The disease is disappearing in much of South America, and scientists say that warming temperatures due to climate change have both expanded the range of the mosquito that carries dengue and allowed it to spread.
In the first two months of this year, Paraguay It is close 100,000 suspected cases – more than five times the normal rate. Peru, wracked by its own epidemic, has declared a state of emergency for much of the country. Argentina has also seen an explosion of cases.
But the disease is particularly prevalent in Brazil, where epidemiologists expect the number of dengue cases to reach the millions – more than double the previous record – and could kill thousands.
The worsening public health crisis serves as a warning to the world, epidemiologists say. The fight against the disease has entered a dangerous new phase. Dengue is entering a place it has never known before. And where it has been for a long time, the case numbers are growing to unprecedented heights.
The disease has historically been confined to warm climates. But in recent years, cases have increased dramatically in most parts of the world – Eightfold increase Since the turn of the millennium – the virus has been introduced into areas after it was largely cured.
Local transmission is now being reported in the warm and humid states of the United States, the vector of the disease, Egyptian temples Mosquito, already wandering. Florida reported a record 178 domestic transmissions last year. California, Arizona and Texas are also experiencing local outbreaks. A similar trend is also being observed in southern EuropeDozens of local transmission cases were registered last year.
Epidemiologists warn This is probably just the beginning. Climate change in the coming years. Egypt Mosquitoes, the disease is prevalent, and may even spread, in southern Europe and the southern United States.
“Dengue cases are increasing at an alarming rate,” said Gabriela Paz-Bailey, a dengue specialist at the Centers for Disease Control and Prevention. “It’s becoming a public health crisis and it’s coming to unprecedented places.”
The risk in rich northern climates is weakened by several factors, including the expansion of net windows, extensive air conditioning and strong hygiene practices, which can reduce the number of pools. Egyptian temples Can reproduce.
But epidemiologists, the concern should not be dismissed, especially this year. Brazil recorded more than 1 million cases of dengue fever in January and February alone. By the end of the year, the country is expected to suffer from 4.2 million – more than what was recorded in the entire United States last year Record epidemic Dengue.
“It hasn’t been widespread in the U.S., but that could change,” said Albert Ko, an epidemiologist at Yale University. The large epidemics in Brazil and the rest of South America should be of concern to us about its spread and spread in the US.
An alarming increase in dengue fever
Over the years, dengue cases have been increasing in Brazil. They jumped from a few hundred thousand a year to more than 1.4 million in 2013, then nearly 1.7 million last year. But this year, many forces came together to declare the outbreak unconditional.
An unusual heat wave collided with El Nino, which usually coincides with dengue outbreaks, leading to its widespread spread. Egyptian temples Mosquitoes and prolonging their life.
“It’s not just their numbers, it’s their longevity,” says Kleber Luz, who coordinates dengue research at the Brazilian Society of Epidemiology. “Even if it’s just a day or two, it will affect the number of dengue patients.”
Then came another catalyst: the simultaneous spread of all four types of dengue fever. In countries where dengue has been present for a long time, people have reduced their immune defenses. “I’ve been working with dengue since 1997, and I’ve never seen another year with all four spreading at the same time,” Luz said.
According to Felipe Naveca, an epidemiologist at the Osvaldo Cruz Foundation, a Brazilian scientific research institute, such moments are especially dangerous when there are many types of dengue circulating because people can contract the disease multiple times in a short period of time. Issues will likely remain high as each alternate peak increases in succession.
“The situation is not good,” he said.
Complicating Brazil’s fight against dengue is the death toll from chronic social ills. Egyptian temples The mosquito has long used: inequality, poverty, disorganized urban planning, and an increasingly weak public health system.
Millions of Brazilians live in densely populated, informal communities – either favelas or so-called “fringes” – often beyond the reach of government services and basic services. With unreliable plumbing, people often try to store water outside, creating countless breeding grounds for mosquitoes.
“If people don’t use the water for a week, the mosquito will breed in it,” said Raman Velayudhan, a dengue expert at the World Health Organization. “This is an urban disease.”
Many of these forces have been clashing with special forces in Brazil’s Federal District, the epicenter of the country’s dengue outbreak, late last month.
‘They didn’t have a bed for me.’
With unprecedented speed, the disease entered the poorest pockets of the district, forming a ring around the wealthy center of Brasilia. By the end of February, illness was everywhere — nearly 120,000 cases of dengue in a city of 2.8 million residents. The district’s hospital system, which had been coping with the coronavirus outbreak, began to get overwhelmed. He had run out of hospital beds.
“Public and private health systems in the federal district have now collapsed”. he said. District Governor Ibanez Rocha. “Times are tough, and we’re still not at the peak of the epidemic.”
When Lloyd Rocha dos Santos, 57, arrived at a crowded hospital last month, chaos was palpable, she said. Despite the severity of her condition – dengue fever had reduced her blood platelet count to dangerously low levels – the health clinic in the Gamma region could do nothing to treat her.
“The first two days I had to sit in a wheelchair,” she said. “They didn’t have a bed for me.”
She was one of the lucky ones. Patients were all around her, on the floor, receiving IVs, she said. Others screamed in anger at the lack of care, according to a video captured by her daughter. Someone screamed for pain medicine so he could go home and die.
“There was nowhere for all of us to go,” she said.
At the other end of the circuit, in impoverished Sealandia, another family was scouring the city for hospital beds. Mariana Torres Lima, 5, had dengue fever, vomiting and severe pain. But they said they returned when family members took her to Selandia Regional Hospital.
So the family traveled to a field hospital built to care for dengue patients. After seven hours of waiting, Mariana accepted. She lay curled up under a dry woolen blanket on a military bed.
Outside, her aunt Bruna Lira sighed angrily. “The government is not taking care of us,” she said. “There is garbage on the streets and there is no general cleanliness in the schools. One thing leads to another. “
She sat back down. Around her, at the field hospital, more people were arriving. By noon there were dozens. Many have failed. Others were vomiting.
“This year is different,” said Antonia Natané López de Lima, 32, with her sick son. “This year is worse than ever.”