Dengue in 2024: Brazil has more than 19,540 cases per day – 03/07/2024 – Health

From January 1st to March 6th, 2024, Brazil totaled 1,289,897 probable cases of dengue with 329 deaths and another 767 under investigation, according to the Ministry of Health’s Arbovirus Monitoring Panel. On average, there were 19,544 infections per day .

In the same period of 2023, the country reached 261,434 — an average of four cases per day. When considering last year as a whole, there were 1,658,816 infections and 1,094 deaths.

All reported cases are understood as probable cases, except those discarded.

The incidence of the disease in the country in 2024 —635.2 per 100 thousand inhabitants— indicates an epidemic. According to the criteria used by the WHO (World Health Organization) and the Ministry of Health to classify the disease in relation to the population, there are three levels of incidence: low (less than 100 cases/100 thousand inhabitants), medium ( from 100 to 300 cases/100 thousand inhabitants) and high (more than 300 cases/100 thousand inhabitants), the latter considered epidemic.

Monitoring dashboard discrepancies

With the selection of the topic “confirmed cases” in the Ministry of Health’s monitoring panel, the number of cases and the incidence coefficient drop to 580,760 and 286, respectively. The same occurs in each federation.

The Federal District, for example, has the highest incidence of the disease (4,275.8) based on probable cases (120,452). When filtering the confirmations, the incidence decreases to 1,334.3 with 37,588 probable cases. On March 5, the report questioned the Ministry of Health regarding the discrepancies found on the platform, but there was no response until the conclusion of this text.

For Julio Croda, infectious disease specialist, researcher at the Oswaldo Cruz Foundation and professor at the Federal University of Mato Grosso do Sul, unconfirmed deaths are what make it difficult to understand the magnitude of the disease.

He highlights that suspicious and unconfirmed deaths represent a failure in public surveillance. “The Ministry of Health itself states in its indicators and in press conferences that lethality is low, but it does not consider deaths suspicious. And why? States and municipalities are not closing this data”, he states.

“It is very difficult for us to understand the impact of the disease. We will only observe this in the future and we will have a picture of the past. We do not carry out more current surveillance, which can direct efforts to prevent deaths at this time. Since we have a large epidemic of dengue in Brazil, the objective is to no longer avoid cases due to the difficulty of preventive measures in reducing transmission. This year we will break the number of deaths records.”

‘We were unable to observe hospitalization because there is no such indicator. No one responds to the alarm signals. The death indicator is the only one available and is completely inadequate, because there are many open ones. I don’t worry too much about the closure of reported cases, as long as we can observe the trend, but in relation to deaths, it is very important that it is closed in a timely manner. Clearly this is not happening on the panels,” says Croda.

Dengue advances more slowly in the Northeast

In the northeastern states, the incidence of dengue is lower compared to the rest of the country, except in Bahia (242.8), which totals 34,325 cases. It is important to note that, despite the low coefficient (97.7), Natal, in Rio Grande do Norte, declared an emergency due to the epidemic.

In the researcher’s opinion, there is no way to predict whether dengue behavior will change in the Northeast.

“There is no way of knowing if it will increase. We are still in the seasonality of the disease, which lasts until April or May. So, we could see an increase at any time. For now, it is very silent, with the exception of Bahia. Natal has declared an emergency.

“In some states in the North [a incidência também] is very low. We observed the expansion in the center of Brazil towards the periphery. It started more in the Federal District, now it is in São Paulo, Rio, Espírito Santo and the center-south.

Females account for the majority of cases

The majority of probable cases are concentrated in women — 55.5%. In the country, panel data indicate that another 41.89% occurred in men.

In both genders, the age groups with the most occurrences of dengue are 30 to 39 (138,089 probable cases), 40 to 49 (210,668) and 50 to 59 (195,119). The interval with fewer likely infections is 1 to 4 years (36,400).

Mixed race (49.26%) and white people (41.89%) were those who had the most infections, followed by black people (6.98%), yellow people (1.58%) and indigenous people (0.29%).

Dengue symptoms are more intense and lasting

Patients with dengue fever report to the reporter that the symptoms of the disease are longer lasting and more intense. Andrea Marques, infectious disease specialist at Hospital e Maternidade Brasil, from Rede D’Or, has the same perception and adds that at this time of the epidemic, cases are also more serious.

“This is because dengue has the profile of being more serious and with more intense symptoms when the person has already had a first episode of the disease. So, before this infection, the patient’s immune system already has a memory of how to fight the virus . And when we become infected again with dengue, the immunological response is much more intense. That’s why the patient has more symptoms and a greater risk of having undesirable outcomes”, explains the doctor.

She reinforces the importance of seeking medical care as early as possible. “When you have a fever that does not subside, it is important to seek medical evaluation to classify the risk and begin appropriate treatment, which, in dengue fever, is vigorous hydration — at home or intravenously and under medical supervision when there are warning signs”, says Marques.

“We are observing a higher prevalence of serotype 2. There are studies that show that serotypes 2 and 3 may be associated with different symptoms, possibly more prolonged, with greater severity associated with the disease”, explains Julio Croda.

The infectious disease specialist also warns of fever. Despite being the most common symptom, the elderly do not experience fever spikes with the same frequency and intensity as young adults and children.

The elderly may have a temperature below 37.8º C or not even have a fever. “The other symptoms of dengue are more preponderant in this population. Headache, intense muscle pain throughout the body, malaise and lack of energy. With these symptoms it is important to have a medical evaluation, mainly because the elderly are risk groups that may have greater complications from dengue.”

“In children, the condition is not so typical of dengue, with fever, body pain, headache and malaise. They may have vomiting and diarrhea, which ends up confusing them with other infectious diseases. At this point, we We are not just seeing an increase in dengue cases. Covid and influenza are coming together and hindering the diagnosis”, concludes the infectious disease specialist.