{"id":116,"date":"2009-05-15T01:11:55","date_gmt":"2009-05-15T04:11:55","guid":{"rendered":"http:\/\/scienceblogs.com.br\/brazillion\/2009\/05\/how_governments_should_not_dea\/"},"modified":"2009-05-15T01:11:55","modified_gmt":"2009-05-15T04:11:55","slug":"how_governments_should_not_dea","status":"publish","type":"post","link":"https:\/\/www.blogs.unicamp.br\/brazillion\/2009\/05\/15\/how_governments_should_not_dea\/","title":{"rendered":"How governments should (not) deal with epidemics"},"content":{"rendered":"<p><span style=\"padding: 5px;float: left\"><a href=\"http:\/\/www.researchblogging.org\/\"><img decoding=\"async\" alt=\"ResearchBlogging.org\" src=\"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-content\/uploads\/sites\/208\/2011\/08\/rb2_large_gray5.png\" style=\"border: 0pt none\" \/><\/a><\/span>Brazilian government has been really concerned about swine flu. We have health agents in airports and ports to detect possible flu cases. But let&#8217;s see how it deals with <a href=\"http:\/\/en.wikipedia.org\/wiki\/Dengue\">Dengue<\/a>, another infectious disease with a well-known life cycle, efficient prevention strategies and distinguishable symptoms.<\/p>\n<p align=\"center\"><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-content\/uploads\/sites\/208\/2011\/08\/Aedes_aegypti.jpg\" alt=\"Aedes_aegypti.jpg\" height=\"317\" width=\"400\" \/>\n<\/p>\n<p><\/p>\n<p>Dengue is a serious issue in Americas, with <a href=\"http:\/\/www.paho.org\/english\/ad\/dpc\/cd\/dengue-cases-2008.htm\">more than 850,000<\/a> cases only in 2008. Until 2007, Brazil had detected the Dengue\u00b4s serotypes 1, 2 and 3. In April, 2008 researchers found at Manaus, the largest city in Brazilian Amazon forest, Dengue virus type 4 in three patients <b>with no history of traveling outside the city<\/b>. This was a matter of great concern because serotype 4 has a low prevalence but is involved with a bigger occurrence of dengue hemorrhagic fever. <b>[1]<\/b><\/p>\n<p>However, instead of taking action, Brazilian Health Ministry <a href=\"http:\/\/portal.saude.gov.br\/portal\/saude\/Gestor\/visualizar_texto.cfm?idtxt=28240\">made a public announcement denying<\/a> that serotype 4 occurs in Brazil and has accused the laboratory of contamination, despite the fact that this laboratory does not maintain any dengue 4 virus in culture. Later, <a href=\"http:\/\/www.cdc.gov\/eid\/content\/15\/4\/626.htm\">a EID publication about Amazon endemic diseases<\/a> that has a Health Ministry worker (R. Glatt) as one of the authors, claimed, <b>with no supporting reference<\/b>, that:<\/p>\n<blockquote>\n<p>&#8220;<i>In September 2008, data on the isolation of DEN-4 in the Amazon region<br \/>\nwere revised and now show that there is no evidence that this serotype<br \/>\ncirculates in the Amazon region of Brazil.<\/i>&#8220;<\/p>\n<\/blockquote>\n<p>In April this year, some of my lab colleagues reanalyzed the dengue virus sequences with a more phylogenetic approach as the authors of the previous publication had typed the virus using BLAST, which is not the best tool to find the closest relatives of the virus.<b>[2]<\/b><\/p>\n<p>Not surprisingly, not only the results were confirmed but things got a little more interesting: they found that Dengue 4 of the genotype II (there are 3 genotypes: I, II and III) have been in America for at least 20 years as it was found in Brazil in 1982. <b>However, the closest relative to the serotypes isolated in Manaus is the genotype I, that circulates only in Asia<\/b>.<\/p>\n<p><\/p>\n<p align=\"center\"><img decoding=\"async\" src=\"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-content\/uploads\/sites\/208\/2011\/08\/dengue.png\" alt=\"dengue.png\" height=\"511\" width=\"400\" \/><\/p>\n<p align=\"center\">Dengue 4 phylogenetic tree with Manaus sequences in pink. Source: <b>[2]<\/b>\n<\/p>\n<p><\/p>\n<p>In conclusion, not only do we have Dengue 4 circulating in Brazil, in low frequencies (yet), but it also came from Asia! This could become a great problem to the country if the right measures are not taken.<\/p>\n<p>In the year that Brazil government denied dengue 4, <a href=\"http:\/\/www.paho.org\/english\/ad\/dpc\/cd\/dengue-cases-2008.htm\">more than 700,000 people were infected<\/a> by dengue. <a href=\"http:\/\/new.paho.org\/hq\/index.php?option=com_content&amp;task=view&amp;id=1243&amp;Itemid=1167\">Up to March 2009<\/a>, there have been 126,139 suspect cases, including several epidemics in a few cities in Bahia State like Jequi\u00e9, where at least 5% of the population having contracted the virus.