Epidemiological, prevention and control updates of yellow fever outbreak in Brazil
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摘要
Yellow fever is an acute viral disease endemic to tropical countries, like Brazil, where, since the 1940 s, has no significant documented outbreaks similar to that observed between 2016/2018(2 045 confirmed cases and 677 deaths; caused by the sylvatic form).The principal manipulating factors inciting this change were absence of appropriate vaccination campaigns and increased urbanization & population growth in forest areas, with prevalence of the virus in the species inhabiting of these areas.The 2016/2018 outbreaks exhibited incidence in areas with historically low or no yellow fever virus activity, triggering a surge in recorded deaths-mainly in the Southeastern states of Brazil.The Brazilian government aggressively responded, reforming the countries' prophylactic measures, including vaccine implementation-as of March, 2018, switching from the former double dose regimen of the vaccine, to a single dose protocol, deemed as adequate.Moreover, some states appropriated the fractionated dosage(1/5 of the standard dose), in foresight of potential vaccine shortages.To prevent the uprising of new sylvatic yellow fever cases in Brazil, it's obligatory the development of effective combative plans, including adaptation of prophylactic measures individually(use of repellents, protective clothing etc.), applicable vaccination campaigns in every endemic region, to raise awareness to locals and visitors alike.Notwithstanding these preventative strategies, the persistence of cases and the recent outbreaks in Brazil, highlight the possible ineffectiveness of combative measures.Based on these considerations, the objective of this review was to raise more awareness of the epidemiological impact of the disease in Brazil.
Yellow fever is an acute viral disease endemic to tropical countries, like Brazil, where, since the 1940 s, has no significant documented outbreaks similar to that observed between 2016/2018(2 045 confirmed cases and 677 deaths; caused by the sylvatic form).The principal manipulating factors inciting this change were absence of appropriate vaccination campaigns and increased urbanization & population growth in forest areas, with prevalence of the virus in the species inhabiting of these areas.The 2016/2018 outbreaks exhibited incidence in areas with historically low or no yellow fever virus activity, triggering a surge in recorded deaths-mainly in the Southeastern states of Brazil.The Brazilian government aggressively responded, reforming the countries' prophylactic measures, including vaccine implementation-as of March, 2018, switching from the former double dose regimen of the vaccine, to a single dose protocol, deemed as adequate.Moreover, some states appropriated the fractionated dosage(1/5 of the standard dose), in foresight of potential vaccine shortages.To prevent the uprising of new sylvatic yellow fever cases in Brazil, it's obligatory the development of effective combative plans, including adaptation of prophylactic measures individually(use of repellents, protective clothing etc.), applicable vaccination campaigns in every endemic region, to raise awareness to locals and visitors alike.Notwithstanding these preventative strategies, the persistence of cases and the recent outbreaks in Brazil, highlight the possible ineffectiveness of combative measures.Based on these considerations, the objective of this review was to raise more awareness of the epidemiological impact of the disease in Brazil.
Yellow fever is an acute viral disease endemic to tropical countries, like Brazil, where, since the 1940 s, has no significant documented outbreaks similar to that observed between 2016/2018(2 045 confirmed cases and 677 deaths; caused by the sylvatic form).The principal manipulating factors inciting this change were absence of appropriate vaccination campaigns and increased urbanization & population growth in forest areas, with prevalence of the virus in the species inhabiting of these areas.The 2016/2018 outbreaks exhibited incidence in areas with historically low or no yellow fever virus activity, triggering a surge in recorded deaths-mainly in the Southeastern states of Brazil.The Brazilian government aggressively responded, reforming the countries' prophylactic measures, including vaccine implementation-as of March, 2018, switching from the former double dose regimen of the vaccine, to a single dose protocol, deemed as adequate.Moreover, some states appropriated the fractionated dosage(1/5 of the standard dose), in foresight of potential vaccine shortages.To prevent the uprising of new sylvatic yellow fever cases in Brazil, it's obligatory the development of effective combative plans, including adaptation of prophylactic measures individually(use of repellents, protective clothing etc.), applicable vaccination campaigns in every endemic region, to raise awareness to locals and visitors alike.Notwithstanding these preventative strategies, the persistence of cases and the recent outbreaks in Brazil, highlight the possible ineffectiveness of combative measures.Based on these considerations, the objective of this review was to raise more awareness of the epidemiological impact of the disease in Brazil.
引文
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[2]Higuera A,Ramírez JD.Molecular epidemiology of dengue,yellow fever,zika and chikungunya arboviruses:An update.Acta Tropic 2018;190:99-111.
[3]Monath TP.Yellow fever:An update.Lancet Infect Dis 2001;1(1):11-20.
