The greatest Dengue epidemic in Brazil: Surveillance, Prevention, and Control

The greatest Dengue epidemic in Brazil: Surveillance, Prevention, and Control

2024 | Rodrigo Gurgel-Gonçalves, Wanderson Kleber de Oliveira and Julio Croda
This review discusses dengue surveillance, prevention, and control measures in Brazil. Data from 2000 to 2024 show an increase in dengue cases and deaths, with the highest number of cases projected to reach 2024. Dengue mortality has expanded geographically, with approximately 6 million probable cases and 4,000 confirmed deaths as of June 2024, representing the greatest dengue epidemic in Brazil. Several technologies have been developed to control Aedes aegypti, including Wolbachia-infected mosquitoes, indoor residual spraying, sterile insect techniques, and mosquito-disseminated insecticides. The Brazilian Ministry of Health recommends integrating these technologies into health services. Brazil is the first country to incorporate the Takeda vaccine into its public health system, and the Butantan vaccine is undergoing Phase 3 clinical trials. Increasing vaccination coverage and implementing novel Ae. aegypti control technologies could reduce dengue cases in Brazil. Community activities such as home cleaning and elimination of potential mosquito breeding sites, facilitated by social media and health education, are essential. A multisectoral approach encompassing sanitary improvements, mosquito control, vaccination, and community mobilization is crucial in the fight against dengue epidemics. Climate change is a key driver of the increase in dengue cases, and new technologies for controlling Ae. aegypti are described. Advances in dengue vaccines and prospects for surveillance, control, and prevention are outlined. Dengue has been a notifiable disease in Brazil since 1961, with electronic registration implemented in 1993. The historical series of dengue epidemics in Brazil between 2000 and 2024 shows a significant increase in cases and deaths. The number of dengue cases has increased dramatically, with the highest number of cases recorded in 2024. Dengue serotypes have spread throughout Brazil, with DENV-2 possibly responsible for increased mortality. The Ministry of Health has promoted policies to manage dengue epidemics, including the introduction of the NS1 rapid test and the establishment of a Center of Emergency Operations (CEO). However, the CEO faces challenges in implementation due to the constant change of professionals and insufficient training of health teams. Brazil needs to move towards more anticipated surveillance actions by applying nowcasting and forecasting models. The quality of diagnostic procedures is a limitation in the impact of dengue fever in Brazil. Training programs are recommended to improve the diagnosis and clinical management of dengue in affected municipalities. New technologies have been developed to control Ae. aegypti and are now recommended by the Brazilian Ministry of Health. Integrating these technological solutions into the healthcare systems of Brazilian municipalities is the next critical challenge. While these technical interventions may assist in controlling future dengue outbreaks, their effectiveness depends on various external factors. Increasing tetravalThis review discusses dengue surveillance, prevention, and control measures in Brazil. Data from 2000 to 2024 show an increase in dengue cases and deaths, with the highest number of cases projected to reach 2024. Dengue mortality has expanded geographically, with approximately 6 million probable cases and 4,000 confirmed deaths as of June 2024, representing the greatest dengue epidemic in Brazil. Several technologies have been developed to control Aedes aegypti, including Wolbachia-infected mosquitoes, indoor residual spraying, sterile insect techniques, and mosquito-disseminated insecticides. The Brazilian Ministry of Health recommends integrating these technologies into health services. Brazil is the first country to incorporate the Takeda vaccine into its public health system, and the Butantan vaccine is undergoing Phase 3 clinical trials. Increasing vaccination coverage and implementing novel Ae. aegypti control technologies could reduce dengue cases in Brazil. Community activities such as home cleaning and elimination of potential mosquito breeding sites, facilitated by social media and health education, are essential. A multisectoral approach encompassing sanitary improvements, mosquito control, vaccination, and community mobilization is crucial in the fight against dengue epidemics. Climate change is a key driver of the increase in dengue cases, and new technologies for controlling Ae. aegypti are described. Advances in dengue vaccines and prospects for surveillance, control, and prevention are outlined. Dengue has been a notifiable disease in Brazil since 1961, with electronic registration implemented in 1993. The historical series of dengue epidemics in Brazil between 2000 and 2024 shows a significant increase in cases and deaths. The number of dengue cases has increased dramatically, with the highest number of cases recorded in 2024. Dengue serotypes have spread throughout Brazil, with DENV-2 possibly responsible for increased mortality. The Ministry of Health has promoted policies to manage dengue epidemics, including the introduction of the NS1 rapid test and the establishment of a Center of Emergency Operations (CEO). However, the CEO faces challenges in implementation due to the constant change of professionals and insufficient training of health teams. Brazil needs to move towards more anticipated surveillance actions by applying nowcasting and forecasting models. The quality of diagnostic procedures is a limitation in the impact of dengue fever in Brazil. Training programs are recommended to improve the diagnosis and clinical management of dengue in affected municipalities. New technologies have been developed to control Ae. aegypti and are now recommended by the Brazilian Ministry of Health. Integrating these technological solutions into the healthcare systems of Brazilian municipalities is the next critical challenge. While these technical interventions may assist in controlling future dengue outbreaks, their effectiveness depends on various external factors. Increasing tetraval
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