ABSTRACT
Although the number of confirmed cases of spotted fever has been declining in Brazil since 2005, the mortality rate (20% to 30%) is still high in comparison to other countries. This high mortality rate is closely related to the difficulty in making the diagnosis and starting the correct treatment. Only two groups of antibiotics have proven clinical effectiveness against spotted fever: chloramphenicol and tetracyclines. Until recently, the use of tetracyclines was restricted to adults because of the associated bone and tooth changes in children. Recently, however, the American Academy of Pediatrics and various researchers have recommended the use of doxycycline in children. In more severe cases, chloramphenicol injections are often preferred in Brazil because of the lack of experience with injectable tetracycline. Since early diagnosis and the adequate drug treatment are key to a good prognosis, health care professionals must be better prepared to recognize and treat spotted fever.
Subject(s)
Rocky Mountain Spotted Fever/epidemiology , Adult , Animals , Animals, Wild/parasitology , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/therapeutic use , Arachnid Vectors/microbiology , Brazil/epidemiology , Child , Delayed Diagnosis , Diagnosis, Differential , Disease Notification , Disease Reservoirs/parasitology , Female , Humans , Male , Population Surveillance , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/microbiology , Rickettsia rickettsii/isolation & purification , Rocky Mountain Spotted Fever/diagnosis , Rocky Mountain Spotted Fever/drug therapy , Rocky Mountain Spotted Fever/physiopathology , Rocky Mountain Spotted Fever/prevention & control , Tick Infestations/veterinary , Ticks/microbiologyABSTRACT
Risk perception of acquiring vaccine preventable diseases and the immune status of 187 health care workers (HCW) from a high-complexity university hospital in São Paulo, Brazil, were assessed. The vaccine preventable diseases more cited as at risk for acquisition were hepatitis B (94.1%), influenza (92.5%), meningococcal disease (90.3%), tuberculosis (85.0%), and varicella (72.7%). Previous disease or vaccination reported by HCW were hepatitis B (82.4%), tetanus (87.7%), diphtheria (81.8%), measles (86.6%), mumps (85.6%), rubella (85.0%), varicella (82.9%), and influenza (35.8%). One third of HCW reported previous percutaneous or mucosal occupational accidents, and 83.6% had notified the event to the Hospital Infection Control Committee. Despite good risk perception of acquiring vaccine preventable diseases, only 35.8% of individuals were fully immunized. Efforts should be made to increase influenza vaccination coverage among all professionals and to reduce the number of nonreported accidents, especially among physicians.
