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Nearly three months after the notification of the first cases of toxoplasmosis in Santa Maria (RS), the epidemic of the disease in the municipality of Rio Grande do Sul continues to worry doctors and health authorities . From March to now, 569 people have been diagnosed and 312 cases are under investigation. According to the Federal Prosecution, figures are already the largest epidemic of toxoplasmosis in the world.
The highest alert is among pregnant women – at least 50 received a positive result and 145 have symptoms and are also studied. In addition, five spontaneous miscarriages caused by the infection were counted. Toxoplasmosis is transmitted to the fetus by the mother and, if it does not cause the death of the baby, causes permanent sequelae, such as blindness and neurological impairment.
Infectologists and the health department of the municipality ask for more financial help. At the University Hospital of Santa Maria, where the majority of patients, including pregnant women infected with toxoplasmosis, receive care, inadequate supplies, medicines and diagnostic tests that can confirm the disease in the laboratory – a fundamental step for the treatment
very talked about in the management. But is it possible to manage with so little budget? This has. You can do the management with little budget. But when is an unforeseen event? We need strengthening in this budget, "said Liliane Mello Duarte, Secretary of Health Santa Maria, at a public hearing today (28) at the Senate Committee on Human Rights. man and participatory legislation. "We came to ask for help. The department participated in the survey on the 26th [de abril] and is participating in a major way, but we need more. "
Lack of protocol
Another problem is that in the case of a public hearing on the outbreak of toxoplasmosis in Santa Maria, half of the hundreds of confirmed cases of infection in the city, health professionals do not rely on the so-called clinical protocol and therapeutic guidelines for the disease. The document would establish clear criteria for the diagnosis and treatment of toxoplasmosis, with appropriate doses of drugs and clinical surveillance mechanisms.
Infectologist Twenty years ago, Alexander Schwarzbold participated in the public hearing by video conference and was in the habit of seeing cases of toxoplasmosis. It ensures, however, that the outbreak in Santa Maria has important peculiarities and a great social impact, since the disease has a high mortality rate in young children and newborns.
"We are facing an undocumented environmental situation," says, referring to the possibility of the source of the epidemic being linked to water and contaminated food and offered in the municipality herself. "This serves as an opportunity model for the Ministry to establish a protocol for this disease, a broad protocol, prevention, diagnostic inputs and drug availability."
Alert to new pregnancies
with concern the epidemic in the municipality. Through videoconferencing, she highlighted the work of a joint effort of health professionals to meet the demand of pregnant women infected in Santa Maria. Treatment in such cases should be started as soon as possible and maintained until the end of pregnancy. Women with more than 18 weeks of pregnancy with a positive result for toxoplasmosis receive a badtail of 11 drugs to try to protect the fetus against more serious sequelae.
According to the infectious disease, the guidelines for the general population and for pregnant women, does not include drinking water in natura only boiled; do not consume raw food; and keep the meat properly chilled, then cook it thoroughly cooked before eating. During the public hearing, the doctor even suggested that new pregnancies be avoided until the situation in the municipality is normalized.
"As a technique of care, I reaffirm: in no case can we transmit to the population environment, water, food.Everyone must maintain the recommended care," he said, accusing what he said. it calls for a paradigm shift. "There is a 25% risk of fetal infection in the first trimester, when at least half of the cases will result in an abortion and the rest will have major sequelae."
Claims
At the end of the hearing, list of claims was submitted to the Department of Health: the adoption of a national protocol of therapeutic guidelines in case of a medical condition. epidemic of toxoplasmosis; the reinforcement of funds for the Hospital Universitario de Santa Maria; definition of guidelines for the monthly examination of the disease during antenatal care; and the detection of toxoplasmosis in the foot test, besides promoting a disease prevention policy nationwide.
During the debate, the health surveillance secretary of the Ministry of Health, Osnei Okumoto, guaranteed what he called the involvement of the pulp in the monitoring and control of the toxoplasmosis epidemic in Santa Maria. He said that he had discussions with the Secretariat of Science and Technology to obtain more funds and investments to fight the disease in the municipality of Rio Grande do Sul.
By note, the briefing indicates that the outbreak is likely to contaminate water contamination, with possible contamination of vegetables as a secondary cause. The notice was presented to the state and the municipality last Tuesday (26), after badyzing data from the case study conducted by a ministry team with local officials.
"It should be noted that other common possible causes in cases of toxoplasmosis have been eliminated during research, such as beef, chicken and cheese, among other foods." However, the investigation will continue to be carried out, "concluded the statement.
Edition: Juliana Andrade
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