[4]Bonaldo MC,Gómez MM,Santos AAC,Abreu FVS,Brito AF,Miranda RM,et al.Genome analyses of yellow fever vírus of the ongoing outbreak in Brazil reveals polymorphisms.Mem Inst Oswaldo Cruz 2017;112(6):447-451.
[5]World Health Organization.Disease:Yellow fever.c2018.about 2 screens.[Online]Available from:http://www.who.int/csr/disease/yellowfev/en/[Accessed on Dec.1 2018].
[6]Kotar SL,Gessler JE.Yellow fever:A worldwide history.1st ed.Jefferson,North Carolina:McFarland&Company;2017,p.5-11.
[7]Centers for Disease Control and Prevent Infectious Disease Related to Travel.Yellow fever.Chapter 3.about 10 screens.[Online]Available from:https://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseasesrelated-to-travel/yellow-fever[Accessed on Dec.1 2018].
[8]Pan American Health Organization/World Health Organization.Brazil announces end of yellow fever outbreak.c2017.about 5 screens.[Online]Available from:http://www.paho.org/bra/index.php?option=com_co ntent&view=article&id=5486:brasil-anuncia-fim-do-surto-de-febreamarela&Itemid=812[Accessed on Dec.4 2017].
[9]World Health Organization.Yellow fever Brazil.Disease outbreak news.c2017.about 2 screens.[Online]Available from:http://www.who.int/csr/don/24-november-2017-yellow-fever-brazil/en/[Accessed on Dec.12018].
[10]Vasconcelos PFC.Febre amarela.Rev Soc Bra Med Trop 2003;36(2):275-293.
[11]Mir D,Delatorre E,Bonaldo M,Louren?o-de-Oliveira R,Vicente AC,Bello G.Phylodynamics of yellow fever virus in the Americas:New insights into the origin of the 2017 Brazilian outbreak.Sci Rep 2017;7(1):7385.
[12]Douam F,Ploss A.Yellow fever virus:Knowledge gaps impeding the fight against an old foe.Trends Microbiol 2018;26(11):913-928.
[13]Klitting R,Fischer C,Drexler JF,Gould EA,Roiz D,Paupy C,et al.What does the future hold for yellow fever virus?(II).Genes 2018;9(9):425.
[14]Souza-Neto JA,Powell JR,Bonizzoni M.Aedes aegypti vector competence studies:A review.Infect Genet Evol 2019;67:191-209.
[15]Chippaux J,Chippaux A.Yellow fever in Africa and the Americas:Ahistorical and epidemiological perspective.J Venom Anim and Toxins Incl Trop Dis 2018;24:20.
[16]Schmid MA,Kauffman E,Payne A,Harris E,Kramer LD.Preparation of mosquito salivary gland extract and intradermal inoculation of mice.Bio protoc 2017;7(14):e2407.
[17]Vasconcelos PFC,Bryant JE,Travassos da Rosa APA,Tesh RB,Rodrigues SG,Barrett ADT.Genetic divergence and dispersal of yellow fever virus in Brazil:periodic expansions of the enzootic zone.Emerg Infect Dis 2004;10(9):1578-1584.
[18]Siqueira-Batista R,Gomes AP,Geller M,Ant?nio VE,Nunes ER,Felippe K.Febre Amarela.Rev Bras Med 2008;64(4):497-503.
[19]Monath TP.Yellow fever.In:Plotkin SA,Orenstein WA.(eds).Vaccines.4th ed.Philadelphia:WB Saunders Company;2004,p.1095-1176.
[20]Monath TP,Barrett AD.Pathogenesis and pathophysiology of yellow fever.Adv Virus Res 2003;60:343-395.
[21]Cupertino MC,Bay?o T,Gomes AP,Mayers N,Siqueira-Batista R.Ecoepidemiological aspects of mosquitoes of the genus Haemagogus and Sabethes involved in sylvatic yellow fever transmission in Brazil.Trends Entomol 2018;14:1-9.
[22]Bayao T,Cupertino MC,Gomes AP,Siqueira-Batista R.Yellow fever vaccination and neurological complications.Rev Soc Bras Med Trop 2018;51(5):723-724.
[23]Vasconcelos PF,Costa ZG,Travassos da Rosa ES,Luna E,Rodrigues SG,Dias JP,et al.Epidemic of jungle yellow fever in Brazil,2000:Implications of climatic alterations in disease spread.J Med Virol 2001;65(3):598-604.
[24]Lee H,Halverson S,Ezinwa N.Mosquito-borne diseases.Prim Care2018;45(3):393-407.
