HEALTH-BRAZIL:
Yellow Fever - Epidemic
or False Alarm?
By Fabiana Frayssinet
RIO DE JANEIRO, (IPS)
- The Brazilian Health
Ministry is fighting a
war on two fronts. It is
taking measures to
prevent an outbreak of
sylvatic (or jungle)
yellow fever while
countering speculation
in the press about an
imminent epidemic of the
disease. There have been
no cases of urban yellow
fever in the country
since 1942.
In all, 24 cases of
yellow fever have been
reported to the ministry
since December. Two have
been confirmed by
laboratory tests, and
five have been ruled
out, leaving 17
suspected cases,
according to the Health
Ministry.
In the first two weeks
of 2008, three patients
have died. One of the
victims was confirmed to
have contracted yellow
fever, and the others
are suspected to have
died of the illness on
the basis of clinical
assessments that have
not yet been confirmed
by laboratory tests,
which take several days.
"There is exaggerated
alarm, because we have
only had rare sporadic
cases," Valdineia Veloso,
the head of the Evandro
Chagas Research
Institute, part of the
Oswaldo Cruz Foundation
(FioCruz), said in an
interview with IPS.
Veloso, a specialist in
infectious diseases, is
one of the official
spokespersons charged
with denying stories
about an outbreak of
yellow fever.
Yellow fever is a
haemorrhagic viral
disease transmitted by
Aedes aegypti
mosquitoes, the same
species of insect that
transmits dengue fever.
It is present in 18 out
of the 27 Brazilian
states -- in the north,
west-centre and south --
according to the Health
Ministry.
But Veloso stressed that
this is not an urban
variety of the virus,
like the one that caused
the epidemic prior to
1942, but a sylvatic
strain, confined to
jungles and forests and
mainly infecting
monkeys.
"We are not experiencing
an outbreak of urban
yellow fever. What we
have are suspected cases
of sylvatic yellow fever
in persons who travelled
to at-risk areas and may
have become infected
with the disease," the
expert said.
Even if it were
confirmed that these are
cases of yellow fever,
"which occur
sporadically in Brazil,"
what really matters is
ascertaining whether
these infections were
contracted in urban
areas, according to
Veloso.
She said that in the
case of all three
fatalities, "there was a
history of having
visited jungle areas
where sylvatic yellow
fever is an established
risk."
One of the deceased
patients was Graco
Abubakir, a computer
technologist from
Brasilia, who had
travelled to Pirenópolis,
a historic city in the
central state of Goiás,
which has forested
areas.
Another was Almir
Rodrigues da Cunha, a
member of the business
community who died in
Maringá, a city in the
southern state of Paraná,
after spending the New
Year holidays with his
family in Novas Caldas,
another city in Goiás.
The third victim was
Salvador Pérez, a
Spaniard, who died on
Sunday in Goiania, the
capital of Goiás. He too
had travelled to the
interior of Goiás before
falling ill.
"This tale that urban
yellow fever is back is
a lie. I personally
guarantee that there is
no possibility of urban
yellow fever anywhere in
the country," Health
Minister José Gomes
Temporao said last week.
"The situation is
absolutely under
control. There is no
danger of an epidemic,"
he told a press
conference. He repeated
this message in a
television appearance
Sunday.
The minister made his
statements last week
after his ministry
issued an international
alert through the
Foreign Ministry and
Tourism Ministry,
recommending that
foreigners be vaccinated
against yellow fever
before visiting this
country.
At the same time as he
was trying to calm the
population, Temporao
announced that two
million additional doses
of yellow fever vaccine
were being distributed.
Production of the
vaccine is being
doubled.
According to Veloso,
this is a "routine"
measure, taken whenever
there is a suspected
case of yellow fever.
The vaccine is part of
the regular immunisation
schedule for Brazilians
over the age of nine who
live in at-risk areas,
she said.
The vaccines are
produced by FioCruz,
which was already
increasing output
because vaccination in
risk areas has been
expanding since 1998,
Veloso said.
Brazil also exports the
vaccine to other
countries.
Temporao said that
people who are planning
to visit at-risk areas
should be vaccinated at
least 10 days in
advance, so that the
body has time to build
up antibodies against
the virus.
Immunity lasts 10 years,
and the vaccine is
available at all health
centres, although
because of the scare,
there are temporary
shortages in some
places.
"What’s happening is an
over-reaction," the
minister said. "People
are caught up in a
frenzied rush to be
vaccinated. There is no
reason to panic. People
who have already been
vaccinated and are still
immune are lining up
unnecessarily to be
revaccinated," he said.
There are long lines at
health posts around the
country.
According to Health
Ministry statistics,
there were 349 cases of
sylvatic yellow fever
between 1996 and 2007,
with 161 deaths.
Brazil’s total
population is over 188
million.
Last year six people
were infected, two in
the state of Amazonas,
two in Goiás, one in
Roraima and the other in
Pará, in the northwest,
centre and north of the
country, respectively.
Five of them died.
Yellow fever has a high
mortality rate in
serious cases, Veloso
said.
The present alert
follows an earlier
warning by health
authorities in December,
when wild monkeys were
found dead near urban
areas in Goiás and the
Federal District
surrounding the capital,
Brasilia.
Between Dec. 29, 2007
and Jan. 12, health
personnel vaccinated
892,982 people in the
Federal District, which
has an estimated total
population of 2.4
million. Vaccine
coverage was over 90
percent before the
alert, according to the
Health Ministry,
indicating that a large
number of people were
presenting for
revaccination.
The disease is caused by
the yellow fever virus,
which attacks the liver
and other organs, and is
fatal in approximately
50 percent of toxic
cases. Treatment is
limited to supportive
measures.
Veloso said that the
symptoms -- which are
easily confused with
those of dengue, malaria
or other acute febrile
illnesses -- include
muscular pain, debility,
nausea, vomiting and, in
serious cases,
haemorrhages.
|
