May 19, 2015

Dengue Fever Outbreak in Brazil

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May

19

Dengue Fever Outbreak in Brazil

Aline Sodre-Lopes, Supply Chain account manager in Cartus’ Brazil office, recently brought me up to date on the current outbreak of dengue fever in São Paulo and what it might mean to assignees and managers who have volume in the area.

São Paulo has been suffering through the worst drought in nearly a century, and the water shortage has contributed to an outbreak of dengue fever due to the practice of storing scarce water in open containers, such as buckets and vases, which enables proliferation of the mosquitoes that carry the virus (Aedes Egypti).

Dengue fever often results in high fever, intense muscle pain, extreme weakness, and headaches, and may also cause convulsions. This year to date, it has killed 169 people in São Paulo alone—the most deaths from the disease in the São Paulo state territory since 1990. An official report issued by the government indicates 745,900 reported cases—an occurrence rate of nearly five per minute.

Even though the dengue outbreak is concentrated mostly in São Paulo this year, the rest of the country is far from exempt from the situation. The national incidence rate now stands at 367.8 cases per 100,000 inhabitants, a statistic that makes the outbreak three times more severe than the rate recorded in the same period last year. In the past, contracting dengue has been linked with poor sanitation in urban areas, but recently, the mosquito population appears to be increasing, and people in all locations, from the poorest areas to the wealthiest, need to take precautions.

The main impact, other than overcrowded hospitals, has been a concerted effort to increase public awareness coming from the government via TV, radio, and the press. These informational messages cover important precautions people need to take to protect themselves from contracting dengue fever. One of the most valuable tips is to use insect repellents diligently—one of the most effective ways to prevent infection. No wonder this particular product has practically vanished from all the shelves in Brazilian stores and supermarkets!

A vaccine against dengue is being developed by the National Sanitary Surveillance Agency (ANVISA) in partnership with Butantan Institute in São Paulo, but it’s not yet known when the vaccine will be available.

The good news is that with the Brazilian winter approaching, the outbreak will likely decrease considerably because the dengue mosquito most often proliferates in hot environments. In the meantime, assignees living in Brazil or those planning to travel there should be aware of the following:

•  No vaccines or drugs are currently available to prevent dengue fever infection.

•  The infection is transmitted by mosquitoes, so prevention of mosquito bites is most important.

•  Avoid storing water in open containers such as buckets or vases.

•  Insect sprays should be applied to the body and clothing to minimize risk of mosquito bites.

•  Choose accommodations with well-screened windows or air conditioning, whenever possible.

•  Onset of symptoms may occur between three and 14 days after a mosquito bite and will likely include fever, headache, and body aches.

•  Treatment is bed rest and maintenance of fluid intake to prevent dehydration.

•  Acetaminophen (e.g., Tylenol) should be used to control fever and pain.

Aspirin, aspirin-containing drugs, and non-steroidal drugs should be avoided because of their anticoagulant properties.

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John Fisher

About John

John Fisher, P.A., is physician assistant in Cartus’ Wellness Center in Danbury. He previously practiced occupational medicine at Corporate Health Care and worked in family practice at the Western Connecticut Medical Group in Brookfield, CT. He has been employed by Danbury Hospital as a physician assistant for 37 years.

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