[25]Barrett ADT,Higgs S.Yellow fever:A disease that has yet to be conquered.Annu Rev Entomol 2007;52:209-229.
[26]Mengesha Tsegaye M,Beyene B,Ayele W,Abebe A,Tareke I,Tayachew A,et al.Sero-prevalence of yellow fever and related flavi viruses in ethiopia:A public health perspective.BMC Public Health 2018;18(1):1011.
[27]Costa ZGA,Romano APC,Elkhoury ANM,Flannery B.Evolu??o histórica da vigilancia epidemiológica e do controle da febre amarela no Brasil.Rev Pan-Amaz Saude 2011;2(1):11-26.
[28]Faria NR,Kraemer MUG,Hill SC,De Jesus JG,Aguiar RS,Iani FMC,et al.Genomic and epidemiological monitoring of yellow fever virus transmission potential.Science 2018;361(6405):894-899.
[29]Strier KB,Tabacow FP,de Possamai CB,Ferreira AIG,Nery MS,de Melo FR,et al.Status of the northern muriqui(Brachyteles hypoxanthus)in the time of yellow fever.Primates 2019;60(1):21-28.
[30]Consoli RAGB,Loren?o-de-Oliveira R.Principais mosquitos de importancia sanitária no Brasil.1st ed.Rio de Janeiro:Fiocruz;1994,p.104-152.
[31]Brazilian Government.Monkeys are not transmitters of yellow fever.c2017.about 2 screens.[Online]Available from:http://www.brasil.gov.br/saude/2017/03/macacos-nao-sao-transmissores-de-febreamarela[Accessed on Dec.12 2018].
[32]Pan American Health Organization/World Health Organization.Yellow fever:Epidemiological alerts and updates.c2003-2018.about2 screens.[Online]Available from:https://www.paho.org/hq/index.php?option=com_topics&view=readall&cid=2194&Itemid=40784&lang=en[Accessed on Dec.07 2018]
[33]Pan American Health Organization/World Health Organization.Yellow fever:Number of confirmed cases and deaths by country in the Americas,1960-2015.c1960-2015.about 2 screens.[Online]Available from:http://ais.paho.org/phip/viz/ed_yellowfever.asp[Accessed on May 07 2018].
[34]Health Ministry of Brazil.Brasília,DF;c1980-2018.[Online]Epidemiological Situation/Data[about 4 screens].Available from:http://portalsaude.saude.gov.br/index.php/situacao-epidemiologica-dadosfebreamarela[Accessed on Sep.23 2018].
[35]World Health Organization.Disease outbreak news.c2017.about 2screens.[Online]Available from:https://www.who.int/csr/don/13-january-2017-yellow-fever-brazil/en/[Accessed on May 10 2018].
[36]Couto-Lima D,Madec Y,Bersot MI,Campos SS,Motta MA,Barreto dos Santos F,et al.Potential risk of re-emergence of urban transmission of yellow fever virus in Brazil facilitated by competent Aedes populations.Sci Rep 2017;7(1):4848.
[37]Strategic Management Support Room of Health Ministry of Brazil.c2001-2016.Health situation.about 2 screens.[Online]Available from:http://sage.saude.gov.br/[Accessed on Dec.12 2017].
[38]Franco O.A história da febre amarela no Brasil.1st ed.Rio de Janeiro:Ministério da Saúde.Departamento Nacional de Endemias Rurais;1969,p.78-85.
[39]Pan American Health Organization/World Health Organization.c2018.Epidemiological update yellow fever.about 7 screens.[Online]Available from:https://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=44111&lang=en[Accessed on May 10 2018].
[40]Pan American Health Organization/World Health Organization.Washington,D.C.Media Center.about 2 screens.c2017.[Online]Available from https://www.paho.org/hq/index.php?option=com_content&view=ar ticle&id=13098&Itemid=1926&lang=fr[Accessed on May 10 2018].
[41]Health Ministry of Brazil.Brasília,DF;Last News.c2018.about 2screens.[Online]Available from:http://portalms.saude.gov.br/noticias/agencia-saude/42655-febre-amarela-ministerio-da-saude-atualiza-casosno-pais[Accessed on Dec.07 2018].
[42]Health Ministry of Brazil.Yellow fever vaccine for all Brazilians.Brasília,DF;c2018.about 15 screens[Online].Available from:http://portalarquivos2.saude.gov.br/images/pdf/2018/marco/20/AmpliacaoFebre-Amarela.pdf and http://portalarquivos2.saude.gov.br/images/pdf/2018/novembro/12/informe-FA-n.1_8nov_final2.pdf[Accessed on Jan 03 2019].
[43]Barrett ADT.The reemergence of yellow fever.Science 2018;361(6405):847-848.
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