<\/p>\n<p>In conclusion, instead of paying attention at science funded by itself (virtually all research done in Brazil is financed by public money), the Brazilian Health Ministry<br \/>\nhas opted to have corporativist attitude and simply denied the<br \/>\ndiscovery. The results of this attitude are, unfortunately, human lives as we already had 23 confirmed deaths in 2009.<\/p>\n<p><\/p>\n<div style=\"line-height: 1.1em;margin-left: 0.5in;text-indent: -0.5in\">\n<p style=\"margin: 0pt\">[1] Figueiredo, Regina Maria Pinto de, Felipe Gomes Naveca, Michele de Souza Bastos, Miriam do Nascimento Melo, Suziane de Souza Viana, Maria Paula Gomes Mour\u00e3o, Crist\u00f3v\u00e3o Alves Costa, e Izeni Pires Farias. &#8220;Dengue Virus Type 4, Manaus, Brazil.&#8221; <a href=\"http:\/\/www.pubmedcentral.nih.gov\/articlerender.fcgi?artid=2570911\"><span style=\"font-style: italic\">Emerging Infectious Diseases<\/span> 14, no. 4 (Abril 2008): 667-669<\/a>.&nbsp; <\/p>\n<\/div>\n<p><\/p>\n<div style=\"line-height: 1.1em;margin-left: 0.5in;text-indent: -0.5in\">\n<p style=\"margin: 0pt\">[2] <span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.jtitle=PLoS+Neglected+Tropical+Diseases&amp;rft_id=info%3Adoi%2F10.1371%2Fjournal.pntd.0000390&amp;rfr_id=info%3Asid%2Fresearchblogging.org&amp;rft.atitle=Introduction+of+Dengue+Virus+4+%28DENV-4%29+Genotype+I+into+Brazil+from+Asia%3F&amp;rft.issn=1935-2735&amp;rft.date=2009&amp;rft.volume=3&amp;rft.issue=4&amp;rft.spage=0&amp;rft.epage=0&amp;rft.artnum=http%3A%2F%2Fdx.plos.org%2F10.1371%2Fjournal.pntd.0000390&amp;rft.au=de+Melo%2C+F.&amp;rft.au=Romano%2C+C.&amp;rft.au=Zanotto%2C+P.&amp;rfe_dat=bpr3.included=1;bpr3.tags=Biology%2CEvolutionary+Biology%2C+Genetics%2C+Ecology\">de Melo, F., Romano, C., &amp; Zanotto, P. (2009). Introduction of Dengue Virus 4 (DENV-4) Genotype I into Brazil from Asia? <span style=\"font-style: italic\">PLoS Neglected Tropical Diseases, 3<\/span> (4) DOI: <a rev=\"review\" href=\"http:\/\/dx.doi.org\/10.1371\/journal.pntd.0000390\">10.1371\/journal.pntd.0000390<\/a><\/span><\/p>\n<p style=\"margin: 0pt\">\n<p><\/p>\n<p>&#8212;<\/p>\n<p><em>This is a post written by Atila at <a href=\"http:\/\/scienceblogs.com.br\/rainha\/\">Rainha Vermelha<\/a>. Revised by <a href=\"http:\/\/scienceblogs.com.br\/brontossauros\/\">Carlos Hotta<\/a><\/em>. <\/p>\n<p style=\"margin: 0pt\"><span class=\"Z3988\" title=\"ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.jtitle=PLoS+Neglected+Tropical+Diseases&amp;rft_id=info%3Adoi%2F10.1371%2Fjournal.pntd.0000390&amp;rfr_id=info%3Asid%2Fresearchblogging.org&amp;rft.atitle=Introduction+of+Dengue+Virus+4+%28DENV-4%29+Genotype+I+into+Brazil+from+Asia%3F&amp;rft.issn=1935-2735&amp;rft.date=2009&amp;rft.volume=3&amp;rft.issue=4&amp;rft.spage=0&amp;rft.epage=0&amp;rft.artnum=http%3A%2F%2Fdx.plos.org%2F10.1371%2Fjournal.pntd.0000390&amp;rft.au=de+Melo%2C+F.&amp;rft.au=Romano%2C+C.&amp;rft.au=Zanotto%2C+P.&amp;rfe_dat=bpr3.included=1;bpr3.tags=Biology%2CEvolutionary+Biology%2C+Genetics%2C+Ecology\"><\/span> <\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Brazilian government has been really concerned about swine flu. We have health agents in airports and ports to detect possible flu cases. But let&#8217;s see how it deals with Dengue, another infectious disease with a well-known life cycle, efficient prevention strategies and distinguishable symptoms. Dengue is a serious issue in Americas, with more than 850,000 [&hellip;]<\/p>\n","protected":false},"author":550,"featured_media":12,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"editor_plus_copied_stylings":"{}","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"pgc_sgb_lightbox_settings":"","_vp_format_video_url":"","_vp_image_focal_point":[],"footnotes":""},"categories":[3],"tags":[],"class_list":["post-116","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-geral"],"_links":{"self":[{"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/posts\/116","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/users\/550"}],"replies":[{"embeddable":true,"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/comments?post=116"}],"version-history":[{"count":0,"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/posts\/116\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/media\/12"}],"wp:attachment":[{"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/media?parent=116"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/categories?post=116"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.blogs.unicamp.br\/brazillion\/wp-json\/wp\/v2\/tags?post=116"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}