Emergência em saúde pública por inundações: a atuação do Ministério da Saúde em ocorrências no Brasil de 2004 a 2017 / Emergency in public health caused by floods: the Ministry of Health actions in occurrences in Brazil, from 2004 to 2017

RESUMO Este artigo teve por objetivos contextualizar os impactos das inundações na saúde e analisar relatórios do Centro de Operações de Emergência em Saúde, mobilizados pelo Ministério da Saúde (MS), para monitoramento federal desses eventos no Brasil, de 2004 a 2017. Para isso, foi realizado levantamento bibliográfico e documental, incluindo relatórios do MS sobre inundações, e feita análise de dados do Sistema Integrado de Informações sobre Desastres, da Defesa Civil, no referido período. Verificou-se que as inundações atingiram todas as regiões brasileiras, com eventos críticos em 2004, 2009, 2010 e 2011. O MS atuou em nove ocorrências, e essa experiência subsidiou o estabelecimento da estratégia de preparação e resposta, incluindo Comitês de Saúde em Desastres, documentos e normativas para orientar a atividade do Sistema Único de Saúde (SUS) na atuação em desastres hidrológicos. Inundações de grande magnitude exigem resposta rápida, e isso prescinde de preparação prévia. O MS avançou nas articulações intersetoriais e interinstitucionais, no entanto, dotar o SUS municipal da capacidade necessária para atuação oportuna apresenta-se ainda como um desafio a ser superado.

ABSTRACT The objective of this article is to contextualize the impacts of floods on health and to analyze reports from the Emergency Health Operations Center, mobilized by the Ministry of Health (MS), for the federal monitoring of these events in Brazil, between 2004 and 2017. For such, a bibliographical and documentary survey was carried out, including MS reports on floods and data analysis of the Integrated Disaster Information System, from the Civil Defense, from 2004 to 2017. It was verified that floods reached all Brazilian regions, with critical events in 2004, 2009, 2010, and 2011. The MS worked in nine occurrences and this experience subsidized the establishment of the preparedness and response strategy, including Health in Disaster Committees, documents, and regulations to guide the SUS's (Unified Health System) action in hydrological disasters. Floods of great magnitude require rapid response and this does not require prior preparation. The MS has advanced in inter-sectorial and interinstitutional articulations, however, providing the municipal SUS with the necessary capacity for timely action is still a challenge to be overcome.

COVID-19 in Brazil: advantages of a socialized unified health system and preparation to contain cases.

The outbreak of new coronavirus disease 2019 (COVID-19) reported for the first time in Wuhan, China in late December 2019 have rapidly spread to other countries and it was declared on January 30, 2020 as a public health emergency of international concern (PHEIC) by the World Health Organization. Before the first COVID-19 cases were reported in Brazil, several measures have been implemented including the adjustment of legal framework to carry out isolation and quarantine. As the cases increased significantly, new measures, mainly to reduce mortality and severe cases, have also been implemented. Rapid and robust preparedness actions have been undertaken in Brazil while first cases have not yet been identified in Latin-American. The outcome of this early preparation should be analyzed in future studies.

Competência de peixes como predadores de larvas de Aedes aegypti, em condições de laboratório / Efficacy of fish as predators of Aedes aegypti larvae, under laboratory conditions

