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      Dengue situation in Brazil by year 2000


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          Dengue virus types 1 and 2 have been isolated in Brazil by the Department of Virology, Instituto Oswaldo Cruz, in 1986 and 1990 respectively, after many decades of absence. A successful continental Aedes aegypti control program in the Americas, has been able to eradicate the vector in most countries in the 60's, but the program could not be sustained along the years. Dengue viruses were reintroduced in the American region and the infection became endemic in Brazil, like in most Central and SouthAmerican countries and in the Caribbean region, due to the weaning of the vector control programs in these countries. High demographic densities and poor housing conditions in large urban communities, made the ideal conditions for vector spreading. All four dengue types are circulating in the continent and there is a high risk of the introduction in the country of the other two dengue types in Brazil, with the development of large epidemics. After the Cuban episode in 1981, when by the first time a large epidemic of dengue hemorrhagic fever and dengue shock syndrome have been described in the Americas, both clinical presentations are observed, specially in the countries like Brazil, with circulation of more than one dengue virus type. A tetravalent potent vaccine seems to be the only possible way to control the disease in the future, besides rapid clinical and laboratory diagnosis, in order to offer supportive treatment to the more severe clinical infections.

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          Isolation of dengue virus type 2 in Rio de Janeiro

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            Epidemic dengue 1 in Brazil, 1986: evaluation of a clinically based dengue surveillance system.

            In the last 15 years, dengue fever has emerged as a major health problem in tropical America. Prevention and control of epidemic disease are enhanced by the rapid identification of new or increased dengue activity. Most surveillance systems, however, identify cases by clinical case reports and, therefore, lack the sensitivity needed for early detection. During the 1986 dengue 1 epidemic in Rio de Janeiro, Brazil, the authors evaluated the usefulness of a clinical case definition by comparing it with laboratory-confirmed infection status of residents in two cities. The case definition had a sensitivity of 64% and a false-positive rate of 57%. Thus, for every 100 laboratory-confirmed dengue infections, 230 cases were reported. Both infected and noninfected residents who used medical services and who lived in the city with the highest transmission were more likely to meet the case definition. Thus, factors unrelated to actual infection influenced the sensitivity. With the use of stepwise logistic regression, the authors analyzed combinations of patient symptoms and produced nine new hypothetical case definitions. However, none of the new definitions had a false-positive rate lower than 38%. This study emphasizes the need for laboratory-based dengue surveillance systems.
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              Dengue and dengue hemorrhagic fever


                Author and article information

                Memórias do Instituto Oswaldo Cruz
                Mem. Inst. Oswaldo Cruz
                Instituto Oswaldo Cruz, Ministério da Saúde (Rio de Janeiro, RJ, Brazil )
                : 95
                : suppl 1
                : 179-181
                [01] Rio de Janeiro RJ orgnameInstituto Oswaldo Cruz orgdiv1Departamento de Virologia Brasil
                S0074-02762000000700030 S0074-0276(00)09500030

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                : 07 August 2000
                : 04 September 2000
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 3

                SciELO Brazil

                Round tables

                dengue-1,dengue in Brazil,Flaviviridae,dengue-2
                dengue-1, dengue in Brazil, Flaviviridae, dengue-2


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