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OBJECTIVES: To demonstrate the importance of country surveillance systems for leptospirosis and their use for preliminary epidemiological analysis, as well as to generate research questions for future, morecomprehensive studies on the disease. METHODS: In 2015, for the first time, the Pan American Health Organization (PAHO) included human cases of leptospirosis in its Regional Core Health Data Initiative, an open-access database that collects annual health indicators from the countries and territories of the Americas. This new information was used to analyze leptospirosis cases by country and sex and to calculate cumulative incidence rates. Maps were used to help present the results. To supplement that general review of leptospirosis in the Americas, more detailed descriptions of the epidemiological situation and the surveillance programs of four selected countries (Brazil, Colombia, Cuba, and Honduras) were provided. RESULTS: In this first year of PAHO requesting leptospirosis data, of the 49 countries and territories in the Americas, 38 of them (77.6%) reported information. Among those 38, 28 of them (73.7%) reported the presence of human cases; the majority of instances of zero cases were in Caribbean territories. From those 28, a total of 10 702 human cases were recorded. The largest numbers of cases in Latin America were in Brazil (40.2%), Peru (23.6%), Colombia (8.8%), and Ecuador (7.2%). The cumulative incidence rate for Latin America was estimated to be 2.0 per 100 000 population. On average, 65.1% of cases were males. CONCLUSIONS: This study demonstrates that many countries in Latin America are making efforts to establish strong surveillance systems and programs for leptospirosis. The study also shows the importance of having leptospirosis surveillance systems as well as how the information generated can be used for evidence-based decision-making on leptospirosis.
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BACKGROUND: Hantavirus infection is an emerging zoonosis transmitted by wild rodents. In Brazil, high case-fatality rates among humans infected with hantavirus are of serious concern to public health authorities. Appropriate preventive measures partly depend on reliable knowledge about the geographical distribution of this disease. METHODS: Incidence of hantavirus infections in Brazil (1993-2013) was analyzed. Epidemiological, socioeconomic, and demographic indicators were also used to classify cities' vulnerability to disease by means of multi-criteria decision analysis (MCDA). RESULTS: From 1993 to 2013, 1752 cases of hantavirus were registered in 16 Brazilian states. The highest incidence of hantavirus was observed in the states of Mato Grosso (0.57/100,000) and Santa Catarina (0.13/100,000). Based on MCDA analysis, municipalities in the southern, southeastern, and midwestern regions of Brazil can be classified as highly vulnerable. Most municipalities in northern and northeastern Brazil were classified as having low vulnerability to hantavirus cardiopulmonary syndrome. CONCLUSIONS: Although most human infections by hantavirus registered in Brazil occurred in the southern region of the country, a greater vulnerability to hantavirus was found in the Brazilian Midwest. This result reflects the need to strengthen surveillance where the disease has thus far gone unreported.
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Brazilian spotted fever (BSF) is caused by the bacterium Rickettsia rickettsii. Because of its high case-fatality rate and apparent increase in areas of transmission, it is considered to be the rickettsial illness of primary public health interest. Cases of this disease have historically occurred in Southeastern Brazil. This article reports the first fatal case of BSF in Southern Brazil. This case high lights the importance of BSF to be considered as a differential diagnosis for acute hemorrhagic fever in areas where cases of BSF may not be expected.
Assuntos
Febre Maculosa das Montanhas Rochosas/diagnóstico , Anticorpos Antibacterianos/sangue , Brasil , Criança , Evolução Fatal , Feminino , Humanos , Rickettsia rickettsii/imunologiaRESUMO
BACKGROUND: Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs. METHODS: This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015. RESULTS: In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed. CONCLUSIONS: The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.
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ABSTRACT Objectives To demonstrate the importance of country surveillance systems for leptospirosis and their use for preliminary epidemiological analysis, as well as to generate research questions for future, more comprehensive studies on the disease. Methods In 2015, for the first time, the Pan American Health Organization (PAHO) included human cases of leptospirosis in its Regional Core Health Data Initiative, an open-access database that collects annual health indicators from the countries and territories of the Americas. This new information was used to analyze leptospirosis cases by country and sex and to calculate cumulative incidence rates. Maps were used to help present the results. To supplement that general review of leptospirosis in the Americas, more detailed descriptions of the epidemiological situation and the surveillance programs of four selected countries (Brazil, Colombia, Cuba, and Honduras) were provided. Results In this first year of PAHO requesting leptospirosis data, of the 49 countries and territories in the Americas, 38 of them (77.6%) reported information. Among those 38, 28 of them (73.7%) reported the presence of human cases; the majority of instances of zero cases were in Caribbean territories. From those 28, a total of 10 702 human cases were recorded. The largest numbers of cases in Latin America were in Brazil (40.2%), Peru (23.6%), Colombia (8.8%), and Ecuador (7.2%). The cumulative incidence rate for Latin America was estimated to be 2.0 per 100 000 population. On average, 65.1% of cases were males. Conclusions This study demonstrates that many countries in Latin America are making efforts to establish strong surveillance systems and programs for leptospirosis. The study also shows the importance of having leptospirosis surveillance systems as well as how the information generated can be used for evidence-based decision-making on leptospirosis.
