Only in summer? Second time is hemorrhagic? See myths and truths about dengue – 05/26/2022

Dengue is still on the rise in Brazil and its causative agent, the mosquito Aedes aegypti, also. From January to April 2022, the country accounted for more than 500,000 cases of the disease, almost the same total of notifications for the entire year of 2021, according to data from the Ministry of Health.

Next, Live wellwith the help of experts, clarifies the main doubts about recognizing, taking precautions and what to do if you are affected by this threat.

Dengue is a summer disease?

São Paulo City Hall employee pours chemicals into standing water at home in the North Zone - Moacyr Lopes Junior/Folhapress - Moacyr Lopes Junior/Folhapress

São Paulo City Hall employee pours chemicals into standing water at home in the North Zone

Image: Moacyr Lopes Junior/Folhapress

Myth. You could say it’s been here. Dengue, although very common in the summer, which, because it is hot, humid and rainy, favors the multiplication of Aedes aegyptimay appear on other stations as well.

“In Brazil, from October to May, especially in the months of March, April and May”, informs Carla Kobayashi, an infectious disease specialist at Hospital Sírio-Libanês, in São Paulo.

With global warming, the estimate is that the disease will become increasingly common and spread through previously colder and drier regions. By the end of this century, around 89% of the world’s population will be at risk, they warned last year in the journal The Lancet Planetary Healthresearchers at the London School of Hygiene and Tropical Medicine, England.

Is transmission by sting only?

Partial truth. In the overwhelming majority of cases, yes, dengue is acquired by the bite of the mosquito. However, although it is extremely rare, transmission can also occur through organ transplants and blood transfusions.

“Direct contact between a healthy person and another who is affected by the disease does not represent any risk, as in covid-19, for example”, explains Giovanna Sapienza, a doctor at Hospital Emílio Ribas and an infectious disease specialist at the Meniá Prevention Center, in São Paulo. Paul.

Can you get zika and chikungunya along with dengue?

Yes. “THE Aedes aegypti it can either acquire or transmit more than one virus and, worse, at the same time, causing three different diseases —dengue, zika, chikungunya, for example”, says Clarissa Cerqueira Ramos, an infectious disease specialist at Hospital Cárdio Pulmonar, in Salvador (BA).

According to researchers at the University of Colorado (USA), who published in 2017 in the journal Nature Communications a study on the subject, requires only one sting for the triple coinfection to occur. This would be much easier in concurrent outbreak areas.

For the second time is hemorrhagic?

In common, flu, cold, covid and dengue are caused by viruses - Getty Images - Getty Images
Image: Getty Images

Not necessarily. Recurrent infections may have more serious presentations, but this is not the rule. There are those who can get very bad in a first infection and there are those who may not even need hospitalization in a reinfection, guarantee the infectologists of Sírio-Libanês and Emílio Ribas.

Another point to clarify, according to Ramos, is that the term “hemorrhagic” is being used less and less, because in a worse evolution there are not only hemorrhages. She talks about “severe dengue”, which is when the organism, once sensitized by the disease, eventually produces more antibodies to fight it, causing, unintentionally, an “attack” to itself.

Dengue is just one, all the same?

Not. There are four serotypes of the dengue virus, all present in Brazil. In general, called DENV-1, DENV-2, DENV-3 and DENV-4, they can cause both the classic manifestation of the disease and the form considered severe.

Classic dengue has symptoms of high and sudden fever, headache or eye pain, tiredness or muscle and bone pain, lack of appetite, nausea, dizziness and skin rashes. It lasts five to ten days, but the recovery period can take weeks.

Severe dengue, as the term suggests, progresses with worsening of the condition on the third or fourth day, with the appearance of hemorrhages, intense and constant abdominal pain, painful and palpable liver, drop in blood pressure and shock, the main cause of death.

Can it be treated at home?

Yes. With prior guidance from a doctor and return to the health service, dengue symptoms can be treated at home with simple analgesics and antipyretics, in addition to rest, oral hydration with increased intake of water, teas, juices and homemade serum.

“It is mandatory to avoid the use of non-steroidal anti-inflammatory drugs and derivatives of AAS (acetylsalicylic acid), as they increase the risk of bleeding”, warns infectious disease specialist Carla Kobayashi, continuing that in the case of severe dengue, hospitalization is required.

Is there a vaccine for dengue?

Dengue Vaccine - iStock - iStock
Image: iStock

Yes, one, however, as in the severe form of the disease, the immune response generated by this vaccine, which uses the attenuated dengue virus and covers all four serotypes, can harm the organism, which has led to restrictions on its use. To be vaccinated, the person would first need to be examined, which makes its large-scale application economically unfeasible.

On the part of science, efforts on behalf of the population do not stop, but Brazil still lacks investments in health and education, which makes it impossible to specify when vaccines will be available for the disease, leaving as an alternative the measures to combat mosquitoes.

Is it a recent illness?

Not. Dengue has been known in tropical and subtropical regions since the beginning of the last century. There are references to dengue epidemics in 1916, in São Paulo, and in 1923, in Niterói (RJ), however, without laboratory diagnosis. The first scientifically documented epidemic in the country occurred in 1981-1982, in Boa Vista (RO), by the DENV-1 and DENV-4 serotypes.

Is your mosquito identifiable?

Yes. THE Aedes aegypti, which emerged in Africa and from there spread to Asia and the Americas, mainly with maritime traffic, is recognized for having its legs, trunk and head striped in black and white. It also flies low, has translucent wings and urban habit, and makes a much quieter noise compared to other mosquitoes.

By using human blood to mature its eggs, the female mosquito is the one who bites. “But not every mosquito that carries, is infected by the dengue virus”, informs Sapienza.

Is it possible to control it?

standing water in RJ - Fábio Motta/Estadão Content - Fábio Motta/Estadão Content
Image: Fábio Motta/Estadão Content

Yes, but with a lot of awareness. In 1955, for example, PAHO (Pan American Health Organization) promoted a major campaign that led to the eradication of A. aegypti in Brazil. However, it was not maintained and the mosquito, present in neighboring countries, has returned to spread here.

Today, due to population growth, disorderly occupation and irregular and massive disposal of objects, such as plastics, the complete elimination of dengue is no longer expected. However, with care on the part of society and the authorities, which includes constantly monitoring houses, vacant lots and abandoned properties (with sources of accumulation of stagnant and clean water), it is possible to consider the decrease and intensity of epidemic outbreaks.

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