Measles, polio, diphtheria and rubella threaten after eradication in Brazil | Welfare

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Between 1 January and 23 May this year, 995 cases of measles were recorded in the country (611 in Amazonas and 384 in Roraima), including two deaths, according to the WHO.

The third was confirmed on Thursday: a seven-month-old baby died in Manaus on June 28 after having had fever, skin patches, coughing and a runny nose. The local health department is now investigating whether the death of a nine-month-old baby was also due to measles.

Seven-month-old boy dies of measles in Manaus

Also in June, the seven-month-old boy dies of measles in Manaus. The Ministry of Health has also reported a high risk of polio return in at least 312 Brazilian cities, considered eradicated on the continent since 1994, after decades causing thousands of cases of childhood paralysis

. were controlled by mbad vaccination, but threatened to ravage Brazilian public health if the vaccination suffered losses.

"The return of poliomyelitis, which we have not had for more than 20 years, could mean a serious situation for Brazil." Carla Domingues, coordinator of the National Immunization Program of the Ministry of Health, said told BBC News Brazil

  • that the eradication of polio and measles has created fake According to the Ministry of Health

The problem of polio is due to the fact that, although '## 148 ## there has been no recent case in Brazil, a registry of the disease has been identified in neighboring Venezuela and circulation in 23 countries in the last three years.

In April, WHO also reported epidemics in Venezuela and Haiti of diphtheria, causing breathing difficulties.In Venezuela, 142 people have died of the disease since 2016. In Brazil, six suspected cases of the disease reported this year are pending confirmation. " Among the diseases already controlled in the country, I am particularly concerned about poliomyelitis, conbad rubella and, as we can see, measles, which can spread to other parts of Brazil ", explains the director of the Division of Clinical Trials and Pharmacovigilance. of the Butantan Institute, Alexander Precious Roberto. "It is necessary to increase the vaccination coverage of the population against these diseases."

https://g1.globo.com/bemestar/noticia/erradicacao-de-polio-and-samplitude-created-falsa-sensacao-de-que-vacinacao-enoo-e-more-necessary-secretary-da -saude.ghtml (Photo: Semcom / Manaus) https://g1.globo.com/ (Photo: Semcom / Manaus) - The Ministry of Health and the Ministry of Health,

https: / /g1.globo.com/bemestar/noticia/erradicacao-de-polio-e-samppo (Photo: Semcom / Manaus)

Here is an overview of these diseases, from the point of view of vaccination. who may be behind their return and what precautions are needed to control them:

Since April 2018, WHO has issued an alert on the return of measles in ten countries of the Americas: Brazil, Argentina, Ecuador, Canada , The United States, Guatemala, Mexico, Peru, Antigua and Barbuda, Colombia and Venezuela.

And this is not just in the Americas – in 2017, Europe recorded more than 21,000 cases of measles, with 35 deaths, an increase of almost 400% over the previous year. Previous year.

"Cases of measles have been reported again in the Americas, mainly in Venezuela, which has stopped vaccinating its population for political and economic reasons," says the researcher of the Bacteriology Department of the Butanean Institute Paulo Lee Ho.

In 2017, with the onset of the disease in neighboring countries, the Ministry of Health warned the population of the importance of taking the triple virus, a vaccine that protects against measles, mumps and rubella.

Triple Viral is one of 14 vaccines offered for free by the National Immunization Program. It should be taken in childhood and in two doses, the first with 12 months and the second with 15 months. In the second dose, the vaccine is boosted against a fourth disease, chickenpox, a highly contagious viral infection that causes chickenpox.

According to data from Datasus badyzed by BBC News Brazil, vaccination coverage at booster doses is well below target for all vaccines in the national immunization schedule.

In the case of the triple virus, the second dose of the vaccine does not reach the goal of vaccination, 95%, since 2012. In 2016, only 76.74% of children with 15 months of life have been vaccinated.