RESUMEN Objetivos Demostrar la importancia de los sistemas nacionales de vigilancia de la leptospirosis y su uso para realizar el análisis epidemiológico preliminar, así como para generar preguntas de investigación que se utilicen en futuros estudios más integrales sobre la enfermedad. Métodos En el año 2015, la Organización Panamericana de la Salud (OPS) incluyó por primera vez casos humanos de leptospirosis en su Iniciativa Regional de Datos Básicos de Salud, base de datos de acceso abierto que recoge indicadores de salud anuales de los países y territorios de la Región de las Américas. Esta nueva información fue utilizada para analizar los casos de leptospirosis por país y sexo, así como para calcular las tasas de incidencia acumulada, y los resultados se presentaron en mapas. Para complementar ese examen general de la leptospirosis en esta Región, se aportó una descripción más detallada de la situación epidemiológica y los programas de vigilancia de cuatro países (Brasil, Colombia, Cuba y Honduras). Resultados En este primer año en que la OPS solicitó datos sobre la leptospirosis, de los 49 países y territorios en la Región de las Américas, aportaron información 38 (77,6 %). De esos 38, 28 (73,7 %) notificaron casos humanos; la mayor parte de las instancias sin ningún caso humano se registraron en territorios del Caribe. En esos 28 países y territorios, se registraron 10 702 casos humanos. En América Latina, los países que registraron los números más altos de casos fueron Brasil (40,2 %), Perú (23,6 %), Colombia (8,8 %) y Ecuador (7,2 %). Se calculó que la tasa de incidencia acumulada de América Latina es de 2,0 por 100 000 habitantes. En promedio, 65,1 % de los casos correspondieron a hombres. Conclusiones Este estudio demuestra que muchos países de América Latina están tomando medidas para instaurar sistemas y programas sólidos de vigilancia de la leptospirosis. Asimismo, revela la importancia de los sistemas de vigilancia de la leptospirosis, así como el modo en que la información generada puede servir para tomar decisiones basadas en la evidencia acerca de esta enfermedad.
RESUMO Objetivos Demonstrar a importância dos sistemas nacionais de vigilância para a leptospirose e seu uso na análise epidemiológica preliminar, além de gerar perguntas de pesquisa para futuros estudos mais aprofundados sobre a doença. Métodos Em 2015, a Organização Pan-Americana da Saúde (OPAS) incluiu, pela primeira vez, casos humanos de leptospirose em sua Iniciativa Regional de Dados Básicos de Saúde, uma base de dados de acesso aberto que coleta indicadores de saúde anuais nos países e territórios das Américas. Utilizamos estas novas informações para analisar os casos de leptospirose por país e por sexo e calcular as taxas de incidência acumuladas. A apresentação dos dados é facilitada pelo uso de mapas. Para complementar esta revisão geral da leptospirose nas Américas, apresentamos descrições mais detalhadas da situação epidemiológica e dos programas de vigilância de quatro países selecionados (Brasil, Colômbia, Cuba e Honduras). Resultados Neste primeiro ano em que a OPAS solicitou dados sobre a leptospirose, 38 dos 49 países e territórios das Américas (77,6%) apresentaram informações. Destes 38, 28 (73,7%) notificaram a presença de casos humanos; em sua maioria, os que não apresentaram nenhum caso foram territórios do Caribe. Dentre os 28, foi registrado um total de 10.702 casos humanos. O maior número de casos na América Latina foi observado no Brasil (40,2%), Peru (23,6%), Colômbia (8,8%) e Equador (7,2%). A taxa de incidência acumulada para a América Latina foi estimada em 2,0 por 100.000 habitantes. Em média, 65,1% dos casos foram em homens. Conclusões Este estudo demonstra que muitos países da América Latina estão fazendo esforços para estabelecer fortes sistemas de vigilância e programas contra a leptospirose. O estudo também revela a importância da existência de sistemas de vigilância para a leptospirose e demonstra que as informações geradas podem ser usadas para a tomada de decisões baseadas em evidências científicas para a leptospirose.
