Rocky Mountain spotted fever: who should answer for the 3 deaths in SP? – 06/15/2023 – Balance and Health

After confirming three deaths from Rocky Mountain spotted fever and three other cases being under investigation, the city hall of Campinas, in the interior of São Paulo, said it had taken a series of measures to prevent new cases.

The intention is that forest regions and places where there is a greater chance of disease proliferation are signaled and avoided.

The Adolfo Lutz Institute, in the capital, points out that Fazenda Santa Margarida, in the Campinas district of Joaquim Egídio, is identified as the likely place where the six people were infected, during an event called Feijoada do Rosa, on May 27. The space was preventively interdicted by the city hall.

Fazenda Santa Margarida will only be able to hold new events after presenting a communication and environmental contingency plan to guide visitors about the risks that the region presents.

But there is one responsible for these infections transmitted by the star tick (Amblyomma cajennense), in a situation already considered an outbreak in the region?

The city of Campinas said, in a note sent to BBC News Brasil, that, “since this is a place with no known cases of spotted fever so far”, there were no specific health requirements in relation to this disease.

However, Campinas and the municipalities that make up its metropolitan region are endemic for the disease. Going forward, the county said it will require a communication plan so that those attending similar events are aware of the risks.

In this way, there is no expectation that the farm, its owners and the organizers of the event in which people may have been infected will be held responsible for the contamination.

In a note, the organizers of Feijoada do Rosa lamented the deaths and sympathized with the families of the victims of spotted fever.

The organization stated that this edition was attended by 3,500 people and said that, “so far, it cannot be ruled out that contamination may have occurred during this frequency at Santa Margarida Farm, even because the local health surveillance has made it public to reinforce that the city of Campinas gains special expression as a focus of that disease”.

“It is important to make everyone aware that Feijoada do Rosa is a traditional festival in the city of Campinas, having held its 22nd edition this year, and in the last 10 years it has hosted Santa Margarida Farm, in the District of Joaquim Egídio , known and consecrated space of great celebrations for decades.”

The administration of Fazenda Santa Margarida also regretted the deaths and stated that “it has always acted and acts in accordance with all legal rules and requirements related to health surveillance”.

The farm said it “is working on an action plan” that will be presented to the city hall by the end of the week.

Awareness

The Health Surveillance Department of the Municipal Health Secretariat of Campinas determined, among the strategies of the action plan, that the farm should “build paths for people to travel through the place”.

The intention is for visitors to avoid passing through areas of forest and grass, where the presence of the star tick, capable of transmitting Rocky Mountain spotted fever, is more likely.

The place is known in the Campinas region for hosting shows by nationally and internationally known artists, such as Seu Jorge, Ivete Sangalo and Gusttavo Lima, who have a show scheduled at the farm for the 21st of July.

The farm was also notified of the need to install signs to inform visitors about the risk of Rocky Mountain spotted fever infection.

According to the city hall, “the place has a permit for events and inspection report from the regular Fire Department (AVCB) and was authorized to hold the event”.

The Secretary of State for Health of São Paulo warned that all people who were at Fazenda Santa Margarida from May 27th to June 11th and feel fever, headaches or body aches, or reddish spots on the skin, should seek medical attention. immediately and report that they have been there.

The government highlighted that it is important to be aware of these signs, as the incubation period for Rocky Mountain spotted fever ranges from two to 14 days.

endemic region

Of the 12 confirmed cases of the disease in 2023, three were people who attended events held on the farm.

Early treatment prevents the disease from worsening, according to health authorities. Rocky Mountain spotted fever is treated with antibiotics, such as doxycycline, which works by fighting bacteria in the body.

Rocky Mountain spotted fever, also known as tick disease, is a febrile infection of varying severity, with a high lethality rate. It is caused by a bacterium of the genus Rickettsia and transmitted by tick bites.

Environmental infestation by nymphs (juvenile stage) of star ticks is high between June and November, according to health authorities. And the cities with the highest frequency of cases are Campinas, Piracicaba, Assis and Sorocaba – all in the interior of São Paulo.

The board of directors of the Center for Epidemiological Surveillance of the State of São Paulo stated that people should be aware of the risks they run when visiting certain regions during the star tick reproduction period.

“When venturing into forest and waterfall regions, it is important to be aware that we are in the star tick’s reproduction period, with the risk of transmission of Rocky Mountain spotted fever through its bite.”

Among the ways to avoid the disease are checking frequently if there are any ticks attached to the body, wearing light clothes with long sleeves, long pants and closed shoes.

The most recent survey by the Ministry of Health shows that, from 2007 to 2021, 36,497 cases of Rocky Mountain spotted fever were reported in Brazil, of which 7% were confirmed, in an average of 170 per year in this period.

Of the 2,545 confirmed cases, 2,538 reported situations related to risk exposure and, of these, 68.5% had frequented forest environments.

Lago do Café, which is located in Campinas, was closed from 2008 to 2013 after three local employees died of Rocky Mountain spotted fever. Upon reopening to the public, signs were installed directing visitors to remain only in the paved areas.