An update on the epidemiological situation of spotted fever in Brazil

Background Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs. Methods This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015. Results In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed. Conclusions The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.(AU)

An update on the epidemiological situation of spotted fever in Brazil

Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs. Methods This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015. Results In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed. Conclusions The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases

We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database.

Scorpionism in Brazil in the years 2000 to 2012

Background Scorpionism is a serious public health problem in Brazil. Nationwide epidemiological analyses of scorpion stings are scarce. In this context, the present study aims to provide an epidemiological analysis of accidents involving scorpions in Brazil.Methods An analytical epidemiological study of the scorpion accidents reported in the Information System for Notifiable Diseases (SINAN) was conducted from 2000 to 2012 in Brazil.Results During this period, 482,616 accidents and 728 deaths were reported. The annual average incidence and mortality rates per 100,000 inhabitants were 19.6 and 0.030, respectively, with annual average lethality rate of 0.16%. The highest accident frequency was recorded in male subjects, aged 20-49 years, from September to December and in urban areas, except in the northern region of the country, where accidents were most frequent in June and July, and in rural areas. Males up to age 9 and rural areas were defined as an age group and area for greatest death risk, respectively.Conclusions Scorpionism in Brazil is a predominantly urban health problem that mostly affects people at an economically active age. The Northeast and Southeast hold the majority of cases and deaths, as well as the highest annual incidence and mortality averages, but the Central West and North presented the highest average annual lethality rates. The epidemiological changes described in this study highlight the need for intensifying health surveillance actions to prevent scorpion accidents in Brazil.(AU)

Scorpionism in Brazil in the years 2000 to 2012

Background Scorpionism is a serious public health problem in Brazil. Nationwide epidemiological analyses of scorpion stings are scarce. In this context, the present study aims to provide an epidemiological analysis of accidents involving scorpions in Brazil.Methods An analytical epidemiological study of the scorpion accidents reported in the Information System for Notifiable Diseases (SINAN) was conducted from 2000 to 2012 in Brazil.Results During this period, 482,616 accidents and 728 deaths were reported. The annual average incidence and mortality rates per 100,000 inhabitants were 19.6 and 0.030, respectively, with annual average lethality rate of 0.16%. The highest accident frequency was recorded in male subjects, aged 2049 years, from September to December and in urban areas, except in the northern region of the country, where accidents were most frequent in June and July, and in rural areas. Males up to age 9 and rural areas were defined as an age group and area for greatest death risk, respectively.Conclusions Scorpionism in Brazil is a predominantly urban health problem that mostly affects people at an economically active age. The Northeast and Southeast hold the majority of cases and deaths, as well as the highest annual incidence and mortality averages, but the Central West and North presented the highest average annual lethality rates. The epidemiological changes described in this study highlight the need for intensifying health surveillance actions to prevent scorpion accidents in Brazil.

Intoxicação natural por Brachiaria spp. em ovinos no Brasil Central / Brachiaria spp. poisoning in sheep in Central Brazil

Brachiaria spp. é a principal forrageira utilizada para ruminantes no Brasil Central, mas a sua toxicidade, devida à presença de saponinas esteroidais, torna-se um importante entrave à sua utilização. Neste trabalho descrevem-se 34 surtos e um foco de intoxicação por Brachiaria spp em ovinos, que ocorreram em diferentes épocas do ano. A morbidade geral foi de 23,2% e a letalidade foi 88,3%. O tempo que os animais permaneceram no pasto até o surgimento dos sinais clínicos da intoxicação por Brachiaria spp. variou de 15 dias até mais de 12 meses. Em 90,1% dos surtos os animais eram menores de 12 meses de idade. O curso clínico da intoxicação variou de 2 a 45 dias. Os sinais clínicos e as lesões macroscópicas foram características de fotossenssibilização hepatógena, no entanto, nos casos mais agudos não foram observadas dermatite nem icterícia, ocorrendo severo edema em face e orelhas. Na histologia do fígado as lesões mais características foram a presença de macrófagos com citoplasma espumoso, encontrados principalmente nos sinusoides hepáticos e, às vezes, com imagens negativas de cristais acutiformes no citoplasma. Em oito das 11 fazendas visitadas os surtos ocorreram em pastagens de Brachiaria decumbens; em duas em pastagens de B. brizantha e uma em pastagem de B. decumbens, B. humidicola e Andropogon sp. As concentrações de saponinas nas pastagens, em 5 surtos, variou de 0.3% a 2.56%. As informações geradas neste trabalho permitem a proposta de medidas para controle e profilaxia da intoxicação por Brachiaria spp. no Brasil Central.

Brachiaria spp. is the main pasture for ruminants in Central-Brazil, but the crucial problem for their utilization is the toxicity due to the presence of steroidal saponins. This paper reports 35 outbreaks of poisoning by Brachiaria spp in sheep. The poisoning occurred in different seasons of the year. Mean morbidity was 23.2% and mean lethality was 88.3%. The occurrence of clinical signs after the introduction of the sheep into the pastures varied from 15 days to more than 12 months. In 90.1% of the outbreaks, sheep younger than 12 months of age were affected. Clinical signs and gross lesions were characteristic of hepatogenous photosensitization, but more acute cases showed edema of the face and ears, without dermatitis or jaundice. The main histologic lesions of the liver were the presence of macrophages with foamy cytoplasm, found mainly in sinusoids, and sometimes containing negative images of crystals. In eight out of 11 farms visited the outbreaks occurred in Brachiaria decumbens pastures, two in B. brizantha pastures, and one in a pasture of B. decumbens, B. humidicola, and Andropogon sp. Saponin concentrations in the pastures of 11 outbreaks varied from 0.3 to 2.56%. The information generated by this report allows the proposal of measures for control and prevention of Brachiaria spp. poisoning in Central-Brazil.