Assuntos
Zoonoses , Sistema de Vigilância em Saúde , Programas Governamentais/organização & administração , Leptospirose , América Latina/epidemiologiaRESUMO
Objectives. To demonstrate the importance of country surveillance systems for leptospirosis and their use for preliminary epidemiological analysis, as well as to generate research questions for future, more comprehensive studies on the disease. Methods. In 2015, for the first time, the Pan American Health Organization (PAHO) included human cases of leptospirosis in its Regional Core Health Data Initiative, an open-access database that collects annual health indicators from the countries and territories of the Americas. This new information was used to analyze leptospirosis cases by country and sex and to calculate cumulative incidence rates. Maps were used to help present the results. To supplement that general review of leptospirosis in the Americas, more detailed descriptions of the epidemiological situation and the surveillance programs of four selected countries (Brazil, Colombia, Cuba, and Honduras) were provided. Results. In this first year of PAHO requesting leptospirosis data, of the 49 countries and territories in the Americas, 38 of them (77.6%) reported information. Among those 38, 28 of them (73.7%) reported the presence of human cases; the majority of instances of zero cases were in Caribbean territories. From those 28, a total of 10 702 human cases were recorded. The largest numbers of cases in Latin America were in Brazil (40.2%), Peru (23.6%), Colombia (8.8%), and Ecuador (7.2%). The cumulative incidence rate for Latin America was estimated to be 2.0 per 100 000 population. On average, 65.1% of cases were males. Conclusions. This study demonstrates that many countries in Latin America are making efforts to establish strong surveillance systems and programs for leptospirosis. The study also shows the importance of having leptospirosis surveillance systems as well as how the information generated can be used for evidence-based decision-making on leptospirosis.
Objetivos. Demostrar la importancia de los sistemas nacionales de vigilancia de la leptospirosis y su uso para realizar el análisis epidemiológico preliminar, así como para generar preguntas de investigación que se utilicen en futuros estudios más integrales sobre la enfermedad. Métodos. En el año 2015, la Organización Panamericana de la Salud (OPS) incluyó por primera vez casos humanos de leptospirosis en su Iniciativa Regional de Datos Básicos de Salud, base de datos de acceso abierto que recoge indicadores de salud anuales de los países y territorios de la Región de las Américas. Esta nueva información fue utilizada para analizar los casos de leptospirosis por país y sexo, así como para calcular las tasas de incidencia acumulada, y los resultados se presentaron en mapas. Para complementar ese examen general de la leptospirosis en esta Región, se aportó una descripción más detallada de la situación epidemiológica y los programas de vigilancia de cuatro países (Brasil, Colombia, Cuba y Honduras). Resultados. En este primer año en que la OPS solicitó datos sobre la leptospirosis, de los 49 países y territorios en la Región de las Américas, aportaron información 38 (77,6 %). De esos 38, 28 (73,7 %) notificaron casos humanos; la mayor parte de las instancias sin ningún caso humano se registraron en territorios del Caribe. En esos 28 países y territorios, se registraron 10 702 casos humanos. En América Latina, los países que registraron los números más altos de casos fueron Brasil (40,2 %), Perú (23,6 %), Colombia (8,8 %) y Ecuador (7,2 %). Se calculó que la tasa de incidencia acumulada de América Latina es de 2,0 por 100 000 habitantes. En promedio, 65,1 % de los casos correspondieron a hombres. Conclusiones. Este estudio demuestra que muchos países de América Latina están tomando medidas para instaurar sistemas y programas sólidos de vigilancia de la leptospirosis. Asimismo, revela la importancia de los sistemas de vigilancia de la leptospirosis, así como el modo en que la información generada puede servir para tomar decisiones basadas en la evidencia acerca de esta enfermedad.