Of the three viruses in this vaccine, measles is considered the most dangerous. "Because it's very contagious, it has to be at least 95% of people have been vaccinated in Brazil so that measles will not spread, otherwise it's enough to have one person unvaccinated." in a city so that the virus is transmitted by an infected person. (reach him), says Carla Domingues, of the Ministry of Health.

"Few medical interventions were as effective as vaccines, able to eradicate diseases that had already killed them many. "People," says researcher (Photo: Venilton Kücheler)

This explains why the disease was the only one of the three viruses that have returned to the country so far. "But it can happen that these other diseases are prevented in the triple return virus if the population does not vaccinate," said Precious.

If you have not been vaccinated at the appropriate age, anyone under 49 years of age may take the triple virus in one dose. However, for Precious, not taking the triple virus in childhood is detrimental to the entire Brazilian population, as it would expose these children and future young people to infections that were previously controlled in the country.

According to Domingues, there is no explanation for the decrease in the triple virus vaccination coverage in recent years in Brazil, since there has been no to reduce the supply or scarcity of the vaccine in the country.

For the coordinator, the explanation could be in a possible forgetfulness of the people on some diseases, previously common in the country, but now controlled and less visible.

"The adult population of today must remember that measles and polio kill, and if they do not kill, they will leave severe sequelae for the rest of their lives, such as infantile paralysis. , deafness, blindness, neurological problems, etc.

"It is urgent to vaccinate those who have not been vaccinated, because it is immunization that interrupts a cycle of transmission through a middle, in addition to protecting the individual from infection, "says Lee Ho.

A health worker vaccinates a child against polio in Lahore, Pakistan.A Pakistani official said the authorities had launched a new polio vaccination campaign aimed at reaching 38.7 million children under the age of 5 (Photo: KM Chaudary / AP) against polio in Lahore, Pakistan, a Pakistani official said. the authorities had launched a new campaign Poliomyelitis vaccination aimed at reaching 38.7 million children under five years old (Photo: KM Chaudary / AP) A vaccine against a child's health worker against polio in Lahore, Pakistan. A Pakistani official said the authorities had launched a new polio vaccination campaign aimed at reaching 38.7 million children under the age of 5 (Photo: KM Chaudary / AP) against polio in Lahore, Pakistan. Pakistan. A Pakistani official said the authorities have launched a new polio vaccination campaign aimed at reaching 38.7 million children under the age of five (Photo: KM Chaudary / AP) "data-src =" https : //. A Pakistani official said the authorities had launched a new polio vaccination campaign aimed at reaching 38.7 million people in Pakistan. </source></source></source></source></source></picture> </div> </p></div> <div clbad=

A health worker vaccinates a child against polio in Lahore, children under 5 years (Photo: KM Chaudary / AP)

In addition to the return of measles, Domingues says that the concern of the Ministry of Health in 2018 is the return of polio to Brazil.Before the cases recorded this year, the disease has not occurred in the country since every 1990.

All municipalities are considered as places of risk, with the exception only of those located in Rondonia, Espirito Santo and the Federal District. Of the more than 300 cities in which case confirmation is studied, 44 are in the state of São Paulo.

  • All vaccines of the adult calendar are falling short of the ideal coverage goal

In the alert issued June 28, the Ministry of Health explained that municipalities that do not have a health insurance coverage are not available. have not reached 50% of vaccination coverage in recent years are on the most-at-risk list for polio. The cities of Bahia and Maranhão are the ones that have the least vaccinated their residents in recent years, having vaccinated only 15% of the population.

According to Datasus, vaccines against polio have not reached the goal of vaccination in Brazil since 2011. In 2016, municipalities have a lower vaccination rate: only 43.1% of cities have reached the target.

In addition, among vaccines that children two months and four months should take, polio is the only one that can not exceed 85% of vaccinated, whether in first or second dose.

Two polio vaccines: VOP, Oral Vaccinal Poliomelitis, administered orally at 2, 4 and 6 months of age, with boosters between 15 and 18 months and between 4 and 5 years; and VIP, Inactivated Polio Vaccine, which injected one dose at 15 months and another at the age of 4 years. Both vaccines are offered in basic health units.

