Brazil's battles against dengue fever, measles
Dengue fever
Dengue is the most relevant urban arbovirus (disease caused by a virus transmitted by mosquitoes) in the Americas, mainly in Brazil.
During the first 10 months of 2023, Brazil health officials report more than 1.6 million probable cases of dengue. The data indicates an increase of 21.4% when compared to the same period in 2022.
Last Saturday, Brazil celebrated the National Day to Combat Dengue, a day to fight against and dissemination of care to prevent the disease since 2010.
The Ministry of Health is moving forward with actions to combat Aedes Aegypti, a mosquito that also transmits Zika and chikungunya.
A Arbovirus Emergency Operations Center (COE) was installed to respond to the increase in cases of chikungunya and dengue, especially the most serious cases and deaths.
The actions were carried out in an integrated and coordinated manner with states and municipalities, and included the participation of secretariats from the Ministry of Health, Anvisa, Conass (National Council of Health Secretaries) and Conasems (National Council of Municipal Health Secretaries). In total, 11 support actions were carried out in the states with the highest number of cases and deaths from dengue and chikungunya, with the distribution of approximately 345 thousand serology reactions and 131 thousand RT-PCR tests.
The Department invested R$295 million to facilitate the acquisition and distribution of four types of inputs to control Aedes, in 2023. In addition, the Ministry of Health launched the Arbovirus Monitoring Panel, with public access; brought forward the national campaign to combat arboviruses to May; trained more than 9,500 health professionals via UNA-SUS (SUS Open University) and another 2,100 health professionals for clinical management, surveillance and control of arboviruses.
The Department's efforts also included the beginning of the intra-municipal risk stratification process in priority areas for the implementation of new technologies to combat mosquitoes, such as traps that disseminate larvicides, Wolbachia and intra-household residual spraying.
Measles
The great news in Brazil concerning measles is they were upgraded from “endemic country” to “country pending re-verification” of measles after reporting no new cases in 74 weeks.
This was announced during the Third Annual Meeting of the Regional Commission for Monitoring and Rechecking the Elimination of Measles, Rubella (SR) and Congenital Rubella Syndrome (CRS), promoted by the Pan American Health Organization (PAHO/WHO).
Since 2020, the country has seen a drop in the number of measles cases with 20,901 records in 2019; 8,100, in 2020; 670, in 2021; and 41, in 2022. The last case was confirmed in June 2022, in Amapá.
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The Ministry of Health carries out joint actions with states and municipalities to interrupt the circulation of the measles virus in the four states with the highest transmission in 2022: Amapá, Pará, Rio de Janeiro and São Paulo.
In 2023 alone, R$724.1 million were invested in health surveillance actions, state laboratories, immunobiologicals, training and immunization, with microplanning and multi-vaccination strategies.
The new condition allows Brazil to begin the process of recertification as a measles-free country; category suppressed in 2019. The intense migratory flow from neighboring countries associated with low vaccination coverage in several municipalities in 2018 allowed the reintroduction of the disease virus in the country. Brazil had received certification as a disease-free country in 2016.
According to Éder Gatti, director of the Department of Immunization and Vaccine-Preventable Diseases, the commission recognized the Brazilian effort in recovering vaccination coverage. “It was recommended that we continue with microplanning as a strategy to strengthen vaccination in municipalities. It is necessary to recognize the work carried out by states and municipalities in the fight against measles,” he said. “In addition to continuing to strengthen vaccination, we will continue to intensify surveillance of exanthematous diseases, so that Brazil remains free of measles and congenital rubella.”