The Aedes aegypti mosquito, which transmits dengue, is a matter of concern for the Municipal Health Department of Novo Hamburgo (SMS). An old enemy of public health, the disease could worsen the epidemiological scenario in the city in the coming weeks, tightening the bottleneck on the health system already pressured by Covid-19 and the H3N2 flu.
Fearing the explosion of cases of the disease, signaled by the infestation rates of Aedes aegypti in the cities of the region and by the large volume of rain registered since the second half of March, the City Hall tries to anticipate the crisis by reinforcing actions to combat the mosquito foci.
“The contingency plan is being implemented so that we can actually control the proliferation of transmission points in order to contain the advance. We want to believe that the result of the work will prevent this, but categorically guaranteeing that there will be no outbreak in Novo Hamburgo would be a pretentious statement on my part”, argued the Secretary of Health, Naasom Luciano.
According to the secretary, the increase in residents looking for care in health units with symptoms of dengue is noticeable and significant. Until Wednesday afternoon (30) there were 182 confirmed cases and another 518 suspects. Hospitalizations are still not numerous in both the public and private networks. At the Municipal Hospital, there were three positive patients with the disease.
The issue also concerns the Dengue Prevention and Combat Project, carried out in partnership with the City Hall and Feevale University, which appeals to the population: “It is time to redouble the care with standing water”.
According to the most recent newsletter of the Rapid Survey of Indexes for Aedes aegypti (LIRAa), released in early March, of the 250 samples collected for analysis and identification in the laboratory of the Project to Combat Dengue, 82% showed a positive result for the mosquito that transmits dengue, zika and chikungunya. Of the 3,597 properties visited, 4.9% had vector outbreaks, that is, every 20 properties, one has the presence of the mosquito.
Circulation between cities is a concern
According to the Secretary of Health, the proximity between the cities and the movement of people from neighboring municipalities, which also face problems with the high incidence of the disease, lit the warning signal. “The circulation of the virus between regions is rapid and does not respect geographical boundaries. The mosquito bites someone who is infected and quickly spreads the virus among people who are close, so more worrying than the movement of the mosquito is that of infected people,” he argues.
In this scenario, in the region, two cities are experiencing an outbreak of arboviruses transmitted by the mosquito. In Dois Irmãos, the municipality that leads the ranking of cities in Vale do Sinos with diagnoses of dengue, according to the Municipal Health Department, as of Wednesday, confirmed cases reached 860, with 870 samples awaiting results at the Central State Laboratory (Lacen ).
According to the Secretary of Health of Dois Irmãos, Júlia Lopes de Oliveira, the municipality has taken all possible measures to contain the spread of the disease through daily cleaning efforts in the neighborhoods where there is a higher incidence of cases, home visits by endemic agents and application of larvicides in water reservoirs. In addition, the neighborhoods with the highest number of cases are pulverized. “But none of this is of any use if the population does not do its part”, emphasizes the secretary.
In Vale do Paranhana, Igrejinha recorded 696 cases of dengue in less than a month and intensified the fight against the transmitting mosquito with guidance to the community, in addition to inspections with the identification and elimination of outbreaks. According to the most recent update from the prefecture, made this Thursday (31), there are 1,591 people with the disease. On average, according to the Health Department, about 100 people a day appear at the Triage Unit complaining of symptoms such as body pain and fever, which characterize both Covid-19 and dengue.
According to Ronaldo Hallal, an infectious disease specialist and professor of the Medicine course at Feevale University, Aedes aegypti is a transmitter of viral diseases that are called arboviruses. Among the most common diseases in this group, sengue, zika and chikungunya stand out. “Other arboviruses can be transmitted by the mosquito, such as the yellow fever virus, however, so far, there are no records of any confirmed case in humans, only cases in monkey primates, which shows the circulation of the virus and the need for vaccination”, he argues.
Of the arboviruses, dengue is the one that requires the most attention, as it can become a risky condition, even requiring blood transfusion and hospitalization in the Intensive Care Unit (ICU).
The disease levels are classified as dengue, dengue with warning signs, when the patient has pain or vomiting, and severe dengue, when there is bleeding. “There are studies that show that serotypes 2 and 3 can be more aggressive, however, what makes the severe form of dengue is not the serotype itself, but the way the body reacts”, highlights Hallal.
According to the expert, the fight against dengue cannot only be in epidemic moments, but requires cultural change and political change. “It has to be continuous and needs to consider all aspects related to urban issues and the movement of people. It needs to be included in the municipal master plans. Without education, without income and opportunities distribution and with permanent privilege to capital, that doesn’t change”, highlights.
Hallal believes that it is essential that city halls restore the structures to control the transmitting mosquito, which were dismantled during the pandemic. “It is important to recompose the teams and even resume home visits, since most of the outbreaks are inside the houses”, he said.
Prevention is important
The Novo Hamburgo Health Department reinforces the necessary actions to prevent the proliferation of the mosquito. “It is important not only to remove the water from the object, but also to clean and maintain it,” he says. Naason also explains that the mosquito egg can stay in a dry environment for a long time before hatching in water.