Objetivos. Demonstrar a importância dos sistemas nacionais de vigilância para a leptospirose e seu uso na análise epidemiológica preliminar, além de gerar perguntas de pesquisa para futuros estudos mais aprofundados sobre a doença. Métodos. Em 2015, a Organização Pan-Americana da Saúde (OPAS) incluiu, pela primeira vez, casos humanos de leptospirose em sua Iniciativa Regional de Dados Básicos de Saúde, uma base de dados de acesso aberto que coleta indicadores de saúde anuais nos países e territórios das Américas. Utilizamos estas novas informações para analisar os casos de leptospirose por país e por sexo e calcular as taxas de incidência acumuladas. A apresentação dos dados é facilitada pelo uso de mapas. Para complementar esta revisão geral da leptospirose nas Américas, apresentamos descrições mais detalhadas da situação epidemiológica e dos programas de vigilância de quatro países selecionados (Brasil, Colômbia, Cuba e Honduras). Resultados. Neste primeiro ano em que a OPAS solicitou dados sobre a leptospirose, 38 dos 49 países e territórios das Américas (77,6%) apresentaram informações. Destes 38, 28 (73,7%) notificaram a presença de casos humanos; em sua maioria, os que não apresentaram nenhum caso foram territórios do Caribe. Dentre os 28, foi registrado um total de 10.702 casos humanos. O maior número de casos na América Latina foi observado no Brasil (40,2%), Peru (23,6%), Colômbia (8,8%) e Equador (7,2%). A taxa de incidência acumulada para a América Latina foi estimada em 2,0 por 100.000 habitantes. Em média, 65,1% dos casos foram em homens. Conclusões. Este estudo demonstra que muitos países da América Latina estão fazendo esforços para estabelecer fortes sistemas de vigilância e programas contra a leptospirose. O estudo também revela a importância da existência de sistemas de vigilância para a leptospirose e demonstra que as informações geradas podem ser usadas para a tomada de decisões baseadas em evidências científicas para a leptospirose.
Assuntos
Leptospirose , Zoonoses , Programas Governamentais , Programas Governamentais , Sistema de Vigilância em Saúde , América Latina , Sistema de Vigilância em SaúdeRESUMO
Introdução: A febre maculosa (FM) é uma doença transmitida por carrapatos, o que, no Brasil, preocupa as autoridades do Sistema Único de Saúde (SUS) por apresentar elevados coeficientes de letalidade. Objetivo: Descrever os conhecimentos e as atitudes de prevenção sobre a FM entre profissionais do SUS. Métodos: Foi realizado entre os meses de outubro a dezembro de 2015, um inquérito sobre os conhecimentos e as atitudes de prevenção sobre a FM entre os profissionais da saúde. Um questionário na plataforma FormSUS foi submetido a 426 profissionais de todo o Brasil que previamente já haviam participado de capacitações e atividades que envolviam o tema em questão. Resultados: vinte unidades federadas foram respondedoras da pesquisa (112/426). Foi possível verificar que a maioria dos profissionais de saúde conhece as condutas de notificação e de investigação epidemiológica. As incorporações recentes no programa de vigilância epidemiológica são de conhecimento da maioria dos respondentes. A rotatividade dos profissionais foi mencionada como principal dificultador das ações de vigilância da doença. Ações de fortalecimento dos programas de vigilância são realizadas de forma esporádica, somente no momento da ocorrência de casos de FM e não ocorrem de forma integral no âmbito do SUS. Conclusão: Cabe a cada segmento do SUS buscar seguir as diretrizes do sistema de vigilância epidemiológica da FM para que, de forma integral, se consiga reverter o panorama de morbimortalidade desta importante doença no Brasil. (AU)
Introduction: Spotted fever (SF) it's a tick-borne disease, that in Brazil worries the Unified Health System (named as SUS), because of its high fatality rates. Objective: Describe the knowledge and attitudes of prevention on SF between SUS professionals. Methods: It was realized in 2015, between October and December, an inquiry of the knowledge and attitudes of prevention on SF between health professionals. A questionnaire on FormSUS platform was subjected to 426 professionals from all over Brazil, who previously has participated in training and activities involving the present issue. Results: Twenty federal units answered the inquiry (112/426). It was possible to verify that most health professionals know the conduct of notification and epidemiological research. Recent incorporations in the surveillance program are known to most respondents. The turnover of professionals was mentioned as main complication on the surveillance actions of the disease. Strengthening actions regarding surveillance programs are performed occasionally, only at the time of the incident occurrence, and do not occur integrally in SUS. Conclusion: It's up to each SUS segment seek to follow the guidelines of epidemiological surveillance system for SF, to be able of reverse in full the scenario of morbidity and mortality of this important disease in Brazil. (AU)
Assuntos
Doenças Transmitidas por Carrapatos , Infecções por Rickettsia , Zoonoses , Inquéritos Epidemiológicos , Capacitação em ServiçoRESUMO
Abstract Brazilian spotted fever (BSF) is caused by the bacterium Rickettsia rickettsii. Because of its high case-fatality rate and apparent increase in areas of transmission, it is considered to be the rickettsial illness of primary public health interest. Cases of this disease have historically occurred in Southeastern Brazil. This article reports the first fatal case of BSF in Southern Brazil. This case high lights the importance of BSF to be considered as a differential diagnosis for acute hemorrhagic fever in areas where cases of BSF may not be expected.
