Experts warned about zika and chikungunya epidemics next summer



A few months earlier in the summer experts warn that Brazil can again suffer from epidemics of Zika and Chikungunya. Despite the reduction in the incidence of cases this year, diseases transmitted by the Aedes aegypti mosquito can regain strength from December or January 2019, when the first wave of the outbreak has already passed in some states.

The researcher at Fundação Oswaldo Cruz in Pernambuco, Carlos Brito, said the country spent more than two years studying the effects of Zika as a result of the outbreak and bewilderment caused by microcephaly in infants. He pointed out, however, that the country is still not prepared for new cases of arboviruses, especially Chikungunya.

Basissanering has been identified as a solution to prevent outbreaks of diseases caused by arbovirus - Marcelo Camargo / Agência Brasil
Basissanering has been identified as a solution to prevent outbreaks of diseases caused by arbovirus – Marcelo Camargo / Agência Brasil

"In fact Chikungunya has been left aside, which for me is the most serious arboviruses, and people are usually unaware of gravity and also unwilling to lead Chikungunya, a disease that is not only acute in the acute phase. leads to severe cases, including fatalities, but also leaves a contingent of chronic patients, who have suffered pain almost two years ago, withdrawal from the usual activities of work, leisure, social life, "Brito said to Agência Brasil.

The researcher said that the incidence of the diseases will vary from region to region. Those states where many people are infected in the early morning of the outbreak, such as in the Northeast, may be immune for a while. However, many municipalities still have the opportunity to get new outbreaks, such as Rio de Janeiro, which recently registered several cases. (Link1)

"In Brazil everything has a very large dimension, because it is a country with a continental dimension, so we are not prepared, health workers are trained, nor are we aware of the dimension of disease intensity, nor are institutions aware of a major epidemic in a state like São Paulo with 40 million inhabitants or Rio de Janeiro, with 20 million inhabitants, & # 39; warned Brito.

reduction

According to the latest epidemiological bulletin from the Ministry of Health, released on Friday (17), 63,395 probable cases of Chikungunya fever were recorded from January to July 28 this year. The result is less than half of the number of reported cases in the same period last year of 173,450. In 2016 there were 278 thousand cases.

More than half, 61% of the cases reported this year, are concentrated in the Southeast region. Subsequently, the Middle West (21%), the Northeast (13%), the North (7%) and the South (0.35%) appear.

In the first seven months of 2018, 16 deaths were confirmed by Chikungunya. In the same period last year, 183 people died of arboviruses. The reduction in the number of deaths was 91.2%. Already before the Zika, 6,337 probable cases were recorded across the country and two deaths were recorded until the end of July. Last year, the virus infected more than 15,000 people in the same period. The highest incidence of Zika is also in the southeast this year (39%), followed by the Northeast region (26%).

threat

Despite the reduction of the incidence, researcher Luiz Tadeu Moraes Figueiredo, a professor at the Center for Virological Research at the Medical School of the University of São Paulo (USP), in Ribeirão Preto, warns that even after the dry season virus circulation these arboviruses can come back any moment. just like it happened with dengue fever and yellow fever.

"We do not have an epidemic, we have sporadic cases, but it's still a problem that can come back, yes, the arboviruses are like that, dengue, Zika, they all have times when they disappear and then come back. "It's in Brazil and it's still a threat." He can come back now, even this summer, the risk is present, "he told Agência Brasil.

Figueiredo said that it remains the challenge to timely diagnose Zika in order to prevent its consequences. Despite the progress in the research of recent years, rapid detection of the Zika virus that can be made available throughout the country has not yet been developed, according to the researcher.

"The difficulty continues, we've discovered some things that can help diagnose, but the problem is not solved yet, the more effective you are to find the virus, isolate it is more complicated, or you think that the genome of the virus or a certain virus protein in the acute phase would be very useful, you can discover in the woman if you are pregnant, "he explained.

Researchers point out that the development of a vaccine is the ideal way to prevent the consequences of new outbreaks. They regret, however, that this solution is far from being realized. Meanwhile, the focus is still on controlling mosquito-borne viruses. "People need to be aware of and have control over the vector in their homes and thus avoid transfer, it is the only one [solução] that we have at that moment, "said Figueiredo.

Researcher Carlos Brito argues that the state should invest in improvements in the quality of life of the population and in sanitation infrastructure to control the epidemics caused by arboviruses.

Permanent monitoring

The Department of Health reported that the allocation of resources for vector control and other surveillance actions is permanent and has increased from R $ 924.1 million in 2010 to R $ 1.93 billion in 2017. For this year, the estimated budget is R $ 1, 9 billion.

In addition to the national mobilization to combat the mosquito, the map pointed out that since November 2015, when the state of emergency was declared by Zika, about R $ 465 million was allocated for research and development of vaccines and new technologies.


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