Cavalcanti Luciano Pamplona de Góes, Freitas André Ricardo Ribas, Brasil Patrícia, Cunha Rivaldo Venâncio da
Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil.
Faculdade São Leopoldo Mandic, Campinas, SP, Brasil.
Mem Inst Oswaldo Cruz. 2017 Aug;112(8):583-585. doi: 10.1590/0074-02760160537.
Did death occur DUE TO dengue, or in a patient WITH dengue virus infection? It seems a matter of semantics, but in fact, it underscores how challenging it is to distinguish whether the disease contributed to death, or was itself the underlying cause of death. Can a death be attributed to chikungunya virus, when some deaths occur after the acute phase? Did the virus decompensate the underlying diseases, leading to death? Did prolonged hospitalisation lead to infection, resulting in the patient's progression to death? Were there iatrogenic complications during patient care? The dengue question, for which there has not yet been a definitive response, resurfaces prominently under the chikungunya surveillance scenario. We are facing an epidemic of a disease that seems to be more lethal than previously thought. The major challenge ahead is to investigate deaths suspected of occurring due to arbovirus infections and to understand the role of each infection in the unfavourable outcome.
死亡是由登革热导致的，还是发生在感染登革热病毒的患者身上？这看似只是语义问题，但实际上，它凸显了区分该疾病是导致死亡的原因，还是本身就是死亡的根本原因有多困难。当一些死亡发生在急性期之后时，能否将其归因于基孔肯雅病毒？病毒是否使潜在疾病失代偿，从而导致死亡？长时间住院是否导致感染，进而致使患者死亡？在患者护理期间是否存在医源性并发症？登革热的这个问题，目前尚无定论，在基孔肯雅热监测的背景下又再次凸显出来。我们正面临一种似乎比之前认为的更具致命性的疾病的流行。未来的主要挑战是调查疑似由虫媒病毒感染导致的死亡病例，并了解每种感染在不良结局中所起的作用。
