30 years of fatal dengue cases in Brazil: a review

Abstract

BackgroundOver the last 30 years, extensive dengue epidemics have occurred in Brazil, characterized by emergences and re-emergences of different serotypes, a change in the epidemiological profile and an increase in the number of severe and fatal cases. Here, we present a review on the dengue fatal cases that occurred in Brazil in 30 years (1986–2015).MethodsWe performed an ecological study by using secondary data on dengue fatal cases obtained in the National System of Reported Diseases (Sistema de Informação de Agravos de Notificação -SINAN) and in the Mortality Information System (SIM), both maintained by the Brazilian Ministry of Health. Cases were analyzed by region, demographic variables, clinical classification and complications based on the data available.ResultsIn 30 years (1986–2015), the Southeast region reported 43% (n = 2225) of all dengue deaths in the country. The Midwest region was responsible for 18% of the fatal cases. After 2000, deaths occurred in almost all states, with the exception of Santa Catarina and Rio Grande do Sul, South region. From 2006 to 2010, the number of deaths increased, with higher rates of mortality, especially in Goiás and Mato Grosso. From 2011 to 2015, Goiás became the state with the highest mortality rate in the country, and Rio Grande do Sul reported its first dengue deaths. In 30 years, a total of 2682 dengue deaths occurred in males and 2455 in females, and an equal distribution between the sexes was observed. From 1986 to 2006, dengue deaths occurred predominantly in individuals over 15 years old, but this scenario changed in 2007–2008. After 2009, fatal cases on individuals above 15 years old became more frequent, with peaks in the years of 2010, 2013 and 2015.ConclusionsThe Brazil is experiencing a hyperendemic scenario, which has resulted in the co-circulation of the four DENV serotypes and with the increasing occurrence of severe and fatal cases. The disease surveillance and studies characterizing what has been reported overtime, are still important tools to better understand the factors involved in the disease outcome.

Population mobility and dengue fever transmission in a major city in Southeastern Brazil, 2007-2015

“…There is evidence that women usually seek health care assistance more frequently, not necessarily meaning that they are more affected by diseases, but, instead, that they tend to be more careful with their own wellness [64,65]. In Brazil, some studies found higher dengue notification among women [66,67], and others showed no significant sex difference [68,69]. In our data, from 2007 to 2015, 55% of patients that notified DENV cases were women while 45% were men, while the 2010 Population Census indicates that 52% of the residents in Campinas were women, and 48% were men [20].…”

Pulmonary manifestations of dengue

“…populations, uncontrolled urbanization, population growth, climate change, and increasing numbers of international travelers. (1,2,4,5,7) In Brazil, the number of cases of dengue fever reported in January-August 2019 was approximately 600% higher than that reported during the same period in 2018. As of August 2019, the disease had caused 591 deaths, compared with only 141 for the same period in 2018.…”

“…The dengue virus (DENV) belongs to the Flaviviridae family, and humans can be infected with any of the four antigenically distinct serotypes (DENV 1-4). (1)(2)(3)(4)(5)(6)(7) The prevalence of DENV infection has increased dramatically in recent decades; the disease is now endemic in > 100 countries worldwide. The global resurgence of dengue is thought to be due to the failure to control Aedes spp.…”

Early identification of dengue virus lineage replacement in Brazil using portable genomic surveillance

“…DENV was first detected in Brazil in 1982 [12]. Since then, it has become a serious public health concern due to its high incidence in the country and association with severe dengue illnesses [13]. Co-circulation of dengue serotypes has been observed throughout Brazil [14, 15], particularly in highly populated areas of the southeastern region that includes the federal states of São Paulo, Rio de Janeiro, Minas Gerais and Espírito Santo.…”

“…Between 1995 and 2015, Brazil reported nearly 8 million DENV cases, which comprises 55% of all cases reported in the Americas during this period [12]. Over the last thirty years, the southeast region of Brazil has reported 2225 dengue-related fatal cases, representing 43% of all dengue-related deaths in the country [13].…”