Cabezas César, Fiestas Victor, García-Mendoza María, Palomino Miriam, Mamani Enrique, Donaires Fernando
Centro Nacional de Salud Pública, Instituto Nacional de Salud, Lima, Perú
Rev Peru Med Exp Salud Publica. 2015 Jan-Mar;32(1):146-56.
A health problem each time more frequent and dispersed in tropical and subtropical areas of the world, including Peru where it entered in 1990, is dengue. It is produced by the dengue virus with four serotypes and transmitted by Aedes aegypti, a vector that coexists with humans and whose presence is favored by deficient sanitary, social and economic conditions. Manifestations of severe forms of the disease such as shock and bleeding, are related to the frequent co-circulation of the four serotypes and the emergence of new genotypes such as American/Asian serotype 2. The new classification of the disease by WHO as dengue with or without warning signs and severe dengue, is contributing to more timely diagnosis and treatment, enabling reductions in mortality. Of note is the need to highlight the surveillance of acute febrile illness and Aedes indices that contribute to a timely diagnosis and guide vector control measures through sanitary education and environmental management with community and intersectoral participation, in a creative manner according to ecological niches. An alternative for complementary prevention would be vaccination using tetravalent vaccines whose safety and efficacy must be guaranteed before its use in the population under the framework of comprehensive strategies.
登革热是一种在世界热带和亚热带地区日益频繁且分布广泛的健康问题,包括1990年传入的秘鲁。它由登革热病毒的四种血清型引起,通过埃及伊蚊传播,埃及伊蚊与人类共生,卫生、社会和经济条件不足有利于其滋生。该疾病严重形式的表现,如休克和出血,与四种血清型的频繁共同传播以及新基因型(如美洲/亚洲2型血清型)的出现有关。世界卫生组织对该疾病的新分类为有或无警示体征的登革热和重症登革热,这有助于更及时地诊断和治疗,从而降低死亡率。需要强调的是,有必要加强对急性发热性疾病和伊蚊指数的监测,这有助于及时诊断,并通过社区和跨部门参与的卫生教育和环境管理,根据生态位以创新方式指导病媒控制措施。补充预防的一种选择是使用四价疫苗进行接种,在综合战略框架下,其安全性和有效性必须在用于人群之前得到保证。