Ten years of a hantavirus disease emergency in the Federal District, Brazil

Abstract

Introduction: Hantavirus diseases are emerging human diseases caused by Hantavirus spp. of the Bunnyaviridae family. Hantavirus pulmonary syndrome (HPS) has been detected in the Federal District (DF) of Brazil since 2004. Among the 27 Brazilian Federal Units, DF has the highest fatality rate. More than 10 years have already passed since then, with confi rmation of cases caused by the Araraquara and Paranoa species. The reservoir is Necromys lasiurus. Methods: Local surveillance data of the confi rmed cases were analyzed, including age, sex, month and year of occurrence, clinical symptoms, syndromes and outcomes, and probable transmission place (PTP). The cases were mainly confi rmed by IgM detection with a capture enzyme immunoassay. The cases were classifi ed as autochthonous if PTPs were in the DF area. Results: From 2004 to 2013, in the DF, 126 cases of hantavirus were confi rmed, and the cumulative incidence was 5.0 per 100,000 inhabitants. The occurrence of cases was predominantly from April to August. At least 75% of the cases were autochthonous. Acute respiratory failure was reported in 47.5% of cases, and the fatality rate was 40%. Conclusions: In the DF, the cumulative incidence of HPS was one of the highest worldwide. A seasonal pattern of hantavirus disease in the dry season is clear. There was a high frequency of severe clinical signals and symptoms as well as a high fatality rate. For the near future, visitors and inhabitants of DF rural areas, particularly male adults, should receive continuous education about hantavirus transmission and prevention.

Human leptospirosis in the Federal District, Brazil, 2011-2015: eco-epidemiological characterization

“…This fi nding reinforces the need for public health policies and management in the FD regarding leptospirosis and other acute febrile diseases (hantavirus, yellow fever, and infl uenza) in addition to dengue fever, which are considered one of the most important public health issues in Brazil 4,15 . Despite leptospirosis having less morbidity than dengue fever in the FD, the lethality of the disease is higher than infections caused by the dengue virus 11 .…”

Magnitude e distribuição dos óbitos por hantavirose no Brasil, 2007-2015*

“…This study corroborates the findings of Willemann & Oliveira, 12 who observed regional differences in hantavirus lethality in a case-control study with secondary data from 2007 to 2010, relating to the regions of Brazil, with the objective of evaluating risk factors for death from hantavirus. With regard to the groups most vulnerable to death from hantavirus, in a descriptive study conducted in Brazil's Distrito Federal between 2004 and 2013, Dusi et al 13 also found higher lethality in females than in males. Menezes et al, 14 in a cross-sectional study conducted in the state of Goias between 2007 and 2013, and Kaya et al, 15 in a review on prognostic factors for hantavirus infection, also identified higher lethality in most vulnerable age groups -such as children -as well as in other groups traditionally considered to be less exposed to infection.…”

Environmental influence on the hantavirosis incidence in the federal district, Brazil / Influência ambiental na incidência da hantavirose no distrito federal, Brasil

“…The outbreaks in São Paulo and DF were due to the deforestation of rodents' native habitats (Ferreira, 2003). Among the 27 Brazilian federative units, DF has the highest fatality rate (Dusi et al, 2016).…”

“…Thus, efforts to detect disease outbreaks should also focus on analyzing the influence of disturbed landscapes, primarily, agricultural areas (Goodin et al, 2006). Dusi et al (2016) described the main epidemiological aspects of hantavirus cases in the DF during the period 2004−2013, including field surveillance of age, sex, month and year of occurrence, clinical symptoms, syndromes and outcomes, and probable transmission place. In this period, the authors found 126 cases of hantavirus, predominantly from April (end of wet season) to August (peak of dry season).…”