Hear
Argentina has already exceeded half a million cases of dengue so far this year, weeks before the end of this season and the start of the next one. That mark of 504,580 cases – only those detected – that the country holds due to lack of adequate preparation places it second, after Brazilwhich has more than seven million infected, among the countries with the largest population that contracted dengue in the region throughout the ongoing epidemic.
“The cases accumulated up to [el 1° de junio] “They represent 3.26 times more than what was recorded in the same period of the previous season (2022-2023) and 7.93 times more than in the same period of 2019-2020,” reported the Ministry of Health Nation when updating provincial figures.
In the current dengue season, 96% of infections occurred since January. But if the epidemiological “year” for the disease is taken into account, which health authorities define as August to August, the country accumulates 521,746 cases reported from all provinces. 18% of the diagnoses (93,135) were in children under 15 years of age.
Unlike last year’s epidemic – the country had two consecutive ones for the first time – the viral circulation spread to 19 provinces: it reached, according to health surveillance, as far as La Pampa.
Jorge Geffnerfull professor and director of the Department of Microbiology, Parasitology and Immunology of the Faculty of Medical Sciences of the UBA, evaluated that this year’s epidemic outbreak “at least tripled” the cases reported from last year at this point. “If we take into account that around 70 to 75% of cases are asymptomatic, the number [oficial] You have to multiply it by three or four. That is, we are above 1.3 million cases this year,” he indicated in a conservative estimate.
That, as he continued when asked by THE NATION“it presents a scenario of concern for the next summer season because cases are growing not only in Argentina but throughout the southern cone, and impressively in Brazil. This is added to the fact that the second infection, although not in all cases, can be more serious than the first to the extent that it is due to a different serotype than the first one.
In the current epidemic, serotypes DEN2, DEN1 and, in smaller quantities, DEN3 circulated. “If that equation changes, something that is difficult to predict, there will be a greater chance of contracting a new infection with another serotype and we will be will complicate the scenario”Geffner added.
Going forward, he raised the need for a “strong dissemination campaign” by the national health authority that clearly conveys to the population that “dengue is here to stay” and that “we are most likely going to face a new important season.” ”, beyond the fact that in some regions the virus circulates all year round and, although it decreases, there are cases even in the coldest months.
“A very important national campaign should be carried out with the classic prevention measures: decluttering and what it means to do so, such as cleaning surfaces and containers well with a brush.” [donde se puede acumular agua]”, he proposed. The eggs of the mosquito vector that remain attached can remain viable for months until the new summer season.
He also mentioned the usefulness of pouring boiling water on grates and, in hot areas of the country, such as the center and the north, installing the importance of using mosquito nets or tulle to the extent of the population’s possibilities. “It will be very important for next season ensure availability of repellents and lower prices, either through importation or enabling production in the public laboratory network. With time, he added, it is very easy to make repellents and at a very low cost. For some families it is prohibitive to buy repellents.”
Finally, he mentioned the importance of starting to vaccinate early, in the areas and age groups recommended by the National Immunization Commission (Conain). “This information is not clear to start vaccination in August, as the Ministry of Health says,” indicated the researcher regarding what he considered “absences in the face of an infectious disease that is going to manifest itself in the same way or worse in the next summer season
The course of the epidemic judging only by official data was also atypical this year. In the reports that are updated every week, the figures from the different jurisdictions jumped by thousands from time to time above what was expected when reading the National Epidemiological Bulletin (BEN). They were, as detailed, cases that had not been uploaded to the national health surveillance system, as occurred with Formosa or Córdoba, among other districts.
And the epidemic that started in the northeastern provinces ended focus on the center of the country: 62% of the cases occurred in the province of Buenos Aires, the City, Entre Ríos, Córdoba and Santa Fe. Only 37% of cases have been confirmed by laboratory so far this season; The majority, faced with the increase in demand for symptoms in health centers, were diagnosed clinically.
The current season will also end with 365 deaths attributed to dengue, as reported by the health authorities of 18 provinces: the majority of these deaths (355) were from January onwards. There were 1,206 people who were diagnosed with severe dengue.
This month, the Ministry of Health issued a circular to epidemiology teams and professionals on how to properly record serious cases and deaths from dengue, indicating one of the great weaknesses of the statistics.
In the text, which is a guide that unifies criteria for the next season and is in line with the work plan for the coming months presented by Salud with the representative in Argentina of the Pan American Health Organization (PAHO), recommends that both serious and fatal cases “be analyzed by a local committee that can reconstruct the care circuit and identify opportunities for improvement,” with the participation of the epidemiology area of each provincial ministry. That is, as mentioned, “one of the main strategies to prevent new deaths” a month and a half before the 2024-2025 season starts.
“This epidemic clearly leaves us with the concern that there may be another“, he considered, when asked, Tomas Orduna, deputy director of the Medical Specialist in Infectious Diseases program at the Faculty of Medical Sciences of the UBA and former head of the Tropical Medicine and Travel Medicine Service at the Muñiz Hospital. Orduna participated in the preparation of the official circular as an external expert consultant.
“There are things that, as a country and community, we can change and improve,” he maintained. That basically has to do with destroying mosquito breeding sites. Aedes aegypti and, for that, there has to be a joint work for a mosquito that moves in the blocks, over a distance of 80 or 100 meters. So part of what happens will depend on the control we make of the Aedes.” For the moment, the implementation of other control tools, such as the use of mosquitoes infected with the wolbachia bacteria, in a territorial area like that of Argentina seems, “for now, distant.”
At the same time, he considered investment in health to be essential so that human resources, infrastructure and supplies “are ready to act in any epidemic; In this case it is dengue, but that is valid for chikugunya, zika or any other pathogen.”
Orduna insisted on the relevance of training health personnel, communication aimed at community health education (appropriate and timely consultation, warning or alarm signs in dengue for a second early and urgent consultation, among others) and, like Geffner , he mentioned include planned vaccination for the next seasonaccording to the immunizers that become available.
“No one should die from dengue,” he had stated to this medium, already during last year’s epidemic, Diana Cappannari. It had been 42 years since the Argentine pediatrician had led a campaign in Cuba to eliminate the mosquito vector.
