Pathogenic viruses do not give us rest. As soon as SARS-CoV-2 takes a breather and its case and mortality figures drop until they are diluted among other infectious diseases such as the flu, another viral disease returns to raise the alarm. In a medical event held last Tuesday, Carlos Giovacchini, coordinator of the National Epidemiology Directorate in the National Ministry of Health, revealed that -in recent days- the registered cases of dengue have doubled. In the most recent registry, the agency noted 9,389 cases of dengue (type 1 and 2), which were confirmed from 63 towns located in 13 Argentine provinces. To compare the situation, in the previous period – the second week of March – the record had been 4,828 cases, in 12 provinces.
This recent increase in infections is not surprising since in the National Epidemiological Bulletin No. 10, published at the beginning of March, it can be read that “in the last three weeks there has been a marked increase compared to the same period of the previous two years: from 683 % compared to the average registered for the same moment of the year in 2022 and 159% compared to the same period of 2021”.
Another interesting fact that emerges from the latest epistemological notes is that, at this moment -taking into account the relative population- the provinces most affected by dengue cases are Tucumán, Salta and Santa Fe, while CABA comes in sixth place. Finally, the age group most “hit” by this virus are young adults.
According to public health experts, unfortunately, this trend should not be too surprising since, although this pathology has been endemic for decades in many of the countries of the region, in the last two years both dengue and another similar emerging pathology , chikungunya, have been “expanding” their reach, both considering the number of cases and their increasing arrival in new geographical areas hitherto virgin of transmission. Figures from the Pan American Health Organization suggest that the “triad” of diseases of this family of viruses transmitted by this mosquito are integrated as follows: dengue reaches almost 90% of cases. The other 10% are chikungunya and 1% are cases of Zika virus infections.
In the case of “chikun”, the most recent figures registered by the epistemological authorities of Argentina also suggest a sustained growth: there are 528 cases, which come from five different provinces. Although the magnitude of these cases is twenty times less than in dengue, it is also an expanding situation because –until now– there had only been records of patients with chikungunya in two provinces: Salta and Jujuy, and a total of around 120 cases. Also, for the first time, the local circulation of this virus was confirmed in Argentina, since it was established that those affected were part of “autochthonous” outbreaks (of patients with no history of travel to areas with confirmed viral circulation).
99% of the cases of “chikun” were registered in the Southern Cone and of those, almost three quarters occurred in Paraguay. In fact, in that country there are already more than 47,000 patients affected by this pathology and a total of fifty deaths.
It is worth remembering that this is not an issue that Argentina is indifferent to, given the extensive shared borders and the intense flow of people who cross them daily. Even, not only the geographical proximity with the provinces of the Argentine north is considered, but it must be observed that many people come and go, directly, from Paraguay to the AMBA area.
Finally, it is also thought that there is already “cocirculation” of two different serotypes of dengue, in the same geographical areas, something that has already been verified in Brazil in previous years. This is not minor since it means that the chances of a person being reinfected with another subtype of the same virus increase. “This situation exponentially increases the risk of contracting severe or hemorrhagic dengue, a complication of the disease that is potentially fatal,” explained Diego Flichman, a CONICET researcher and professor of Virology at the UBA.
History. With respect to dengue, although there are historical cases, from the point of view of public health the “key” year for the re-entry of this pathology and its call for attention in terms of infections dates back to 1998. From that moment until today, recorded three strong epidemic outbreaks in the years 2009, 2016 and 2020.
However, beyond these “peaks”, the observation of experts year after year shows that the risk areas have been progressively expanding towards new regions, especially towards more southern latitudes, a progression facilitated by global warming and change. climate. Along with this, areas with greater “cocirculation” of the different dengue serotypes have also been registered in several countries, which increases the risk that people who become reinfected will suffer from some serious complication.
The recent medical event dedicated to training in dengue infectology, organized by the iSalud University, concluded by highlighting an impressive fact. In the words of Giovacchini, “as of 2023 so far in terms of these viral infections, the current public health scenario is one of the most complex in the history of arboviral diseases in Argentina.”
How to control the mosquito
In one of the talks at the medical event on dengue, the biologist Marcelo Abril, director of the Mundo Sano Foundation, explained that “the great difficulty [con estas patologías] it is like controlling the proliferation of the mosquito vector of virus transmission. “This, on the ground, is very complex, especially due to the lack of provision of drinking running water, which requires having tanks and cisterns in many places. These places serve as hatcheries. It is also a factor that affects poverty since more people accumulate plastic and rubber containers and bottles with the intention of selling them later. And those elements collect stagnant water. For this reason, in order to change this paradigm in the long term, the issue involves reducing poverty, developing the economy and providing adequate services to the people”. Meanwhile, the closest alternatives include the famous littering of patios, balconies and gardens, changing the water in pet drinking fountains, vases and dishes under pots, cleaning drains and gutters; use repellents, spirals and mosquito nets at home.
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