Brazil Battles Severe Dengue
Fever Outbreak In Rio
By Tracey Ober
RIO DE JANEIRO (Reuters) - Brazilian authorities said Wednesday they were struggling to curb an outbreak of dengue fever that was at emergency levels in the southeast and racing through the beach resort city of Rio de Janeiro. Rio residents were reporting new cases of the mosquito-borne viral infection hourly, with a 10 percent daily increase in the total number of sick, officials said.
``We are living in an epidemic here,'' Rio de Janeiro epidemiology consultant Meri Baram told Reuters. ``It's a natural result of the conditions of the city.'' Dengue, which is spread by mosquitoes breeding in stagnant pools of water, can cause mild to high fever, aches and, in rare cases, deadly internal bleeding.
Baram said general ignorance about dengue and slow national response to the outbreak had hampered efforts to control it. Some 40 percent of Rio residents had turned away city health inspectors going from house to house to check for hazardous practices, she said.
The stocks of insecticides needed to spray houses and kill the adult mosquitoes had also been held up, but central government officials said there were now plenty of supplies. Brazil's new Health Minister Jose Serra, who took office Tuesday, raced to Rio Wednesday and said he was mounting an all-out effort to quell the disease.
``It's now crucial that we coordinate all efforts to fight this disease,'' Serra told reporters after meeting Rio de Janeiro state and local health officials. He said the central government was providing 11.4 million reais (about $10 million) to the state of Rio de Janeiro and would bring in army troops to help emergency efforts to kill the mosquitoes.
``We will provide every resource that is needed,'' Serra said. ``The state has an essential role, but it's very important that the population eliminate piles of garbage, plant pots, and other places that collect water that allow it to grow.'' Officials from the Pan American Health Organization (PAHO) said they were keeping a close watch on the most recent outbreak of dengue, which had been epidemic in Brazil in 1986 after having been virtually eradicated earlier this century. ``We are definitely concerned,'' Roberto Chuit, PAHO regional adviser on communicable disease, said in a telephone interview. ``The mosquitoes are growing up and people are getting sick.''
PAHO said the dengue-carrying Aedes Aegypti mosquito had reinfested some urban areas across Latin America and the Caribbean after surveillance programs were relaxed, and were now nearly impossible to rid again.
``There are now many more houses, there is more travel between urban centers within and among countries, and there are more disposable containers per household than ever before,'' PAHO said in a report. Officials in the state of Rio de Janeiro were becoming increasingly alarmed by the growing number of potentially fatal cases being reported, 104 out of a total 5,000 in the first three months this year.
There were 15 cases of hemorrhaging dengue out of 1,700 reported in the whole of 1997. ``While the number of cases in Rio does not seem that great, it's important because it's a big city and it has more of the hemorrhage cases,'' Rosangela Bello, Rio de Janeiro state health secretary, told reporters.
The largest outbreak of the milder form of dengue was in the Minas Gerais state with some 30,000 cases, followed by Espirito Santo with 25,000 victims to date in 1998.

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