The dengue outbreak that hits Brazil has already caused a rise of more than 150% in cases registered until May 7. The number of infected people exceeds 750 thousand, a result that already exceeds all the confirmations of 2021.
Although the virus cycle itself influences more serious waves in certain periods, the increase in social inequalities and the insufficiency of public policies weigh considerably for the worsening of the scenario.
“These diseases, which do not attract much interest from the pharmaceutical industry and the vaccine industry, occur mainly in temperate regions of the planet, where the developing countries are, where there is greater inequality. They affect the poorest people on the planet and, within of each of these countries, they will affect the poorest people in that place” says researcher Ademir Martins, from the Laboratory of Physiology and Control of Arthropod Vectors at the Oswaldo Cruz Institute.
According to him, economic crises in these nations have an immediate impact on the transmission of pathologies such as dengue, “it has everything to do with the demographic, socioeconomic issue and the locations where there is less adequate sanitary infrastructure.”
Dengue was already growing in Brazil before the pandemic. In the years 2015, 2016 and 2019 more than one million cases were recorded. During the health emergency of covid-19, the scenario reversed and there was a fall. In 2022, however, Brazil again saw a significant growth in cases.
The advance of the disease coincides with the fall in public investments. Between 2017 and 2019, the Unified Health System (SUS) lost BRL 20 billion because of the spending ceiling. For this year, the budget foreseen for the sector was also reduced.
Ademir Martins points out that control also depends on investments in primary care and adequate training of health agents who work with the theme.
“Over the last few years, primary care has been dismantled. Health agents are not prepared to work in this area. There is a very high turnover due to the precariousness of jobs. As much as there are important control tools, it turns out that this is not perpetuated by all agents and all municipalities”, says the researcher.
virus cycle
Dengue is caused by a virus transmitted by the bite of the Aedes aegypti mosquito. Among the most common symptoms are high fever, muscle and joint pain, and skin rashes. The disease can cause internal bleeding in organs and tissues and lead to death.
“The link that we should fight more is the mosquito, because we don’t have a fully effective vaccine and specific drugs against this virus. Fighting the mosquito means fighting not only dengue, but also chikungunya and zika”, explains Ademir Martins.
According to the researcher, there are four types of dengue virus circulating on the planet. People infected with one of them are not immune to the others. This dynamic favors the occurrence of more serious waves from time to time. In Brazil, these periods have occurred on average every three years.
“And then you ask me, if we already know that, shouldn’t we prepare better? We should always prepare”, he warns. “The fight against these arboviruses [vírus transmitidos por mosquitos] it is the duty of the state. Provide adequate sanitary infrastructure so that people do not need to accumulate water, garbage collection, health education in schools, advertisements, in commerce, to show the population that they have to do their part. That’s where everyone’s part comes in,” he adds.
Other factors also influence the increase in infections currently observed. As the mosquito proliferates in stagnant water, the intense rain that hit several regions of Brazil at the end of last year and in the first months of this year may have boosted the presence of the vector even more.
In addition, Aedes aegypti has found it easy to proliferate in regions that did not previously record outbreaks. Factor that can be a consequence of climate change and environmental devastation.
“The mosquito is gaining new frontiers, it is gaining colder regions that are now getting warmer. Urban growth and deforestation are creating more favorable conditions for it to survive. It is not a new behavior of the virus. new spaces”, emphasizes Ademir Martins.
Critical situation
While dealing with the increase in cases, states and municipalities face the difficulties imposed on the SUS and even the lack of supplies. Until this week, at least six units of the federation reported a lack of rapid tests for dengue.
This Friday (20), the government of Grande do Norte declared an emergency situation in view of the increase in cases of dengue, zika and chikungunya. In the capital, Natal, the health system is full of patients with the diseases. Health Secretary George Antunes said the city’s health care network is close to collapse.
In the state of São Paulo, the number of deaths grew by more than 100% until May 14, compared to the same period last year. In Rio Grande do Sul almost 90% go through mosquito infestation. In April, the state recorded the most expressive results of cases and deaths in more than 20 years.
Similar scenarios are repeated in Brazilian municipalities from the interior to the metropolises. The Ministry of Health created a Situation Room to monitor the progress of the disease, with the aim of intensifying surveillance actions.
On Monday (16), Minister Marcelo Queiroga said that dengue control does not depend only on the government and demanded actions from the population.
“Who is responsible for fighting the vector? It’s not trying to take the Ministry of Health out of the front line, but each of the citizens has to control it at home too, right? It’s not just charging the health authorities. do your part,” he said.
Editing: Rodrigo Durao Coelho
