Campinas investigates sixth case of spotted fever – 06/14/2023 – Health

Campinas health surveillance is investigating a sixth suspected case of spotted fever in the municipality — the fifth of a participant in a feijoada held on May 27, at Fazenda Santa Margarida, in the district of Joaquim Egídio. The other patient, a 38-year-old woman who is hospitalized, went to a concert by singer Seu Jorge on June 3.

The sixth suspected case is a 40-year-old woman who lives in Hortolândia and who is admitted to a private hospital in Campinas. Her health status was not disclosed.

According to the city hall, the Municipal Health Department was notified of the new suspect this Wednesday (14).

In a note, the municipal administration says that the patient had the onset of symptoms on June 10 and was hospitalized. The folder awaits the result of the laboratory examination to confirm the disease.

The first confirmation of death from spotted fever of a person who was at the farm was on Monday (12), that of dentist Mariana Gioardano, 36. She was at the feijoada with her boyfriend, pilot and businessman Douglas Pereira Costa, 42, who had the cause of death confirmed on Tuesday.

The two died on the 8th, the same day as a 28-year-old woman, a resident of Hortolândia, who attended the same event.

This Tuesday, the teenager Erissa Santana, 16 years old, who had been hospitalized in Campinas since Friday (9) with suspected spotted fever and who participated in the feijoada, died —the Devisa (Department of Health Surveillance) of Campinas still awaits conclusion report from the Adolfo Lutz Institute.

Another patient, a 38-year-old woman, was at Fazenda Santa Margarida at Seu Jorge’s show. She is hospitalized and has not yet had confirmation of her illness. The case was released this morning.

cases and deaths

• Douglas Pereira Costa, 42, businessman and pilot; he was at Feijoada do Rosa, on the farm; confirmed death from Rocky Mountain spotted fever
• Mariana Gioardano, 36, dentist; Costa’s girlfriend, was at feijoada; confirmed death from Rocky Mountain spotted fever
• 28 year old woman; was at Feijoada; confirmed death from Rocky Mountain spotted fever
• Erissa Santana, 16, student; was at Feijoada; suspicious death from Rocky Mountain spotted fever
• 38-year-old woman; she was at a show by singer Seu Jorge, on the same farm; hospitalized with suspected spotted fever
• 40 year old woman; was at Feijoada; hospitalized with suspected spotted fever

The show, according to Campinas City Hall, brought together 8,000 to 10,000 people. The organizer, according to the municipal management, did not know how to specify the exact public. Feijoada do Rosa, around 3,500.

The farm is considered the likely site of infection, according to the city hall, which classifies the condition as an outbreak of the disease.

The restaurant Seo Rosa, responsible for the feijoada on the farm, which is in its 22nd edition, said that it heard about the “fatality”, but that “it is not confirmed that they caught the tick on the spot”.

On Tuesday night, the feijoada organization declared, in a note published on a social network, “its deep regret, solidarity with the bereaved families and friends”.

According to the city hall, the farm will only be able to hold new events when it presents an environmental and communication contingency plan”, said the municipal management.

In a note, the farm said that it received the news with sadness and regrets what happened and that it is working on an action plan that it should present to the competent bodies later this week.

“In view of the latest events and, seeking ways to facilitate and structure necessary adaptation measures, the company, by liberality, will remain closed for the next 30 days”, says an excerpt from the note, which also states that the documentation of the site is up to date.

In the next few days, Campinas will publish a decree with rules for establishments that hold events for large audiences and that are in risk areas or with the presence of the star tick.

The decree will determine that those responsible for events in these places need to ensure the correct information, communication and mobilization of people in relation to the disease, in addition to disclosing ways to prevent contagion.

This Wednesday, a determination was made in the municipality so that every area at risk for Rocky Mountain spotted fever has information about the disease, with posters, banners, signs and other communication devices about the danger.

There are also two other confirmed cases in Campinas this year. Both people died. These two deaths are not related to the outbreak at the Santa Margarida farm.

WHAT IS SPOTTED FEVER?

Acute febrile infectious disease transmitted by ticks infected by the bacterium Rickettsia rickettsii, present mainly in the star tick. The ticks that transmit Rickettsia are called Amblyomma cajennense and are found throughout the national territory. For transmission to occur, the tick needs to be attached to the skin for at least four hours. There is no transmission from person to person.

According to the Ministry of Health, in Brazil, two Rickettsia species are associated with Rocky Mountain spotted fever: rickettsii, considered a serious disease, registered in the north of the state of Paraná and in the states of the Southeast Region; and parkeri, which has been registered in environments of the Atlantic Forest (Rio Grande do Sul, Santa Catarina, Bahia and Ceará), linked to less severe clinical conditions.

WHAT ARE THE SYMPTOMS?

The symptoms are, at first, sudden: high fever, pain in the body, in the head, prostration, loss of appetite, nausea, vomiting and the appearance of reddish spots mainly on the hands and feet, from the second to the fifth day, which can progress to petechiae (small red spots on the skin that resemble mosquito bites) and ecchymosis (purple spots). The disease has mild and severe forms, including hemorrhagic, with evolution to death. The fatality rate can exceed 50%.

TREATMENT

Antibiotics are administered —tetracycline, doxycycline and chloramphenicol— which prevent the proliferation of bacteria, containing the worsening of the disease. The use of medication should already be done even before confirmation of the result.

HOW LONG DOES IT TAKE FOR THE PATIENT’S CONDITION TO DEATH?

The individual can progress to death between the 5th and 15th day after the onset of symptoms. It will depend on the agility in the diagnosis and initiation of treatment. Rocky Mountain spotted fever is difficult to diagnose because it has nonspecific symptoms that can be confused with other diseases, such as leptospirosis, zika, dengue and meningitis, among others.

CAN ANY TICK TRANSMIT SPOTTED FEVER?

The main ticks that transmit Rocky Mountain spotted fever in Brazil are three: Amblyomma cajennense, Amblyomma cooperi (dubitatum) and Amblyomma aureolatum (yellow dog tick).

In the interior of São Paulo, Rocky Mountain spotted fever is associated with the star tick which, in general, occurs in areas of wild forest and riversides. In general, adult men are more affected, as they work in these regions. Nymphs (immature forms of the tick) are the main evolutionary stages involved in transmission and predominate in the colder months.

HOW TO AVOID A TICK BITE?

Those who circulate through endemic areas must wear boots, pants and blouses with long sleeves, covering the whole body. It is important to avoid places with tall weeds.

IS THERE A RISK OF INFECTION IN URBAN AREAS?

Yes. O Amblyomma aureolatum found in dogs is involved in the transmission of the disease in metropolitan regions, mainly in cities in the Southeast and South of the country, where the highest number of cases occurs.

WHAT ARE THE ENDEMIC AREAS IN SÃO PAULO?

Jundiaí, Campinas and Piracicaba, in particular.

REPELLENTS DRIVE AWAY THE DISEASE-TRANSMITTING TICK?

Yes. Icaridin-based repellents are effective not only against mosquito bites but also against ticks, such as the star tick. Long-term presentations ranging from five to 12 hours are available.

Sources: Tania Chaves, infectologist, professor at the Faculty of Medicine at the Federal University of Pará, and Marcelo Simão, infectologist, professor at the Federal University of Uberlândia (MG). Both are consultants to the Brazilian Society of Infectology.