Fundação Casa has two suspected cases of ‘pigeon disease’

The São Paulo State Department of Health is investigating two suspected cases of “pigeon disease” (cryptococcosis) in inmates at Fundação Casa, at the Vila Palmares unit, in Santo André, Greater São Paulo.

The foundation said it was awaiting the results of the tests and that there was no pigeon infestation at the site.

The two young men were referred to the Santo André Municipal Hospital Center in March with symptoms similar to meningitis.

The first, aged 18, was admitted on March 22 with complications in the pulmonary condition and ended up having brain death confirmed 18 days after admission. On the death certificate, the necropsy examination showed death from severe meningoencephalitis, which can be caused by cryptococcosis.

The second, aged 17, was taken to the hospital on March 25 and was discharged last Thursday (21), according to Fundação Casa. The hospital collected a cerebrospinal fluid sample to perform the cryptococcosis diagnostic test at the Adolfo Lutz Institute, in São Paulo, and is awaiting the result of the test.

Cryptococcosis, known as pigeon disease, is caused by a fungus present in pigeon feces (Cryptococcus neoformans and C. gattii).

In general, in healthy individuals, cryptococcosis does not usually progress to a serious condition and cause death, a situation that occurs largely in immunosuppressed individuals, such as the elderly, those with tuberculosis or those with HIV.

On the other hand, the presence in large amounts of feces contaminated with the fungus, if inhaled, can lead to the serious condition of the disease, called cryptococcal meningitis.

According to records from the Hospital Admissions System of the Ministry of Health, from 2017 to 2020 there were 1,105 hospitalizations for cryptococcosis in Brazil, with 185 deaths in the same period. The disease is not notifiable.

Recently, the folder, via Conitec (National Commission for the Incorporation of Technologies in the SUS), incorporated to the SUS (Unified Health Service) the drug flucytosine, recommended by the World Health Organization (WHO) for the treatment of the disease.

Meningitis caused by fungi is not transmissible from person to person and the forms of prevention are the hygiene of enclosures, cleaning of places where there are birds or the use of personal protective equipment (PPE), as well as the control of urban animals.

Sought, Fundação Casa, through a note, told Sheet which awaits the results of exams that indicate the cause of the young man’s death and the teenager’s hospitalization. The institution also stated that there is no infestation of pigeons in the units in Santo André.

“Regarding the young man who died, Fundação Casa clarifies that the patient was treated by the health team of the socio-educational center and referred to general and specialized medical care in the municipality. The family was informed of the situation, as well as the Judiciary. second teenager, he was discharged last Thursday due to an improvement in his general condition,” the statement said.

Also, according to the socio-educational center, an inspection was carried out by the epidemiological surveillance team of the municipality, which did not locate “foci of contamination by pigeon feces”, and, although it did not issue a report, requested “the maintenance of the hygiene care of the environments, hand washing and use of masks by teenagers and servers”.

The Santo André Municipal Hospital Center said that, so far, there are no other suspected cases at the institution.

The São Paulo Health Department, through the Epidemiological Surveillance Group (GVE) of Santo André, said that “both cases are still under investigation, awaiting the conclusion of the reports”.

The Public Defender’s Office says it became aware of the hospitalizations of the two young men “supposedly for meningococcal meningitis” and called the health authorities to investigate.

According to the agency, the cases continue to be analyzed by the authorities, and the results of the exams have not yet been presented to the Public Defender’s Office. “The Public Defender’s Office also informs that, so far, it is not aware of the confirmation of pigeon infestation in Fundação Casa’s centers. Sheet.

The report spoke with a technician from the GVE, who did not want to be identified so as not to interfere in the investigation. According to him, the Public Defender’s Office notified the Municipal Health Department of Santo André at the end of March to investigate the suspected cases.

The GVE, he said, was in Vila Palmares, but on the day of the visit there were no pigeons in the unit. However, the investigation of the group through reports of the inmates who were hospitalized indicate that there are always pigeons in the place.

Also according to him, the two investigations are still ongoing and it has not yet been possible to establish whether the two cases are cryptococcosis, which may just be a temporal coincidence.