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Rise in dengue fever cases in Brazil

04 March 2013

Dengue fever is endemic in Brazil, however, Brazilian health authorities have reported a steep rise in confirmed cases of dengue fever since the beginning of 2013. Official figures show that in the first seven weeks of 2013 there have been more than 200,000 confirmed cases of dengue fever with 33 deaths compared to 70,000 in the same period last year which resulted in 41 deaths. More than half of the cases have been caused by the DENV-4 strain of the dengue virus which was detected in Brazil for the first time in 2011.

The state of Mato Grosso do Sul in southern Brazil has been hardest hit by the dengue fever epidemic which has also affected 7 other states including Amazonas, Minas Gerais, Paraná, Rio de Janeiro and São Paulo states.

Brazil

Map used by permission of the University of Texas Libraries, The University of Texas at Austin

The Ministry of Health has provided extra training to health care professionals and financed improvements to basic health care providers throughout the country to improve diagnosis and treatment of dengue fever patients.

Dengue exists in many parts of the world: 2.5 billion people live in areas where dengue is transmitted, mainly in South East Asia, the Pacific islands, Latin America, the Caribbean islands and now also in Africa and the Middle East. The World Health Organisation (WHO) estimates that there are 50-100 million dengue infections worldwide each year. One of the issues associated with dengue is that many people travel to these countries for holidays or for work and fall ill on return to their homes in Western Europe and North America.

What is dengue fever?

Dengue is a viral disease and it is transmitted through the bite of an Aedes aegypti mosquito. This mosquito lives very close to people in built-up areas and thrives in stagnant water.

Symptoms include sudden onset of high fever which can last from 3-7 days, severe headache, muscle and joint pain, eye pain. It is commonly known as "break bone fever". Nausea and vomiting can also occur. In 1-2% of dengue cases, the illness can progress into a more severe condition called Dengue Haemorrhagic Fever (DHF) which is rare in travellers. Severe haemorrhaging can occur resulting in organ failure and death. There is no preventative vaccine.

There is a general consensus that those who have had a previous attack of dengue fever may experience more severe symptoms on subsequent occasions, so should take particular care to avoid being bitten.

Why has the epidemic occurred?

The disease has spread as a result of rapid urbanisation, especially where a lack of clean water and sanitation are a problem. Some experts think that climate change is also contributing to the rapid spread of dengue fever. Small pools of water have enabled the mosquito to reproduce quickly and in great numbers.

Advice for those travelling to or working in the areas affected:

• Ensure you get rid of all standing water in and around your home and work location. Water can collect in discarded tyres, containers, tins and buckets.

• Avoid being in overcrowded situations.

• Follow bite prevention measures. These include using effective repellents (dengue carrying mosquitoes are usually day-biting), wearing long-sleeved tops, screening windows, using air conditioning if available and sleeping under mosquito nets.

• Seek medical attention quickly if you suspect you have contracted dengue fever. Rest and drink plenty of fluids.

• A full recovery from dengue fever may take weeks during which your energy levels will be significantly reduced. Allow yourself plenty of time to recover fully.

For further advice please click on the related information topics on the right hand panel of this screen.

Sources:

Pro-MED V2013 #78, BBC News online, Travax