Assuntos
Humanos , Feminino , Criança , Febre Maculosa das Montanhas Rochosas/diagnóstico , Rickettsia rickettsii/imunologia , Brasil , Evolução Fatal , Anticorpos Antibacterianos/sangueRESUMO
O presente estudo descreveu as intervenções realizadas em áreas silenciosas do Brasil, sob o aspecto da promoção da saúde. As áreas avaliadas durante o período de 2014 a 2015 compreenderam as seguintes Unidades Federadas: Mato Grosso do Sul, Alagoas, Pernambuco, Rondônia, Roraima, Rio Grande do Norte e Maranhão. Foram avaliados os dados sobre a vigilância da febre maculosa por meio das fichas epidemiológicas disponíveis no Sistema de Informação de Agravo de Notificação, bem como a fauna de vetores e das infecções por riquétsias do grupo da febre maculosa (RGFM). Foram coletados 1.528 vetores de dez espécies diferentes, cuja maior diversidade foi observada em Rondônia. Neste estudo, 85% dos Estados investigados apresentaram RGFM em vetores ou em humanos, sendo Mato Grosso do Sul, Rondônia e Pernambuco, os mais prevalentes. Os resultados apresentados apontam para a necessidade permanente de qualificação das equipes de profissionais de saúde e ambiente, a fim de aprimorar os dados sobre a febre maculosa em nosso meio
RESUMO
Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs. Methods This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015. Results In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed. Conclusions The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.(AU)
Assuntos
Febre Maculosa das Montanhas Rochosas/história , Febre Maculosa das Montanhas Rochosas/veterinária , Febre Maculosa das Montanhas Rochosas/epidemiologiaRESUMO
Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs. Methods This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015. Results In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed. Conclusions The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.
Assuntos
Febre Maculosa das Montanhas Rochosas/epidemiologia , Febre Maculosa das Montanhas Rochosas/história , Febre Maculosa das Montanhas Rochosas/veterináriaRESUMO
Background Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs. Methods This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015. Results In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed. Conclusions The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.(AU)
Assuntos
Infecções por Rickettsia/epidemiologia , Carrapatos , MortalidadeRESUMO
As hantaviroses são zoonoses que causam doenças humanas graves como a síndrome cardiopulmonar por hantavírus (SCPH) registrada no continente americano. No Brasil a SCPH é doença de notificação obrigatória aos serviços de saúde por apresentar elevada letalidade e incipiente conhecimento da sua epidemiologia. O presente estudo descreve o perfil epidemiológico da SCPH no Brasil para o período de 2007 a 2012. Foi realizado um estudo descritivo dos registros do Sistema Nacional de Agravos de Notificação, foram analisadas as fichas de notificação e investigação e os dados foram avaliados quanto a completitude da informação, oportunidade e perfil dos casos registrados. Os resultados são apresentados em números brutos, medidas de proporção e tendência central e as analises foram desenvolvidas pelos softwares Excel 2010, Tabwin 32 e TerraView. No período estudado foram notificados 8.456 casos de SCPH, com confirmação de 9 porcento (756/8.456), preferencialmente pelo critério laboratorial 91,1 porcento (689/756). O coeficiente de letalidade médio para o período foi de 38,2 porcento, as maiores incidências da doença foram nos estados do Mato Grosso, Santa Catarina e Distrito Federal e as maiores letalidades no Amazonas, Mato Grosso e São Paulo. Quanto à sazonalidade foram observados casos em todos os meses do ano; os óbitos foram mais frequentes em homens 72,3 porcento (209/289) e maior letalidade 42,3 porcento (80/189) foi observada em mulheres. Os casos acometeram principalmente pessoas que exerciam atividades relacionadas à agricultura 18,8 porcento (90/478) que se expuseram ao ambiente com roedores 36,9 porcento (279/756).
A maioria dos pacientes necessitou de hospitalização 90,3 porcento (683/756) e os tempos médios expressos em número de dias entre a variável início dos sintomas e as variáveis hospitalização, cura ou óbito foram respectivamente (5, 11, 18). Os dados apresentados neste estudo poderão subsidiar as capacitações técnicas que necessitam estar voltadas para o reconhecimento da circulação do agente, oportunidade no diagnóstico e tratamento e qualidade da informação; fatores prioritários para o fortalecimento dos programas de vigilância epidemiológica da hantavirose.
