Health officials in Rio de Janeiro, Brazil’s second largest city, announced Tuesday that 67 people have died from dengue fever, and tens of thousands others are sickened with the mosquito borne virus. Many of the dead and the most serious cases are children.

According to the Washington Post, more than 1,200 military personnel have been arriving in the coastal city to spray insecticide and put up emergency hospital tents.

Many Brazilians are very angry at the lack of preventive action from their government. Some of them vented their anger to news agencies as they gathered outside the tents.

One woman whose 11 year old daughter was on a drip in one of the temporary hospitals said the state and municipal governments had acted irresponsibly:

“They didn’t do anything until the problem was already out of control”, and now “everyone is just trying to pass the blame around to someone else,” she told the Post.

Disease experts suggest that the rural to urban shift that is occurring in many Latin American countries, together with the relaxation of insecticide spraying that practically eradicated the virus between 1950 and 1980, is the likely reason the disease is making a comeback. The virus causes high fever, headaches and joint pain. There is also a hemorrhagic form of the disease.

A Brazilian doctor with the Pan-American Health Organization, Jarbas Barbosa, told the Washington Post that Aedes aegypti, the mosquito that carries the dengue virus, thrives in cities where there is a rapid population growth without an accompanying growth in infrastructure.

There are many areas of Rio where water and sewerage services are poor, and trash collection infrequent. The mosquito only needs a small pool of standing water to breed, even a broken flower pot or a crumpled soda can is enough.

Reports in various media, both international and local, suggest there is a struggle going on between federal and state officials about whether “postos de saúde” (small health centres run by the government), usually open Monday to Friday from 8 am to 5 pm, should stay open for 24 hours. Apparently a federal decision has been made to that effect, but not yet communicated, while there are reports that it will be countermanded at state or municipal level.

The problem, according to many local health officials, is that there are not enough doctors to staff such an increase in opening hours. Going from 40 to 168 hours a week of operation means a quadrupling of medical staff, said a report in Folha Online.

Folha Online also reports that the governor of the state of Rio, Sérgio Cabral, is considering asking Cuba to send doctors to help make up the numbers. “Cuba has an excellent tradition in the area of public health,” said Cabral.

The total number of dengue cases registered in the state of Rio de Janeiro in 2008 now exceeds 57,000, according to Rio’s Secretary of State for Health, Sérgio Côrtes, last Friday. This reflects an increase of 14,000 on the previous week’s figures.

The state capital is the city with the largest number of cases, totalling over 36,600. The metropolitan region of Nova Iguaçu has registered 3,643 cases, followed by Angra dos Reis with 3,711.

The total number of deaths, 67, is up by 13 from the previous week, and of this total, 21 cases were of the hemmhoragic form of the disease that is characterized by loss of blood.

Cabral said there are field hospitals set up as “hydration centres” ready to treat casualties of the disease, but there are no doctors to staff them.

“The tents in Gávea [southern zone], da Penha [northern zone] and Méier [northern zone] are ready, waiting for prefessionals”, he told the press.

Meanwhile 15 to 20 pediatricians from the southern state of Rio Grande do Sul are getting ready to fly to Rio to help with the outbreak. Rio Grande was the first state to respond to Côrtes’ request for pediatricians from other states. The doctors, who work in state and federal hospitals, will leave for Rio on Sunday (6th) and will be in Rio for about 2 weeks, the Secretary of State for Health in Rio Grande do Sul told Folha Online.

Sources: Washington Post, Folha Online.

Written by: Catharine Paddock, PhD