Mourão Maria Paula Gomes, Bastos Michele de Souza, Figueiredo Regina Maria Pinto de, Gimaque João Bosco de Lima, Alves Valquíria do Carmo Rodrigues, Saraiva Maria das Graças Gomes, Figueiredo Mário Luis Garcia, Ramasawmy Rajendranath, Nogueira Maurício Lacerda, Figueiredo Luiz Tadeu Moraes
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brazil.
Rev Soc Bras Med Trop. 2015;48 Suppl 1:20-6. doi: 10.1590/0037-8682-0133-2013.
The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.
位于巴西西部亚马逊州首府玛瑙斯的热带医学基金会埃托尔·维埃拉·多拉多博士基金会（FMT-HVD），是该地区急性发热性疾病（包括虫媒病毒感染）综合征监测的先驱机构。根据FMT-HVD患者的数据，我们发现在过去15年里，玛瑙斯出现了由四种登革热血清型引起的反复疫情，且疾病严重程度不断增加。这种地方流行情况在2011年达到顶峰，当时四种血清型同时传播，这在巴西尚属首次报道。1996年至2009年期间，亚马逊州登记了42例黄热病病例，其中71.4%（30/42）死亡。自2010年以来，未再报告病例。由于黄热病病毒传入像玛瑙斯这样伊蚊大量滋生的大城市可能会带来黄热病爆发的实际风险，因此为民众维持适当的免疫政策至关重要。玛瑙斯最近还出现了马亚罗热和奥罗普切热的隐性疫情，其中大多数被误诊为登革热。亚马逊州的热带条件有利于其他能够导致人类疾病的虫媒病毒的存在。在这种由至少四种在玛瑙斯及其他邻国导致人类感染的虫媒病毒构成的实际威胁下，制定一项有效的公共卫生监测策略很重要，其中包括能够对虫媒病毒进行正确诊断的实验室。
