Deaths caused by dengue soar in the state of São Paulo

The number of deaths from dengue in the state of São Paulo in the first five months of this year is at least 139% higher than in the whole of last year, according to data from the State Department of Health and the Ministry of Health.

According to the ministry’s epidemiological bulletin, last year, the disease transmitted by the mosquito Aedes aegypti ​caused 63 deaths in São Paulo — this data is reported by the São Paulo management to the ministry.

This year, from January to the 17th of last month, there were 134 deaths in the state, also according to the same ministry bulletin.

The São Paulo secretariat, with more up-to-date information, says that, this year, until the 24th, there were 151 deaths. Rodrigo Garcia’s management portfolio (PSDB) did not provide the Sheet the number observed in the same period last year.

The sum also exceeds that recorded in the entirety of 2020, when there were 144 deaths, but is lower than in 2019, when there were 273.

Nationally, the latest statistic from the Ministry of Health also counts death data up to May 17. In comparison with the whole of 2021, the total number of deaths increased by 55% – from 246 records to 382.

According to the federal ministry, the fatality rate per 100,000 inhabitants in the state of São Paulo is 0.07. The national average is 0.05.

The number of confirmed cases in São Paulo is also higher now than in the whole of 2021.

From January to May 24 this year, the São Paulo government had registered 194,600 infected patients in the state’s municipalities, against 141,049 in the 12 months of last year — 38% more.

According to the Secretary of State for Health, the number of cases this year is “almost 71% lower than 2015, the worst year of the disease”, and the number of deaths, 69% lower. “This year’s data are also lower than the same period in years of seasonality of the disease, such as 2019, for example, being 49% lower in relation to cases and 37% in relation to deaths”, added the ministry.

The Rodrigo Garcia government (PSDB) states that it has provided R$ 10.7 million in support to city halls to control dengue, zika and chikungunya.

“The 291 municipalities benefited were selected based on epidemiological and entomological indicators”, says the secretary. “The resources will be used in actions to combat the spread of the transmitting mosquito and monitoring of reported cases.”

With no recorded deaths, the city of São Paulo is also facing an increase in cases. This year, 8,665 people had dengue against 7,426 in the whole of 2021, that is, there are already 17% more infected today compared to the entire last year.

Luiz Artur Caldeira, director of the Health Surveillance Coordination of the capital of São Paulo, does not see the increase in the number of cases as a sudden increase and points to the seasonality caused mainly by the weather, for the current high.

However, he says that in 2023 the indicators should be even higher. “The trend is that every five years there is an important increase in the proliferation of the mosquito, because of the weather conditions.”

Caldeira cites the high number of infected in 2019, with almost 16,700 cases in the municipality, as the beginning of an annual increase in cases.

“We have teams dedicated to fighting the vector that work throughout the year, but when it comes to seasonality, they do a more intensive fight”, he says.

According to him, when there is a notification, the health surveillance unit in the region where the patient lives goes to the region to do house-to-house sweeping, with actions in the streets and nearby blocks to try to eliminate breeding sites and make nebulization.

The director of Covisa, however, warns of the difficulty that mosquito combat teams have faced to inspect possible breeding sites. According to him, between 30% and 40% of households prevent the entry of approximately 2,500 city hall agents.

With an eye on the 2023 high, in the final months of this year, when the proliferation of aedes aegypti is smaller —the explosion of cases usually occurs between March and May, because of hot days and rains—, the municipal health intends to intensify the work of epidemiological surveillance, that is, before the seasonality it will collect and analyze mosquito samples.

“With entomological surveillance, we intend to block transmission even before the disease reaches people”, says Caldeira. “We are redesigning the teams to fight with larvicide and insecticide, identifying the problem early.”

all over town

At the end of May, Vila Matilde, in the east, had the highest incidence of cases, with 247.4 infected per 100,000 inhabitants.

But, in the ranking of the ten neighborhoods with the highest rates, it is observed that the virus is spread both in neighborhoods on the periphery and in noble neighborhoods, such as Itaim Bibi.

For Maria Anice Mureb Sallum, professor at the Department of Epidemiology at the School of Public Health at USP (University of São Paulo), it is important to consider the social factors in the dynamics of transmission in rich and poor areas. “It’s no use having a single control measure for the entire city, it doesn’t work. You have to adapt, according to the local situation.”

In the case of the peripheries, he explains, the accelerated urbanization, with constructions without basic infrastructure, is an aggravating factor for the proliferation of arboviruses, diseases transmitted by mosquitoes.

“This is evident in São Paulo and also in other regions of Brazil, such as the Northeast and Amazonas”, says the professor, who cites lack of sanitation and water distribution as factors for the increase in patients.

Until May 24, the Ministry of Health recorded 1,036,505 probable cases of dengue across the country. When compared to the same period in 2021, there was an increase of 191.3%.

According to the professor, in general in the country the measures to control the Aedes were reduced or discontinued during the first two years of the Covid-19 pandemic. And the decrease in control favored both the presence and the increase in mosquito density.

Another important factor, she explains, is the emergence of dengue serotype 1, which, according to her, has not been circulating in Brazil since the early 2000s, and is back. “When a serotype emerges that has not circulated for almost 20 years, many people who have not had contact with it can be contaminated.”

In a note, the Secretary of State for Health recalls that fighting the mosquito aedes aegypti it is a continuous and collective task. And cites preventive measures to avoid accumulating water, which range from eliminating possible breeding sites and cleaning.

The City of São Paulo says that last year, 4.9 million actions were carried out against dengue. This year, the number has reached about 2.2 million operations.

The Ministry of Health says that in the face of the increase in dengue cases, at the beginning of May, the Arbovirus Situation Room was installed, to intensify actions with states and municipalities.

The federal folder also says that 49.8 million tablets of larvicide were sent to the states for the treatment of water containers. “During this period, 5,099 kg of insecticide were distributed for residual treatment at strategic points, such as tire shops and junkyards. And for space application (UBV), 208,350 liters of Imidacloprid 3% + Pralethrin 0.75% .”