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The vaccine surge after the most recent yellow fever outbreak in Brazil almost two years ago was not enough to contain the risk of disease spread. According to recent figures from the Ministry of Health, from January 1 to November 8 this year, there were 1,311 cases and 450 deaths, almost double the same period last year, or 736 cases and 230 deaths
Now, with the proximity of the summer, the period of increased risk of transmission – the increase in temperature promotes the reproduction of mosquitoes that transmit and, therefore, the potential for circulation of the virus -, the government warns that residents of areas with signs of pathology (the full list is available on the MS website) request vaccination as soon as possible
This call originates from newly affected areas and a large contingent of population, such as the metropolitan areas of Rio de Janeiro, Minas Gerais and São Paulo still have a large number of unvaccinated people.
"People should take the vaccine now, before the period of highest incidence of yellow fever, so that when summer arrives they will be immune and will not need to run" says Carla Domingues, coordinator of the National Immunization Program (PNI).
Vaccine Research
Amazon region, the disease is spreading across Brazil. According to Akira Homma, senior scientific adviser at the Institute of Immunology Technology (Bio-Manguinhos / Fiocruz), this is due to certain factors, such as climate change, deforestation, the disorderly growth of the city , Ecological imbalance and
Between 1 December 2016 and 31 July 2017, the Ministry of Health was informed of 3,564 suspected cases, including 777 confirmations and 261 deaths. The southeastern region concentrates the majority (764), followed by the north (10) and the Midwest (3). From July 1, 2017 to June 30, 2018, there were 1,376 cases and 483 deaths, and from January 1 to November 8 of this year, 1,311 and 450 respectively.
For this reason, this year, 30 million doses of vaccine were sent throughout the country. After the last outbreak, vaccination has been extended to 4,469 municipalities, particularly around capital cities and metropolitan areas in the South-East and South, where there are signs of viral circulation.
But despite the availability, the ministry informs that the demand has been low on the part of the population. "The vaccine is still available, but unfortunately, people are only looking for it when cases and, in particular, deaths begin to be reported," Domingues said.
"The problem was due that residents of both areas were considered at risk and those who were not considered in a hurry to get vaccinated "
Today, however, only 50% of Brazilians are protected against the disease But the target indicated by the Ministry of Health to ensure vaccination and prevent the spread of the virus is a coverage of 95% of the target audience.
"Despite the large amount of information disseminated and the precipitation that is last year, the demand was well below expectations and we do not know exactly why, "explains Homma.
One of the reasons could be false news. In a note, Member States said that "no study can measure the magnitude of the impact of false information directly on vaccine coverage, but rumors of serious vaccine effects are circulating on the Internet and may affect the decision of It's time to get vaccinated. "
For this reason, in March this year, the ministry set up a false information monitoring system in the US. digital environment, where more than seven thousand mentions are evaluated every day on what can be a focus of deliberate misinformation. spread rumors about health.
Regarding antiviral movement, which could also have a negative impact on vaccination campaigns, the agency says it's not as expressive. in Brazil and abroad.
On the other hand, it also badesses the success of other actions carried out in the country, which have eliminated polio, measles, rubella and conbad rubella syndrome. in part of the population and even among some health professionals, the false sense that it is no longer necessary to get vaccinated.
To improve the numbers, according to Carla, the government will have a big challenge. Even in this case, she predicts that, for the moment, no yellow fever vaccination campaign will be conducted – last year this was necessary because of the epidemic. Offered to unified health system (UAS) positions throughout the year, the vaccine is indicated for people aged 9 months to 59 years residing in recommended areas or with the intention of traveling within these regions, stating that the request must be made. at least 10 days before the trip. In the case of pregnant women and the elderly, the rule is to seek medical advice.
Infants under 9 months of age can not be vaccinated; women who badfeed babies under 6 months; people suffering from severe allergy to eggs; patients with autoimmune diseases and HIV, with CD4 counts below 350, and patients receiving chemotherapy, radiotherapy and immunosuppressants.
Anyone who has already been vaccinated with the full dose does not need to repeat it, as Brazil adopts the single dose regimen recommended by the World Health Organization (WHO). This year, MS promises that there will be the standard vaccine for the entire population, but as long as priorities are met.
In 2017, São Paulo, Rio de Janeiro and Bahia used in many cases the split vaccine. The efficiency, according to Carla, is the same. The difference is due to the lower dosage and the protection time, which is eight years.
In addition to the vaccine, other precautions are indicated to prevent yellow fever. The first of these aims is not to frequent areas considered to pose a higher risk of exposure, such as forests, forests, rivers, waterfalls, parks and rural areas, especially for those who have contraindications to protect themselves.
Insect repellent and clothing covering as much skin as possible, spending more time in chilled environments, using mosquito nets and mosquito nets on windows.
At the same time, it is essential to fight against the proliferation of mosquitoes, to keep houses and streets clean. "
" Currently, it is essential to conduct epidemiological and entomological surveillance, to vaccinate the population of risk areas and to control the urban vectors of yellow fever and dengue fever. , chikungunya and zika, the goal is not to leave room for the spread of diseases, "says Akira Homma, Bio-Manguinhos / Fiocruz
. is yellow fever?
Fever Yellow is an acute febrile infectious pathology caused by a virus transmitted by the bite of an infected vector mosquito It is not contagious, that is, it is not transmitted from person to person no one and its case fatality rate is about 40%
There are two different epidemiological cycles of transmission: wild (rural or forest) and urban, and in both cases the virus is the same. is due to the type of mosquito.
In nature, non-human primates (monkeys) are the main hosts and amplifiers of the virus.Vectors are mosquitoes with strictly wild habits, the genera Haemagogus and Sabethes being the most well-known Latin America.
In this In this situation, the man participates as an accidental host when he enters forest areas to make ecotourism, to work or because he resides in the area.
In the urban cycle, the human being is the only host of epidemiological significance and transmission is through urban vectors – the mosquito infected with Aedes aegypti.
In both cases, the contamination
The current cycle of the disease is wild – the last case of yellow fever in urban areas was recorded in Brazil in 1942.
Symptoms and treatment
Symptoms The The onset of the disease begins to appear three to six days after the infection of the person. They include sudden fever, chills, severe headache, body aches, nausea, vomiting, fatigue, and weakness.
Most patients recover after the first signs. However, about 15% develop a more serious form of the disease.
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