Hantaviruses are zoonoses that cause serious human diseases in the Americas such as hantavirus pulmonary syndrome (HPS). In Brazil HPS is a notifiable disease to health services due to its high lethality and incipient knowledge of its epidemiology. The present study describes the epidemiology of HPS in Brazil for the period 2007-2012. We conducted a descriptive study of the records of the National Notifiable Diseases System, analyzed the reporting forms and research, and the data were evaluated for completeness of information, opportunity and profile of registered cases. The results are presented as raw numbers, measures of central tendency and proportion and analyses developed using Excel 2010 software, and 32 Tabwin terraView. In the study period 8,456 cases of HPS were reported, with confirmation of 9 percent (756/8,456), ideally by laboratory testing 91.1 percent (689/756). The average coefficient of lethality for the period was 38.2 percent, whilst the highest incidences of the disease were in the states of Mato Grosso, Santa Catarina and the Federal District and the greatest lethalities were in Amazonas, Mato Grosso and São Paulo. Regarding seasonality, cases were observed in all months of the year. Deaths were more frequent in males 72.3 percent (209/289) and high mortality was observed in women 42.3 percent (80/189). The cases were mainly people who conducted activities related to agriculture 18.8 percent (90/478) who were exposed to the rodent environment, 36.9 percent (279/756).
Most of the patients 90.3 percent (683/756) required hospitalization and the average time expressed in number of days between the variable onset of symptoms and hospitalization, cure or death variables, were respectively (5, 11, 18). The data presented in this study highlight the necessity to focus technical skills on the recognition of the circulation of the agent, the opportunity for diagnosis and treatment and quality of information and priority factors for the strengthening of epidemiological surveillance programs of hantavirus.
Assuntos
Humanos , Orthohantavírus , Zoonoses/epidemiologia , Infecções por Hantavirus/etnologia , Infecções por Hantavirus/epidemiologia , Infecções por Hantavirus/mortalidadeRESUMO
As hantaviroses são zoonoses que causam doenças humanas graves como a síndrome cardiopulmonar por hantavírus (SCPH) registrada no continente americano. No Brasil a SCPH é doença de notificação obrigatória aos serviços de saúde por apresentar elevada letalidade e incipiente conhecimento da sua epidemiologia. O presente estudo descreve o perfil epidemiológico da SCPH no Brasil para o período de 2007 a 2012. Foi realizado um estudo descritivo dos registros do Sistema Nacional de Agravos de Notificação, foram analisadas as fichas de notificação e investigação e os dados foram avaliados quanto a completitude da informação, oportunidade e perfil dos casos registrados. Os resultados são apresentados em números brutos, medidas de proporção e tendência central e as analises foram desenvolvidas pelos softwares Excel 2010, Tabwin 32 e TerraView. No período estudado foram notificados 8.456 casos de SCPH, com confirmação de 9 porcento (756/8.456), preferencialmente pelo critério laboratorial 91,1 porcento (689/756). O coeficiente de letalidade médio para o período foi de 38,2 porcento, as maiores incidências da doença foram nos estados do Mato Grosso, Santa Catarina e Distrito Federal e as maiores letalidades no Amazonas, Mato Grosso e São Paulo. Quanto à sazonalidade foram observados casos em todos os meses do ano; os óbitos foram mais frequentes em homens 72,3 porcento (209/289) e maior letalidade 42,3 porcento (80/189) foi observada em mulheres. Os casos acometeram principalmente pessoas que exerciam atividades relacionadas à agricultura 18,8 porcento (90/478) que se expuseram ao ambiente com roedores 36,9 porcento (279/756)...
Hantaviruses are zoonoses that cause serious human diseases in the Americas such as hantavirus pulmonary syndrome (HPS). In Brazil HPS is a notifiable disease to health services due to its high lethality and incipient knowledge of its epidemiology. The present study describes the epidemiology of HPS in Brazil for the period 2007-2012. We conducted a descriptive study of the records of the National Notifiable Diseases System, analyzed the reporting forms and research, and the data were evaluated for completeness of information, opportunity and profile of registered cases. The results are presented as raw numbers, measures of central tendency and proportion and analyses developed using Excel 2010 software, and 32 Tabwin terraView. In the study period 8,456 cases of HPS were reported, with confirmation of 9 percent (756/8,456), ideally by laboratory testing 91.1 percent (689/756). The average coefficient of lethality for the period was 38.2 percent, whilst the highest incidences of the disease were in the states of Mato Grosso, Santa Catarina and the Federal District and the greatest lethalities were in Amazonas, Mato Grosso and São Paulo. Regarding seasonality, cases were observed in all months of the year. Deaths were more frequent in males 72.3 percent (209/289) and high mortality was observed in women 42.3 percent (80/189). The cases were mainly people who conducted activities related to agriculture 18.8 percent (90/478) who were exposed to the rodent environment, 36.9 percent (279/756)...
