Brazil reached the end of 2022 with a record 1,016 Brazilians who died from dengue. This data is from the Epidemiological Bulletin of the Ministry of Health and is the highest number of deaths ever recorded by the disease, since the beginning of the report. According to the Bulletin, Bahia notified more than 36,000 infected people in 2022.
The initial clinical manifestations of dengue are common and can be confused with other viruses, including Covid-19. Lethality is associated with delay in identifying and treating the disease, so it is important to obtain an accurate diagnosis. Also according to the Bulletin, in 2022, other diseases transmitted by the Aedes aegypti mosquito also increased. Chikungunya saw a 78.9% increase in case count when compared to the same period in 2021 – which was already 32.7% higher than the previous year. In Zika cases, the increase was 42%.
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Dengue is a serious disease and can kill
Dengue is an old acquaintance of the Brazilian people. Transmitted by the Aedes aegypti mosquito, which is responsible for outbreaks and epidemics that recur periodically, especially in times of rain. Therefore, in winter or even in summer, in the presence of abundant rainfall, the accumulation of stagnant water favors mosquito proliferation.
The doctor and researcher at Fiocruz Bahia, Viviane Boaventura, points out that, although there is no specific treatment for dengue, there is a way to prevent the spread of the disease by controlling the proliferation of the transmitting mosquito. Today, the problem is a national issue, and weather conditions are closely related to the emergence of these epidemics.
Viviane explains that the rainy season favors the proliferation of the mosquito, because it finds the ideal conditions for the deposit of eggs that, when hatched, can reproduce. “We have seen, recently, with global warming, the profile change. In the past, we had an increase in the number of cases in the north, northeast region. Nowadays, we already see growth in the south and southeast regions as well”, she says.
Winning this battle requires the involvement of all people and the state. “Dengue control requires coordinated and continuous public health actions, which include educating the population to control the vector, sanitary and surveillance measures”, warns the doctor who is also a professor at the Faculty of Medicine of the Federal University of Bahia (Famed /UFBA).
“Improving surveillance measures using more modern tools can help identify areas at risk, detect the onset of the pandemic early and facilitate control in order to avoid the number of deaths”, he declares when listing the preventive actions that are incumbent on the state.
How to avoid dengue fever
Viviane Boaventura works mainly in the areas of immunology and diagnosis of diseases transmitted by vectors (leishmaniasis and arboviruses) and viral diseases. She explains that dengue fever is suspected when there is an acute fever lasting up to seven days, accompanied by at least two other associated symptoms. “Headache, pain behind the eyes, pain in the body, in the joints, prostration, spots on the body, associated or not with the presence of bleeding conditions, such as bleeding gums and bloody stools”, are indicative of suspicion, says the doctor.
In children, dengue can present itself in a less typical way, but it needs the same care and attention. “In childhood, apathy, drowsiness, vomiting and diarrhea are more common. These symptoms are easily confused with the symptoms of other arboviruses, such as chikungunya and zika. However, with dengue, alarm signals may appear between the third and seventh day of the disease”, explains Boaventura.
Therefore, according to the doctor, it is necessary to be attentive to alarm signs during this period when, normally, the fever disappears and care is more relaxed. “Rightened attention for this period. Generally, when the fever subsides, there may be vomiting, severe abdominal pain, shortness of breath, drop in blood pressure, decrease in diuresis, decrease in urine, drop in body temperature or even bleeding”, he warns.
The doctor advises to seek medical assistance in case of arboviruses and, at home, hydrate yourself and avoid self-medication, especially avoiding the use of anti-inflammatory drugs and, more specifically, the anti-inflammatory acetylsalicylic acid (ASS).
COVID-19 and Dengue
Covid and dengue have overlapping symptoms, which can make diagnosis difficult and delay treatment. Some symptoms are common to both clinical conditions. “Headache, body pain, tiredness, fatigue and fever are similar symptoms. This makes the differential diagnosis challenging”, says Boaventura, who reinforces the need for an accurate diagnosis to avoid complications.
“The symptoms may be similar, but the clinical management and treatment of the two diseases are completely different. Corticosteroids and anticoagulants can be used in the treatment of Covid-19, but they are generally not prescribed in the treatment of dengue hemorrhagic fever, for example”, he says.
The discharge of fatal cases, usually associated with late diagnosis of the disease, may be related to the diversion of attention or errors in treatment. Boaventura bets on good surveillance and orientation of the population, as ways to prevent deaths.
“Offering early support measures is essential to avoid complications”, he explains and adds. “There is a licensed vaccine for dengue in Brazil, but this vaccine is restricted for use in cases of people who have already had dengue in the past”, says the doctor who works as a researcher and participates in the study for the development of the dengue vaccine at Butantan in partnership with to Fiocruz.
Source: BdF Bahia
Editing: Gabriela Amorim
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