The Pan American Health Organization (PAHO) highlighted, at an event on arboviruses, that Brazil has controlled the number of deaths in the current dengue epidemic. Despite having already reached almost double the number of cases in 2024 as last year, there was a proportional reduction in the number of deaths recorded. PAHO is the arm of the World Health Organization (WHO) in the Americas.
“This is a very important point, having an increase in transmission and not having a significant increase in deaths”, assesses the arbovirus specialist from the PAHO representation in Brazil, Carlos Melo. Arboviruses are diseases caused by viruses transmitted mainly by mosquitoes, such as Aedes aegypti, which transmits dengue, zika and chikungunya.
“We should not only look at the issue of transmission and the number of cases. We have to take a look at death, which is the first objective in controlling an epidemic, reducing the number of deaths and then reducing serious cases”, added Melo, who participated this Thursday (11) in a seminar on arboviruses organized by the Oswaldo Cruz Foundation (Fiocruz), in Rio de Janeiro.
The meeting takes place in a scenario in which Brazil reaches 3,105,315 probable cases of dengue in the first 14 weeks of 2024. The data was released on Thursday (11). This represents 1,529.2 cases for every thousand inhabitants. In 2023, the country ended the year with 1.6 million total registrations.
According to the Ministry of Health (MS), nine federative units are showing a downward trend in the number of cases; 13 show stability; and five, upward trend.
1,292 deaths due to dengue have already been confirmed, while 1,75 are under investigation. This represents a lethality rate over the total number of probable cases of 0.04% in the year. In 2023, in the same period, the index was 0.07%.
In relation to the total number of serious cases, the lethality is 4.21% in 2024 against 5.22% in 2023.
Carlos Melo attributes the proportional reduction in the number of deaths to the set of actions coordinated by the Ministry of Health, which includes vaccination focused on the public most affected by serious cases and assistance to patients.
“Silver bullet”
The PAHO representative states that there is no single solution to mitigate the dengue epidemic as much as possible. In his view, action is needed on several fronts, such as vaccination, scientific technologies, such as mosquitoes contaminated with the Wolbachia bacteria – which prevents the transmission of the virus – and actions that combat social determinants.
Among the social factors that contribute to the spread of the disease, he cites lack of basic sanitation, irregular supply and need for water storage, uncontrolled urbanization, inadequate management of solid waste and the existence of poverty belts in large cities, for example. .
“We do not believe in a 'silver bullet' to control the dengue epidemic,” he declared.
Vaccination
The general coordinator of Arbovirus Surveillance at the Ministry of Health, Livia Vinhal, agrees with the assessment. “We need to work with a set of strategies that, together, could have an impact on reducing cases.”
Lívia Vinhal understands that vaccination helps to combat the disease, but believes that the results could be better if immunization was carried out with just one dose.
Brazil uses the Qdenga vaccine, produced by the Japanese laboratory Takeda. Immunization is achieved with two doses, with an interval of 90 days between them. The vaccine is safe, and its use was approved by the National Health Surveillance Agency (Anvisa).
“A single-dose vaccine is ideal. We could do [ações preventivas]including in times of outbreak, as we can do, for example, for yellow fever”.
One concern of the Brazilian government is the production capacity of the Takeda laboratory. According to the Ministry of Health, Brazil purchased practically all production of the vaccine. Even so, it had to limit the application to the public between 10 and 14 years of age, the age group that has the highest number of hospitalizations due to dengue, second only to the elderly.
With the increase in Qdenga's supply, coordinator Livia Vinhal expects positive results in the fight against dengue.
“Having an effective, safe vaccine with a large production capacity, we can, not in the short term as we would like, but in the medium and long term, envision changes in this scenario that we have seen in recent years”, he predicts.
Information from Agência Brasil
Source: CNN Brasil
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