Assuntos
Humanos , Orthohantavírus , Infecções por Hantavirus/epidemiologia , Infecções por Hantavirus/etnologia , Infecções por Hantavirus/mortalidade , Zoonoses/epidemiologiaRESUMO
A reprodução e a morte massiva de plantas de longa vida, como taquaras e bambus, estão associadas historicamente a episódios de ratadas. A superpopulação de roedores, que é favorecida pelo evento reprodutivo desses vegetais, traz consigo grandes prejuízos e riscos de emergências de doenças. Nesta nota, relatamos o episódio de ratada ocorrido no município de São Francisco do Sul, Santa Catarina. Para subsidiar esta comunicação foram feitas observações de campo, entrevistas não estruturadas e coleta de material biológico em novembro de 2012. Foi constatada a reprodução da taquara do gênero Merostachys e a invasão subsequente de domicílios por roedores dos gêneros Oligoryzomys e Akodon, reservatórios de hantavírus, no sul do Brasil.
Reproduction and massive death of long lived plants like bamboo are historically associated with episodes of mouse outbreaks. The over population of rodents that is favored by the reproduction of these vegetables brings big losses and risks of emerging diseases. In this note we report the mouse outbreaks happened in the district of São Francisco do Sul, Santa Catarina, Brazil. In order to supoort this communication we conducted observations, unstructured interview and sand collection of biological material in November 2012. It was found bamboo reproduction of the genus Merostachys and subsequent invasion of houses by rodents of the genus Oligoryzomys and Akodon, which are hantavirus reservoirs, in southern Brazil.
La reproducción y muerte masiva de plantas de larga vida, como tacuaras y bambús, están asociadas históricamente a episodios de ratadas. La superpoblación de roedores, que es favorecida por el evento reproductivo de esos vegetales, trae consigo grandes perjuicios y riesgos de emergencias de enfermedades. En esta nota, relatamos el episodio de ratada ocurrido en el municipio de São Francisco do Sul, Santa Catarina. Para subsidiar esta comunicación fueron hechas observaciones de campo, entrevistas no estructuradas y recogida de material biológico en noviembre de 2012. Fue constatada la reproducción de la tacuara del género Merostachys y la invasión subsecuente de domicilios por roedores de los géneros Oligoryzomys e Akodon, reservorios de hantavirus, en el sur de Brasil.
Assuntos
Plantas , Roedores , Materiais Biocompatíveis , Orthohantavírus , BambusaRESUMO
BACKGROUNS: Hantavirus is a genus belonging to the Bunyaviridae family. Human infection occurs mainly by inhalation of aerosols formed from wild rodent droppings. The objectives of this study were to identify the species of rodent reservoirs of hantavirus that cause the cardiopulmonary syndrome in the southern and southeastern regions of Brazil; to understand the eco-epidemiology of this virus and the wild rodents' systematics. MATERIAL AND METHODS: Rodents were captured using Sherman traps distributed throughout natural environments and around human settlements in localities were hantavirus cardiopulmonary syndrome was detected. After species identification, biometric measures were taken of each animal. Samples of blood, liver, kidney, spleen, heart and lung were preserved in liquid nitrogen and sent to the laboratory. Blood samples were tested for IgG antibodies for hantavirus using an enzyme-linked immunosorbent assay (ELISA). Voucher specimens are available at the Instituto Adolfo Lutz collection. RESULTS: A total of 4,069 rodents, belonging to 22 species, were captured. From these rodents, 201 had IgG antibodies for hantavirus. The number of positive specimens per number of captured rodents according to the natural environments studied is the following: a) Mainland: Bolomys lasiurus (130/1187), Oximicterus ruttilans (1/6), Thalpomys lasiotis (0/2), Oligoryzomys stramineus (0/1), Oryzomys nitidus (0/24), Pseudoryzomys simplex (0/14), Calomys tener (22/910), Calomys callosus (2/107); b) Atlantic rainforest: Bolomys sp (1/51), Brucepattersonius soricinus (0/16), Oximicterus quaestor (0/15), Thaptomys nigrita (1/59), Delomys dorsalis (0/1), Delomys sublineatus (0/4) Oligoryzomys delticola (0/5), Oryzomys capito (0/3), Oryzomys ratticeps (0/7), Calomys laucha (0/26); c) Both habitats: Akodon sp (14/910), Oligoryzomys nigripes (28/360), Rattus rattus (0/9), Mus musculus (2/352). Oligoryzomys nigripes was more frequent in the Atlantic rainforest. Bolomys lasiurus showed the highest capture index (44%) and the highest antibody prevalence among mainland species (10.9%). In the Atlantic rainforest, Akodon sp was the most captured species (45,4%) and Oligoryzomys nigripes showed the highest antibody prevalence (7,8%). CONCLUSIONS:Antibody prevalence indicates Bolomys lasiurus as the reservoir of hantavírus in the mainland regions of São Paulo and Minas Gerais and Oligoryzomys nigripes in the Atlantic rainforest of São Paulo, Rio Grande do Sul, Paraná and Santa Catarina. Species belonging to the genus Akodon and Calomys showed lower prevalence, and complementary studies are needed to clarify their role in hantavirus epidemiology.
