Dengue cases rise 55% in Brazil at the beginning of the year

Dengue is on the rise in Brazil. Until the 11th epidemiological week of this year (March 19), 204,159 cases of the disease and 43 deaths were recorded, according to provisional data from the Ministry of Health.

The data exceed those recorded in the same period last year: 131,520 cases and 30 deaths. However, they are below the scenario seen in 2020, also in the same range, when there were 390,684 cases and 106 deaths.

Ricardo Gazzinelli, professor at the Federal University of Minas Gerais and researcher at Fiocruz (Fundação Oswaldo Cruz), says that dengue is cyclical, with a high incidence in some years and a low incidence in others.

It is difficult to know exactly the reason for the lower number of cases in 2021, a pandemic year.

The periods in isolation somewhat blocked the transmission cycle, according to the researcher. “It may have influenced. Although dengue is transmitted by the mosquito [Aedes aegypti], the pathogen goes from one person to another. It is important to mention that the monitoring of diseases, such as dengue and malaria, for example, was affected because attention was diverted to Covid and, with that, it gives the impression of fewer cases.”

In 2022, until March 19, the Midwest had 79,446 infections and an incidence of 475.5 cases per 100,000 inhabitants, the highest in the country.

Next is the North, with 19,498 cases and an incidence of 103.1, and the South, with 26,285 records and a rate of 86.5. The Southeast, with 56,555 infections and an incidence of 63.1, appears in fourth place, and the Northeast, with 22,375 cases and an incidence of 38.8, closes the ranking of regions.

In epidemiology, the incidence rate is the number of new cases of a disease during a defined period, in a population at risk of developing it. For the calculation, the Ministry of Health uses the Brazilian population data according to the IBGE (Brazilian Institute of Geography and Statistics), 213,317,639 inhabitants.

on alert

São Paulo has 42,252 confirmed cases of the disease, equivalent to 20.7% of the country’s total, and an incidence rate of 90.6 cases per 100,000 inhabitants.

In addition, it is the state with the most deaths from dengue (11), followed by Goiás (10) and Bahia (7).

And, of the ten Brazilian cities with the most infections listed by the Ministry of Health, three are in São Paulo: Votuporanga, São José do Rio Preto and Araraquara.

In Votuporanga, the Secretary of Health, Ivonete Félix, said that several factors influenced this situation, including the pandemic. “Last year was very unusual. Many doctors took Covid-19 as their first notification,” she said.

“We reported 425 cases in this period in 2020, 33 in 2021 and 206 now in 2022. We see that it is higher than last year, but half of 2020.”

In March, 1 in 5 municipalities in São Paulo went on alert for dengue risk, most concentrated in the interior of the state. The picture, according to experts, is associated with weather conditions.

Until the last 15th, according to monitoring by Infodengue by FGV (Fundação Getulio Vargas) in partnership with Fiocruz, 21.39% of cities in São Paulo were in epidemic situations, with an environment favorable to transmission or that require attention.

Last week, in Franca (400 km from São Paulo), a 37-year-old woman died of suspected hemorrhagic dengue. In the first three months of the year alone, 964 positive cases were reported, while in the entire previous year, 221.

The Department of Health of Franca attributed the growth to the rains and the intense heat of the beginning of the year. He also stated that it is necessary to consider “underreporting of the disease in the years 2020 and 2021, because of the Covid-19 pandemic”.

“The outlook for the current year is for record levels of dengue, with a significant expansion of the mosquito’s area of ​​occurrence, mainly in the Southeast and South of the country, probably in response to the gradual increase in average temperatures in these regions”, said Flávio Codeço Coelho, coordinator of the FGV’s Infodengue project.

For public health doctor Adriano Massuda, a professor at FGV, despite the favorable time for the proliferation of Aedes aegypti —rain and heat—, there is no reason to justify the increase in dengue cases.

“The disease has the specificity of the cycle of the virus, moments of growth and fall, but it is essential to analyze the territories, identify the regions that may have mosquito hatcheries to carry out urban intervention, public health measures, sanitation. , the work of Family Health teams is essential. This is the great fragility that we are experiencing in Brazil”, he says.

According to the specialist, since mid-2016 there has been a deconstruction of policies that worked in Brazil by the Ministry of Health. The ESF (Family Health Strategy), which expands access to health services and increases control of communicable diseases, such as dengue, is an example. And from 2019 onwards, it was possible to perceive the acceleration of the weakening of Primary Care.

“This makes the teams at the end more fragile. There are a smaller number of community health agents working in Brazil. They have a fundamental role in looking at the territory and identifying the risk regions to intervene at the right time and avoid problems. Those who stayed are overloaded and there are tasks deviation, because they are less and less going to the field”, explains Massuda.

For the researcher, this deconstruction affects the work of endemic agents, responsible for the prevention and control of endemic diseases.

“They are also fundamental. We are warning that this is not new. This is a threat of a return of preventable diseases, from vaccines preventable by vaccines. Low vaccine coverage in Brazil is a huge risk. The increasing number of dengue cases is the weakening of preventive measures. There has to be a strengthening of the SUS (Unified Health System), of Primary Care, of the Family Health teams, and the responsibility for this lies directly with the Ministry of Health.”

capital

The city of São Paulo recorded 758 dengue cases with an incidence rate of 6.36 per 100,000 inhabitants —209 in January, 242 in February and 307 up to March 22. There were no deaths. The data, still provisional, is up to date until March 22.

In the first three months of 2021, 1,580 cases were recorded – 117 in January, 358 in February and 1,113 in March, also without deaths.