OBJETIVO: Avaliar a competência de peixes na predação de larvas de Aedes aegypti, em condições de laboratório. MÉTODOS: Foram testados machos e fêmeas de cinco espécies de peixe. Os testes de predação duravam cinco semanas para cada espécie. Cada ensaio compreendia quatro caixas testes e quatro caixas controles. Das caixas controle, duas tinham somente um peixe e as outras duas, apenas larvas. Cada caixa teste continha um peixe e larvas. Na primeira semana foram expostas 100 larvas em cada caixa, e a cada semana acrescentavam-se 100 larvas por caixa/dia, até se obter um máximo de 500 larvas/dia. Comprimento e peso dos peixes foram medidos semanalmente. RESULTADOS: Foram utilizadas 369.000 larvas no total. O Trichogaster trichopteros foi a única espécie em que ambos os sexos predaram 100 por cento das larvas oferecidas. O Betta splendens deixou de predar apenas 15 larvas. Machos do Poecilia reticulata apresentaram baixa capacidade larvófaga quando comparados às fêmeas da mesma espécie. Em relação ao peso e tamanho o Betta splendens mostrou-se capaz de predar 523 larvas/grama/dia. CONCLUSÕES: Fêmeas e machos de Trichogaster trichopteros e de Astyanax fasciatus, e fêmeas de Betta splendens e de Poecillia sphenops foram os peixes que apresentaram maior competência para predar as larvas. Embora com competência menor, machos de Poecillia sphenops e fêmeas de Poecilia reticulata foram capazes de eliminar o número de larvas de Aedes aegypti que possam emergir durante 24 horas num criadouro, em condições naturais. Machos de Poecilia reticulata não foram predadores eficazes.

OBJECTIVE: To evaluate the efficacy of fish as predators of the Aedes aegypti larvae in laboratory conditions. METHODS: The male and female of five different fish were included in the experiment. The tests to measure their consumption ability lasted five weeks for each species. Each trial involved four test tanks and four control tanks. Two control tanks contained just one fish, and the other two just larvae. Each of the test tanks contained one fish and the larvae. During the first week, 100 larvae were placed in the tank, with an additional 100 added every week, up to a maximum daily amount of 500 larvae. The length and weight of the fish were measured at the beginning and end of every week. RESULTS: A total of 369,000 larvae were used. The Trichogaster trichopteros was the only species in which both sexes ate 100 percent of the available larvae. The Betta splendens failed to eat only 15 larvae. The male Poecilia reticulate showed a strong capacity for larvae eating, compared with the female of the same species. In terms of weight and size, the Betta splendens proved capable of eating 523 larvae per gram of weight per day. CONCLUSIONS: The female and male Trichogaster trichopteros and Astyanax fasciatus, and the female Betta splendens and Poecilia sphenops proved to be the most effective predators of the Aedes aegypti larvae. And although the male Poecilia sphenops and female Poecilia reticulata were less effective, they were also capable of eradicating the total number of Aedes aegypti larvae that could appear over 24 hours in a breeding site under natural conditions. The male Poecilia reticulata, however, proved incapable of doing so.

[Efficacy of fish as predators of Aedes aegypti larvae, under laboratory conditions]. / Competência de peixes como predadores de larvas de Aedes aegypti, em condições de laboratório.

OBJECTIVE: To evaluate the efficacy of fish as predators of the Aedes aegypti larvae in laboratory conditions. METHODS: The male and female of five different fish were included in the experiment. The tests to measure their consumption ability lasted five weeks for each species. Each trial involved four test tanks and four control tanks. Two control tanks contained just one fish, and the other two just larvae. Each of the test tanks contained one fish and the larvae. During the first week, 100 larvae were placed in the tank, with an additional 100 added every week, up to a maximum daily amount of 500 larvae. The length and weight of the fish were measured at the beginning and end of every week. RESULTS: A total of 369,000 larvae were used. The Trichogaster trichopteros was the only species in which both sexes ate 100% of the available larvae. The Betta splendens failed to eat only 15 larvae. The male Poecilia reticulate showed a strong capacity for larvae eating, compared with the female of the same species. In terms of weight and size, the Betta splendens proved capable of eating 523 larvae per gram of weight per day. CONCLUSIONS: The female and male Trichogaster trichopteros and Astyanax fasciatus, and the female Betta splendens and Poecilia sphenops proved to be the most effective predators of the Aedes aegypti larvae. And although the male Poecilia sphenops and female Poecilia reticulata were less effective, they were also capable of eradicating the total number of Aedes aegypti larvae that could appear over 24 hours in a breeding site under natural conditions. The male Poecilia reticulata, however, proved incapable of doing so.