DELINEAMENTO DO PROBLEMA: Os hantavirus formam um gênero da família Bunyaviridae . A infecção humana ocorre, principalmente, pela inalação de aerossóis formados a partir de excretas de roedores silvestres infectados. Os objetivos deste trabalho foram identificar as espécies de roedores reservatórios de hantavírus causadores de síndrome cardiopulmonar nas regiões Sul e Sudeste do Brasil; e compreender a ecoepidemiologia desses vírus e a sistemática de roedores silvestres. MATERIAL E MÉTODOS: Em locais onde ocorreram casos de síndrome cardiopulmonar por hantavírus, foram realizadas capturas de roedores silvestres com auxílio de armadilhas tipo Sherman, distribuídas nos diversos biomas e ambientes domiciliares, peridomiciliares e silvestres. Após identificação sistemática da espécie, medidas biométricas foram tomadas de cada animal. Amostras de sangue, fígado, rim, baço, coração e pulmão foram conservadas em nitrogênio líquido e levadas para o laboratório. O sangue foi testado pela técnica imunoenzimática (ELISA) para detecção de anticorpos IgG para hantavírus. As carcaças dos roedores foram depositadas na coleção do Instituto Adolfo Lutz. RESULTADOS: Foram capturados 4.069 roedores, de 22 espécies. Desses, 201 roedores apresentaram anticorpos IgG para hantavírus. As espécies e os respectivos números de roedores positivos por capturados, de acordo com os biomas estudados foram: a) cerrado: Bolomys lasiurus (130/1187), Oximicterus ruttilans (1/6), Thalpomys lasiotis (0/2), Oligoryzomys stramineus (0/1), Oryzomys nitidus (0/24), Pseudoryzomys simplex (0/14), Calomys tener (22/910), Calomys callosus (2/107), b) Mata Atlântica: Bolomys sp (1/51), Brucepattersonius soricinus (0/16), Oximicterus quaestor (0/15), Thaptomys nigrita (1/59), Delomys dorsalis (0/1), Delomys sublineatus (0/4) Oligoryzomys delticola (0/5), Oryzomys capito (0/3), Oryzomys ratticeps (0/7), Calomys laucha (0/ 26); c) nos dois biomas: Akodon sp (14/910), Oligoryzomys nigripes (28/360), Rattus rattus (0/9), Mus musculus (2/352). Oligoryzomys nigripes foi consideravelmente mais freqüente na mata atlântica. Bolomys lasiurus apresentou maior índice de captura (44%) e de prevalência de anticorpos entre espécies de cerrado (11%), enquanto na mata atlântica, Akodon sp foi a mais capturada (45%) e Oligoryzomys nigripes apresentou maior soropositividade (8%). CONCLUSÕES: Baseando-se na prevalência de anticorpos, Bolomys lasiurus foi identificado como reservatório de hantavírus nas regiões de cerrado de São Paulo e Minas Gerais e Oligoryzomys nigripes nas regiões de mata atlântica de São Paulo, Rio Grande do Sul, Paraná e Santa Catarina. Espécies do gênero Akodon e Calomys mostraram baixas soroprevalências e requerem novos estudos para esclarecer seu papel na epidemiologia do hantavírus.