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EID Updates

EID Updates:

Emerging and Reemerging Infectious Diseases,
Region of the Americas

Vol. 2, No. 26—6 October 2004
Main Updates index


Figure 1

Epidemiological Situation of Hantavirus in Brazil

Up to 5 September 2004, 85 new cases of Hantavirus were confirmed in Brazil as Hantavirus Cardiopulmonary Syndrome (HCPS). The number of cases reported to date for this year is equivalent to the total number of cases reported for 2003 (Figure 1).

These 85 cases were detected in 10 (37%) of the Brazilian states, with only the northeastern region not registering cases. Nearly 60% of the cases were detected in Minas Gerais and the Federal District. The geographical spread of the disease is limited to 45 areas or municipalities of transmission, or 0.8% of the total number of Brazilian municipalities (Figure 2).

Figure 2

Cases for detected every month this year, with 56.5% (48) reported from May to July and an increase in the number of cases from April on (Figure 3).

Figure 3

Concerning the profile of the persons admitted to hospital for HCPS this year, 69.4% (59 cases) were men and 81.2% (69) were between 21 and 50 years of age (Tables 1 and 2). Age ranged from 15 to 71 years, with the mean and median ages 34 and 36, respectively. The mode was 24 years.

Table 1: Hantavirus—Number and Percentage of Cases by Age Group (Brazil, 2004*)

Age Group Cases % Cumulative %
< 10 years -- -- --
11–20 years 12 14.1 14.1
21–30 years 23 27.1 41.2
31–40 years 16 18.8 60.0
41–50 years 18 2.2 81.2
51–60 years 12 14.1 95.3
61–70 years 3 3.5 98.8
> 70 years 1 1.2 100.0
Total 85 100.0 --
Source: Sistema de Vigilância em Saúde, Ministério da Saúde (SVS/MS) (System of Health Surveillance, Ministry of Health, Brazil).
(*) preliminary data

Nearly 65% of the deaths occurred among males; however, case fatality was 24% higher among women (Table 2).

Table 2: Hantavirus—Number of Cases and Deaths and Case-Fatality Rate by Gender (Brazil, 2004*)

Gender Cases % Deaths % Case-Fatality Rate (%)
Male 59 69.4 22 64.7 37.3
Female 26 30.6 12 35.3 46.2
Total 85 100.0 34 100.0 40.0
Source: Sistema de Vigilância em Saúde, Ministério da Saúde (SVS/MS) (System of Health Surveillance, Ministry of Health, Brazil).
(*) preliminary data

Of the 85 cases, 51 of the patients (60%) were released from the hospital. During the period under analysis, the State of Minas Gerais presented the lowest case-fatality rate-32% among the 25 cases-followed by Santa Catarina (with 37.5%) and the Federal District (with 38.5%). Altogether, these states reported 69.4% of all cases (or 59 of them). The average case-fatality rate now stands at 40%, which is lower than in the past (Table 3).

Table 3: Hantavirus—Number of Cases and Deaths and Case-Fatality Rate by State (Brazil, 2004*)

State Cases % Deaths Case-Fatality Rate (%)
AM 2 2.4 -- --
DF 26 30.6 10 38.5
GO 7 8.2 4 57.1
MG 25 29.4 8 32.0
MT 1 1.2 1 100.0
PA 1 1.2 -- --
PR 1 1.2 1 100.0
RS 3 3.5 -- --
SC 8 9.4 3 37.5
SP 11 12.9 7 63.6
Total 85 100.0 34 40.0
Source: Sistema de Vigilância em Saúde, Ministério da Saúde (SVS/MS) (System of Health Surveillance, Ministry of Health, Brazil).
(*) preliminary data

Source: Sistema de Vigilância em Saúde, Ministério da Saúde (SVS/MS) (System of Health Surveillance, Ministry of Health of Brazil).

Jungle Yellow Fever (JYF) in the State of Monagas, Venezuela

On 5 October 2004, the Ministry of Health and Social Development (MSDS) of Venezuela reported to PAHO three new cases of Jungle Yellow Fever, with two deaths. These were confirmed by laboratory by isolating the yellow fever virus from one febrile case. All three cases were identified between Epidemiological Weeks (EWs) 30 and 34 in the northeastern State of Monagas in the municipalities of Bolivar (with two cases) and Maturín (with one). This region is predominantly wooded and also includes some cocoa plantations. For this year, the total number of reported cases in Venezuela so far is five, with the three cases in Monagas added to the two cases previously reported in the State of Mérida. The MSDS immediately intensified vaccination efforts in this area, which was already being vaccinated due to epizootics having been identified over the past few weeks. For the period between 1998 and 2004, vaccine coverage for Bolívar is 65% and for Maturín is 50.3%. Between 2002 and 2004, Venezuela has vaccinated approximately 1.9 million people in areas considered to be enzootic. The country’s goal for 2006 is to have vaccinated seven million people residing in high-risk cities and towns.

Source: Report to PAHO from the Ministry of Health and Social Development (Ministerio de Salud y Desarrollo Social / MSDS) of Venezuela.

New Draft of the International Health Regulations (IHRs) Now Available

The new draft of the International Health Regulations (IHRs), which incorporates the recommendations made at the Regional Consultation Meetings, is now available online via the above link to the WHO website.