The number of tests with a positive result for dengue, carried out in private laboratories between March 17 and 23, increased by 221%, compared to the first epidemiological week of 2023 (12/30/2022 to 1/5/2023). The data are from the Brazilian Association of Diagnostic Medicine (Abramed) and show an evolution from 26.51% to 33.74% in the positive results in this period. The volume of exams performed in such establishments in the period increased by 152%. 
By international consensus, infectologists group data such as occurrences of diseases and outbreaks, hospitalizations and deaths into periods called epidemiological weeks (ES). Time is counted from Sunday to Saturday.
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According to the chairman of the Board of Directors of Abramed, Wilson Shcolnik, the increased demand for tests to diagnose dengue and the increasing positivity in the results are explained by the fact that the country is experiencing a rainy season, despite it being autumn. “The accumulation of water is very conducive to the reproduction of the transmitting agent of dengue, the mosquito. aedes aegypti”, stated Shcolnik.
This Wednesday (12), in an interview with Amazon National Radio, infectologist and researcher at the Evandro Chagas National Institute of Infectology (INI/Fiocruz) André Siqueira highlighted that the mosquito has adapted well to cities, expanding and resisting insecticides. Siqueira associates the increase in cases with climate change. “There are indications that it is all related to climate change, global warming and changes in rainfall patterns.”
The infectologist said that, currently, the issue worries even countries that are outside tropical areas, more prone to the disease. “Before, dengue was restricted to tropical regions, but it has expanded to temperate regions such as the United States. And it has even become a problem in Europe and in countries further south, such as Argentina, Paraguay and Uruguay.”
official data
The high number of dengue cases is also verified by the Unified Health System (SUS). The Ministry of Health released, on the 6th, the Weekly Report of the Center for Emergency Health Operations (Coe-Arboviruses), regarding the 13th Epidemiological Week of 2023.
According to the report, the number of probable cases of dengue and chikungunya reported in Brazil this year (SE from 1 to 13) exceeded the maximum limit expected by the authorities, considering the historical series. According to weekly report, the trend is for an increase in transmission and cases in the coming weeks. “In the Contingency Plan for Response to Public Health Emergencies due to Dengue, Chikungunya and Zika”, Brazil is classified at Level 3 for dengue and Chikungunya, due to the increase in incidence and confirmed deaths.
In the 13th Epidemiological Week of 2023 alone, almost 600,000 (592,453) probable cases of dengue were reported in 4,230 municipalities, which represents an increase of 43% compared to the same period last year. Of this total, 5,773 occurrences are considered serious (art, page 03). The Ministry of Health confirms 183 deaths, and there are 231 deaths under investigation.
Health Actions
In reply to Brazil Agency, the Ministry of Health reported that, given the warning of the spread of dengue in the country, it installed the Emergency Operations Center (Coe-Arboviroses) to act in the control and reduction of severe cases of the disease. The folder says that it “closely monitors the epidemiological situation of arboviruses (diseases caused by viruses transmitted mainly by mosquitoes and more common in urban environments) in the country and that it has invested in actions to combat the disease with states and municipalities.
Among the actions for prevention and control of the transmitting mosquito, the ministry cited the more than 95,000 kits dengue detection tests sent to state health departments and ensured that all states are supplied with three different types of insecticides for dengue control aedes aegypti.
In addition, in March, there was training for professionals in places with an increase in cases, such as the states of Paraná, Mato Grosso do Sul, Santa Catarina, Espírito Santo and Minas Gerais, to prepare doctors and nurses and for clinical management and surveillance of arboviruses.
Preventive care and symptoms
The Ministry of Health defended the development of integrated activities to prevent the proliferation of the mosquito, such as the elimination of possible breeding sites (still water) and treatment with larvicides in those that cannot be eliminated, and support for states and municipalities to provide guidance to the population on care preventive measures related to arboviruses.
André Siqueira warned of the necessary precautions: reducing the number of breeding sites, denouncing the existence of abandoned places to the public authorities, where there are “water collections” that can serve as breeding grounds for mosquitoes, protecting yourself using repellents or long clothes, which can reduce the risk of mosquito bites, especially in times of greater transmission of the disease.
In general, the symptoms of those infected with the dengue virus are intense body aches, malaise, headache and fever. Siqueira asks for attention to the signs and says that, when symptoms appear, the person should seek a basic health unit (UBS), the main form of access to the public service. “To be properly cared for, undergo a medical evaluation and receive adequate guidance on hydration and analgesics.”
It is also necessary to pay attention to the signs of aggravation of the condition: severe abdominal pain, recurrent vomiting, feeling faint, bleeding, drowsiness or irritability.
About dengue vaccines, the infectologist recalls that there are two. “The first was launched a few years ago, but it is restricted to people who know they already had dengue, who have already had their blood tested”. And, in March, the National Health Surveillance Agency (Anvisa) approved the registration of the new vaccine, Qdenga, produced by the company Takeda Pharma. “It had good results, but it is not available. Both the incorporation by the SUS and the offer in private vaccine clinics are still being discussed”, added Siqueira.
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