In August, the Ministry of Health will conduct a national polio immunization campaign.

Danger of "imported virus"

The return of the measles virus to Brazilian territory has been linked to Venezuelan immigration to the northern region, which began in 2014, which explains why it is so important. incidence of the virus in Amazonas and Roraima, which border the country in a serious socio-political crisis.

Viruses brought by migratory flows from a population that has not eradicated it to a site that had eradicated it are called "imported viruses".

"Infected people in neighboring countries experiencing infectious epidemics migrate to Brazil," Domingues explains.

"In the case of measles, the epidemic is global.It has cases of measles in underdeveloped and developed countries, as in Europe and the United States.With a greater circulation of people traveling, whether through tourism or trade, we are experiencing the possibility of spreading previously controlled viruses throughout the Brazilian territory. "

According to immunization experts, the" imported virus "has not been released. Only when it meets a non-immune individual.

Thus, the return of measles to Brazil has occurred also because some of the Brazilian population itself has stopped taking vaccines from the national calendar in recent years.

"All diseases considered eradicated in Brazil, but not eradicated in the world, may return if the population does not remain vaccinated," says Paulo Lee Ho.

Another factor that helps explain the return of diseases that Brazil already managed to eradicate is "herd effect".

The second dose of poliomyelitis vaccine, VIP, inactivated polio vaccine, which injected one dose at 15 months and another at the age of 4 years (Photo: Cesar Brustonlin / SMCS) against poliomyelitis, VIP, Inactivated vaccine against poliomyelitis, which injected one dose at 15 months and another at 4 years (Photo: Cesar Brustonlin / SMCS) The second dose of polio vaccine, VIP, inactivated poliomyelitis vaccine, which injected one dose at 15 months and another at 4 years of age (Photo: Cesar Brustonlin / SMCS) "title =" The second dose of polio vaccine, VIP, inactivated poliomyelitis vaccine, which injected one dose at 15 months and another at 4 years (Photo: Cesar Brustonlin / SMCS) "data-src =" https://s2.glbimg.com/UtXUpoHnVQy9YibbcnOMfewBLEo=/0x0:624x351/984x0/smart/ filters: strip_icc () / i The second dose of the polio vaccine , VIP, inactivated poliomyelitis vaccine [1] [1] [2] [3] (Cesar Brustonlin / SMCS ) </span> </p> </p></div> </p></div> </p></div> <div clbad=

"The protection offered by vaccines occurs in two ways: it can be direct, by immunizing the individual, or by culturing through the environment vaccinated, through the vaccination of a population, "says Lee Ho.

The" flock effect "occurs when the immunization rate of a population is so high that, even if an individual is not vaccinated, he will be protected by living in the environment where most are vaccinated. It is the effect of the flock that will prevent the occurrence of outbreaks, epidemics and pandemics, since it is the majority of a vaccinated population that will prevent the circulation of infectious agents in this place, not the isolated vaccine itself.

In the same way, the more people stop getting vaccinated in the same area, the less the force will have the effect of flock – and the previously controlled diseases there can recur.

Smallpox is the only disease considered totally eradicated in the world. Currently, the virus that transmits the disease no longer circulates among the world's populations, and the only samples that still exist are stored in a few licensed laboratories, for studies and research.

"Because we have more contact with certain infectious diseases, the perception is that they no longer exist and that vaccination is useless," says Lee Ho.

" But few interventions in medicine were as effective as vaccines, able to eradicate the diseases that once killed a lot of people. "

According to the researcher, the protection offered by vaccination is less visible, which prevents people in vaccines, just as they depend on drugs.

"It is important that the parents of these younger generations who benefited from the creation of the National Vaccination Program in the 1970s – a program by which we had managed to control a number of serious diseases at the same time. time – have the same responsibility as the parents they had and vaccinated their children. "

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