Dengue and dengue hemorrhagic fever epidemics in Brazil: what research is needed based on trends, surveillance, and control experiences?

• Main Authors: Maria da Glória Teixeira, Maria da Conceição Nascimento Costa, Maurício Lima Barreto, Eduardo Mota
• Format: Article
• Language: English
• Published: Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz
• Series: Cadernos de Saúde Pública
• Subjects: Dengue; Febre Hemorrágica do Dengue; Incidência
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2005000500002&lng=en&tlng=en

Dengue epidemics account annually for several million cases and deaths worldwide. The high endemic level of dengue fever and its hemorrhagic form correlates to extensive domiciliary infestation by Aedes aegypti and multiple viral serotype human infection. This study analyzed serial case reports registered in Brazil since 1981, describing incidence evolutionary patterns and spatial distribution. Epidemic waves followed the introduction of every serotype (DEN 1 to 3), and reduction in susceptible individuals possibly accounted for decreasing case frequency. An incremental expansion of affected areas and increasing occurrence of dengue fever and its hemorrhagic form with high case fatality were noted in recent years. In contrast, efforts based solely on chemical vector control have been insufficient. Moreover, some evidence demonstrates that educational measures do not permanently modify population habits. Thus, as long as a vaccine is not available, further dengue control depends on potential results from basic interdisciplinary research and intervention evaluation studies, integrating environmental changes, community participation and education, epidemiological and virological surveillance, and strategic technological innovations aimed to stop transmission.