Chikungunya cases increase 142.6% in SP in one year – 12/05/2023 – Health

As of December 1st, the state of São Paulo recorded 2,167 cases of chikungunya and 12 deaths. In the same period last year, there were 893 confirmations, but no deaths. In the state, the increase reaches 142.6%.

In the capital of São Paulo, until November 23, there were 25 cases compared to 13 in the same period in 2022 — an increase of 92%. There were no deaths.

Symptoms of the disease are high fever (above 38°C), severe joint pain, pain in the back, throat, head and behind the eyes, red rash on the skin, nausea and vomiting, chills, diarrhea and abdominal pain.

The disease has three phases: from 5 to 14 days (acute or febrile), up to three months (post-acute) and more than 90 days (chronic).

According to Ralcyon Teixeira, infectious disease specialist at the Emílio Ribas Institute of Infectious Diseases, the chikungunya virus prefers to replicate within the joints, which causes arthritis and consequently pain that can persist for years — in more than 50% of cases, according to experts. .

“Chikungunya is a fearful disease in relation to dengue, because there is a greater risk of sequelae, and the acute phase is intense and disabling. Chronic pain is very bad in every way — social, work — it inflames the joints more than than dengue. You start to have pain that accompanies you. You will need treatment and medical monitoring”, says Teixeira.

The clinical diagnosis of arbovirus, as diseases transmitted by mosquitoes are called, is confirmed through serology or molecular biology testing. It is important that the exam is carried out after the sixth day, counting from the onset of symptoms.

Chikungunya is transmitted by Aedes aegypti, also responsible for cases of dengue and zika. Eliminating mosquito breeding sites is a fundamental strategy for controlling its proliferation and preventing the diseases it transmits.

“We must also sensitize some of the health professionals to start thinking a little more about the disease, about those cases that are suspected of being dengue, but the patient has a lot of joint pain. Differential diagnoses need to be carried out to see how the virus is circulating. alert is important, because it is a virus that we are not used to registering in the state of São Paulo”, concludes Teixeira.

Chikungunya will increase in 2024, according to experts

For infectious disease specialist Melissa Falcão, member of the Arbovirus Committee of the SBI (Brazilian Society of Infectious Diseases), the growth of chikungunya is worrying not only in São Paulo, but in Brazil. The disease is unknown in at least around 50% of the country’s municipalities, which makes it difficult for health professionals to diagnose.

The expectation is for an increase in cases in 2024, with a high chance of an increase in cities where it is already endemic, and spreading to those that have not yet been registered. The warning applies to São Paulo and other large metropolises.

“Chikungunya is usually explosive, with a high number of cases. The disease has an attack rate of around 30%”, says Falcão.

According to the doctor, the spread is fast and a little different compared to dengue, mainly because it does not affect an entire state at once. “It starts in one or two cities. Then, it returns with a second, more intense wave in those same cities and spreads to others”, explains the infectious disease specialist.

The only way to effectively combat arboviruses is to eliminate mosquito outbreaks Aedes aegypti.

“Individually, we can remember to use repellent when waking up, as the Aedes has its period of activity in the early morning and late afternoon, and control the proliferation of mosquitoes at home and at work”, advises Falcão, also remembering not to leave standing water.

A possible change in the profile of chikungunya brings a warning for 2024, says infectologist Kleber Luz, coordinator of the SBI Arbovirus Committee and consultant for arboviruses at PAHO (Pan American Health Organization), a branch of the WHO (World Health Organization) in the Americas. This was the case in Paraguay where, as of December 2022, there were around 200 thousand cases and 300 deaths.

It is not yet known what happened and studies do not point to a mutation of the virus. Without adequate medical care, the patient can die within the first five days of the illness, he explains.

With the increase in dengue cases in the country in the last year, experts also raise concerns about an increase in chikungunya cases in Brazil. The report requested data relating to the period from January to December 1, 2023 on chikungunya, but did not receive a response from the Ministry of Health at the time of writing this text.