Dengue Outbreak Sweeps Through Rio

New York Times April 15, 2008

By MERY GALANTERNICK and ALEXEI BARRIONUEVO

RIO DE JANEIRO — Heavy rains over the past month have created a fertile breeding ground for mosquitoes carrying the dengue fever virus, deepening a crisis that has claimed at least 80 lives in Rio State.

The dengue strain ravaging this tropical city is now believed to be stronger and more lethal than the virus responsible for an epidemic in 2002, considered the worst in recent history in Brazil, according to Dr. Jacob Kligerman, health secretary for the city.

The spreading epidemic has shown no signs of slowing. Since January, 75,399 people have been infected in Rio State, health officials say. The mortality rate is now more than three times as high as it was during the epidemic in 2002, which claimed 91 lives.

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From Paho:

Dengue in Rio de Janeiro, Brazil

From 1 January to 26 March, 2008, the Brazilian health authorities have reported 406 cases of dengue hemorrhagic fever (DHF), with 34 deaths nationally. This constitutes a significant increase in the number of cases in several states compared to the same period in 2007: Amazonas (9.8 times), Rondônia (5.3 times), Sergipe (4.7 times), Bahia (3.4 times), Rio Grande do Norte (2.8 times), Pará (2.5 times), and Rio de Janeiro (2.2 times). DEN 2 and DEN 3 are the circulating serotypes.

The state of Rio de Janeiro has reported 32,615 cases of dengue fever (DF), making up 38% of the total number of cases registered in the country, and 245 cases of DHF. A change in the age distribution of severe cases has been observed: of the 2,116 patients hospitalized, 53% were children under the age of 14 years. There have been 20 reported deaths due to DHF, 8 due to Dengue Shock Syndrome (DSS) and 19 due to DF with complications. More than 50% of the deaths have occurred among children aged 2–13 years. The number of deaths suggests a more severe evolution of clinical illness than expected.

The Ministry of Health (Ministério da Saúde / MS) is working closely with the Rio de Janeiro branch of the Center for Strategic Information in Health Surveillance (Centro de Informações Estratégicas em Vigilância em Saúde / CIEVS: about) to implement the required control measures and identify priority areas for intervention. The Ministry has already mobilized 100 health professionals to the federal hospitals of Rio de Janeiro to support patient management activities, including clinical case management and laboratory diagnosis. Additionally, 550 public health and emergency services professionals will be recruited by the end of next week to assist community-based interventions. Vector control activities were implemented throughout Rio de Janeiro State and especially in the Municipality of Rio de Janeiro. The fire department, military, and health inspectors from the National Health Foundation (Fundação Nacional de Saúde, FUNASA/MS) are assisting in these activities.