulins made of plastic, which may provide breeding grounds for mosquitoes. Some experts say climate change also may have favored the dengue-carrying mosquito.

Although they say the epidemic has probably peaked, officials add that cases are unlikely to end until June or July and the arrival of cooler, drier weather.

Health experts hope that the outbreak will prompt earlier intervention in future years.

"There was evidence of an epidemic risk long ago," Luiz Pinguelli Rosa, an expert at the Federal University of Rio de Janeiro, told Agencia Brasil news service. "If the recent measures had been taken two months earlier, the situation would certainly have been better, both in fighting the mosquito and taking care of those infected."

patrick.mcdonnell @latimes.com

D'Alessandro reported from Rio de Janeiro and McDonnell from Buenos Aires. Special correspondent Marcelo Soares in Sao Paulo contributed to this report.

 

[Sally Furniss]

Re: Brazil: Dengue Outbreak

The health department of Brazil's Rio de Janeiro state announced Tuesday that deaths from dengue this year have reached a new high after surpassing the figure from the year 2002.

Since the beginning of this year, 92 deaths have been reported in Rio de Janeiro state, surpassing the recorded 91 deaths in 2002,said the department.

There have been 57,000 registered cases of dengue in the city since January, bringing the mortality rate close to one per thousand.

In the state's capital alone, 55 people have been killed by the disease among the 45,463 people infected this year.

In 2007, only 26 people reportedly died out of the 25,107 cases in the city.

The municipal civil defense department plans to initiate a program on Wednesday to brief the inhabitants of the eight neighborhoods about dengue precaution.

http://english.people.com.cn/90001/90782/6397616.html

 

[Shiloh]

Re: Brazil: Dengue Outbreak

Source: http://www.iht.com/articles/ap/2008/04/23/news/Brazil-Dengue.php
Brazil: Dengue toll hits 92 in Rio de Janeiro state; tops previous high
The Associated Press
Published: April 23, 2008

BRASILIA, Brazil: The death toll from a dengue outbreak in Rio de Janeiro state has reached 92, topping what was previously the state's deadliest bout with the disease, Brazil's government news agency said Wednesday.

The earlier outbreak, in 2002, killed 91 people, Agencia Brasil reported.

Another 96 possible dengue fatalities have been reported in the current outbreak but have yet to be confirmed, Agencia Brasil said. It cited figures from the Rio de Janeiro state Health Department.

On April 10, the department had been reporting at least 79 people confirmed killed by dengue so far this year.

The mortality rate from dengue has also soared to one death for every 1,204 cases, up from one per 3,167 in the 2002 outbreak.