Dengue virus type 4, Manaus, Brazil

We report dengue virus type 4 (DENV-4) in Amazonas, Brazil. This virus was isolated from serum samples of 3 patients treated at a tropical medicine reference center in Manaus. All 3 cases were confirmed by serologic and molecular tests; 1 patient was co-infected with DENV-3 and DENV-4.     

Dengue and dengue hemorrhagic fever, Brazil, 1981-2002

In the last 5 years, Brazil has accounted for approximately 70% of reported dengue fever cases in the Americas. We analyzed trends of dengue and dengue hemorrhagic fever (DHF) from the early 1980s to 2002 by using surveillance data from the Brazilian Ministry of Health. Two distinct epidemiologic patterns for dengue were observed: localized epidemics (1986-1993), and endemic and epidemic virus circulation countrywide (1994-2002). Currently, serotypes 1, 2, and 3 cocirculate in 22 of 27 states. Dengue and DHF affected mainly adults; however, an increase in occurrence of DHF among children has been recently detected in northern Brazil, which suggests a shift in the occurrence of severe disease to younger age groups. In 2002, hospitalizations increased, which points out the change in disease severity compared to that seen in the 1990s. We describe the epidemiology of dengue in Brazil, characterizing the changing patterns of it and DHF during the last 20 years.     

Particulate suspended matters and cases of respiratory disease in Rio de Janeiro city (Brazil)

This paper investigates the existence of a possible relationship between suspended particulate matters levels and cases of respiratory diseases from a random and systematic sample of medical and air pollution records in the metropolitan area of Rio de Janeiro. Records of emergency cases of the year 1991 (months of January, June and July) were collected at Miguel Couto Hospitals and suspended particulate matter (1980-1995) at FEEMA (Rio de Janeiro Environmental Agency). The results revealed that the diseases of the respiratory system of those patients who seek the hospital's emergency care are more frequent during the wintertime. Their number increases markedly during winter months of June and July when compared with the summer's (January) number of cases. The analysis of the historical series (1980-1995) of atmospheric pollution measured at Bonsucesso monitoring station showed that the monthly figures (measured by the number of times that the value exceed the national standard, maximum daily concentration of 240 micro g (-3), are higher in wintertime (June, July and August). During this same period the level of pollution by atmospheric particulate matter in Rio de Janeiro metropolitan area measured by the annual geometric averages showed results well above the national standard (80 micro g(-3). This unfavorable situation, together with the fast growing number of new cars circulating in the city and the absence of a clear air pollution control and management plan, may contribute to an increase of the incidence and seriousness of respiratory diseases during subsequent winter months.     

Dengue virus 3 genotype 1 associated with dengue fever and dengue hemorrhagic fever, Brazil

Dengue serotype 3 viruses were isolated from patients in Brazil from 2002 through 2004. On the basis of phylogenetic analyses, these isolates were assigned genotype 1. This genotype had never been reported in South America before. Its appearance indicates a major risk factor for dengue epidemics and severe disease.     

Dengue type 3 virus, Saint Martin, 2003-2004

We describe the spread of a dengue virus during an outbreak in Saint Martin island (French West Indies) during winter 2003-2004. Dengue type 3 viruses were isolated from 6 patients exhibiting clinical symptoms. This serotype had not been detected on the island during the preceding 3 years. Genome sequence determinations and analyses showed a common origin with dengue type 3 viruses isolated in Martinique 2 years earlier.     

A Comparison of Social and Spatial Determinants of Health Between Formal and Informal Settlements in a Large Metropolitan Setting in Brazil

Urban informal settlements are often under-recognized in national and regional surveys. A lack of quality intra-urban data frequently contributes to a one-size-fits-all public health intervention and clinical strategies that rarely address the variegated socioeconomic disparities across and within different informal settlements in a city. The 2010 Brazilian census gathered detailed population and place-based data across the country's informal settlements. Here, we examined key socio-demographic and infrastructure characteristics that are associated with health outcomes in Rio de Janeiro with the census tract as the unit of analysis. Many of the city's residents (1.39 million people, 22 % of the population) live in informal settlements. Residents of census tracts in Rio de Janeiro's urban informal areas are younger, (median age of 26 versus 35 years in formal settlements), and have less access to adequate water (96 versus 99 % of informal households), sanitation (86 versus 96 %), and electricity (67 versus 92 %). Average per household income in informal settlement census tracts is less than one third that of non-informal tracts (US\$708 versus US\$2362). Even among informal settlements in different planning areas in the same city, there is marked variation in these characteristics. Public health interventions, clinical management, and urban planning policies aiming to improve the living conditions of the people residing in informal settlements, including government strategies currently underway, must consider the differences that exist between and within informal settlements that shape place-based physical and social determinants of health.     

Dengue 3 epidemic, Havana, 2001

In June 2001, dengue transmission was detected in Havana, Cuba; 12,889 cases were reported. Dengue 3, the etiologic agent of the epidemic, caused the dengue hemorrhagic fever only in adults, with 78 cases and 3 deaths. After intensive vector control efforts, no new cases have been detected.