Source:
https://www.elterritorio.com.ar/un-...odria-llegar-a-un-cuadro-hemorragico-23518-et
Un 15% de quienes ya tuvieron dengue podr?a llegar a un cuadro hemorr?gico
S?bado 23 de marzo de 2019 | 00:00hs.
Google translation: 15% of those who already had dengue could reach a hemorrhagic condition
Saturday, March 23, 2019 | 00: 00hs.
After the confirmation of the circulation of dengue serotype DEN-4 by the sanitary authorities of Encarnaci?n, Paraguay, alarms were lit throughout the area, bearing in mind that Posadas is the mirror city with the Pearl of the South of Paraguay. The situation is even more serious since in late 2015 and early 2016 there was an outbreak of dengue in the country, with Misiones being the epicenter of the cases. The missionary capital and Puerto Iguaz? represented the localities with the highest febrile denunciation at that time.
In this regard, the Chief of Epidemiological Surveillance of the Ministry of Public Health of Misiones, Jorge Guti?rrez, spoke with the program Ac? te lo Contamos por Radioactiva and referred to the situation in the neighboring country and how it could affect the red earth. .
In the first instance, the health official commented that weeks ago there was a first alert when cases of serotype DEN-4 were detected in the neighboring country. He pointed out that in Paraguay cases of serotype 1 and 4 are under evaluation, while in Brazil the four variants are circulating. That is why he insisted that the constant migration that exists in the border context in which Misiones is located does not rule out the entry of other serotypes other than 1, which already circulates in the province, which could complicate the outlook for these sides, considering that a significant number of people contracted the pathology years ago.
"In that 2015/2016 season that was where we had more cases and all these years there have been others, more cases that were asymptomatic, created a carpet of people already infected. And the question is this: in general we have two moments in any patient. When one becomes infected for the first time, in this case with DEN-1, it has the clinical form of dengue, which can be a common clinical form or dengue shock, which is the strongest dengue that leads to hospitalization. What we were not going to have that time was the hemorrhagic form, because to have that shape we need two infections. A first, for example, a couple of years ago when a patient had an infection with serotype 1 and spend a couple of years and have a new infection now with serotype 4. So, there is currently a group, they are not all , about 10% or 15% that will make the hemorrhagic form, "warned the epidemiologist.
But he clarified that what happens in the neighboring city is for the moment "a wake-up call" and remarked that it was something that was expected because the DEN-4 is the serotype that was circulating in Paraguay. "It is the step forward of the different steps that the dengue is going to take in the region as in Misiones," he said.
He also anticipated that sooner or later that serotype will reach the red earth. "Serotype 4 is the next one that will appear. We have had a history of more than five years of serotype DEN-1 and we have a large number of patients who have obviously been having the disease to that serotype and that is going to make a kind of carpet on which in time they will go the patients of another serotype appear. And we knew it was going to be 4 because it is already in the region, "he said and again clarified that in Paraguay are circulating serotypes 1 and 4 of the disease and in Brazil on 1, 2, 3 and 4." So that We will not be exempt from this because we have too much migration of people who come and go to these places, "he said.
Unfailing
Given that compromised sanitary panorama, the person in charge of the Epidemiological Surveillance in Missions commented that cases of hemorrhagic dengue in the zone will appear. "If we have more cases of serotype DEN-4, we will see that cases of hemorrhagic dengue begin to appear in the region and it is something that will be installed almost unfailingly in time, that is, that's why we have to continue in the fight against the aedes, "he said.
On the other hand, he regretted that there are people who do not take to the state of affairs with the seriousness that merits and asked the community to keep eliminating potential breeding sites and avoid being bitten by Aedes aegypti using repellents, shirts and long pants. "We all have to take care of ourselves. But how do you take care of yourself if in your neighborhood there are people who do not take care of themselves and who have containers with water and it gives rise to the appearance of eggs and larvae, that's why it's everyone's problem. Apart from the situation of crossing borders, no matter how much one warns the population about the risks, people cross the same. That is why what we have to say is that we are facing this risk and if we do not need to cross, we do not cross. It is a situation similar to what happens with those who are not vaccinated and will go to places in Brazil where there is yellow fever. And it is sometimes unfortunate that one has to give this type of advice, but it is the most reasonable, "said the health professional.
Finally, he explained that the peak of occurrence of dengue cases in Misiones occurs historically in mid-February, then enters a plateau until the week following Holy Week, when another peak of infected again. "On that date the crossing to Paraguay is inevitable. Because we are going to cross to see the relatives in front and on the way back the disease is brought, it is something that happened every year and then it starts to descend until it almost disappears in June. Here we have the luck, because that is how dengue behaves and because we work hard, that the cases disappear in June and July. Something that has not happened in Brazil for many decades and in Paraguay for about five years, they still have cases in winter. So we have to keep working to maintain that winter gap that allows us to be epidemic and not endemic. "
Asked if the disease can be eradicated, he said no. "Dengue came to stay, at this time we have the largest cases in Iguaz?, but the entire Paran? coast may have dengue due to its proximity to Paraguay," he said.
Also consulted by El Territorio, Miguel Ruiz, Chief of Epidemiological Surveillance for the VII Sanitary Region of Paraguay, gave a new health part for the department of Itap?a and said that there are already 19 cases of dengue serotype DEN-4 in the department Paraguayan border with the province of Misiones, a sick more than yesterday. Of that total, 14 are in neighborhoods of Encarnaci?n, 3 in Natalio, 1 in Cambyret? and 1 in Trinidad. In the study there are 125 febrile and 35 probable cases, which were positive in a first analysis.
Also from the commune obere?a issued a "dengue alert" and affirmed the risk for those who have contracted the classic dengue serotype DEN-1. "It is recommended to maximize preventive measures avoiding stings when traveling to neighboring countries such as Paraguay and Brazil," they said.
A deceased in Paraguay
On March 8, the general director of Health Surveillance of Paraguay, Guillermo Sequera, confirmed the first case of death by dengue in 2019. The fatal victim, a woman of 31 years, from the department of Alto Paran? (opposite Puerto Libertad, Iguaz? and Wanda), entered the system with suspected severe dengue. The result of the Paraguayan Public Health Central Laboratory showed that the serotype was DEN-4. Sequera said that mortality can be prevented through timely consultation, so he asked the public not to minimize the tables and resort to the nearest health facility before any symptoms of fever or discomfort. The person with dengue may present fever, headache, retroocular pain, body aches, skin rashes (rash) and decay. The patient may worsen suddenly and show signs of alarm, including severe abdominal pain, persistent vomiting, even blood, rapid breathing, bleeding gums and fatigue.
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