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LECTURE #9 Pre-departure Lecture: Araçatuba and Jequitinhonha

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Collaborative Course on Infectious Diseases January 2008. LECTURE #9 Pre-departure Lecture: Araçatuba and Jequitinhonha. Jessé Alves and T a nia Chaves [email protected] [email protected] Harvard School of Public Health

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slide1

Collaborative Course on Infectious Diseases

January 2008

LECTURE #9

Pre-departure Lecture: Araçatuba and Jequitinhonha

Jessé Alves and Tania Chaves

[email protected]

[email protected]

Harvard School of Public Health

Faculdade de Ciências Médicas da Santa Casa de São Paulo

Brazil Studies Program, DRCLAS, Harvard University

objectives
Objectives
  • Assess the most prevalent health risks based on local epidemiology
  • Provide information about health and disease prevention based on travel medicine practices
basic travel medicine evaluation
Basic travel medicine evaluation
  • Who
    • Health history, previous immunization, allergy
  • Where
    • Detailed information about itinerary, accommodation
  • When
    • Amount of time prior to departure, season, duration of trip
  • Why
    • Reasons for travel (vacation, work, study)
vaccines
Vaccines
  • Required
    • Yellow fever
  • Routine
    • Updating missed doses and boosters
  • Recommended
    • Variable according to the trip and previous medical history (Hepatitis A, Typhoid fever, MMR, Rabies and Hepatitis B)
other pre travel recommendations
Other pre-travel recommendations
  • Protection against vector-borne diseases
    • Repellents
  • Risk from food and water (drinking and recreational activities)
    • How to eat and drink safely
      • Boiling, chemical disinfection, filters
    • Possible infections related to wading or swimming.
southeast
Southeast
  • Largest regional population (72,412,411)*
  • Most industrialized
  • São Paulo state is leader in health, social and educational development
  • Contrasts between different states and regions

* 2000 census

yellow fever shot why
Yellow fever shot. Why?
  • High morbidity and mortality
  • Recent changes in epidemiology
  • Epizootic transmission outside endemic area
  • Both Araçatuba and Jequitinhonha inside transition zone of transmission
  • Allow for the possibility of additional, unplanned travel
slide12

Yellow Fever

Epidemiological status in Brazil, 2001

Endemic area

12 states

Population:29,327,171

Transition area

7 states

Population: 17,892,237

YF-Free area

8 states

Population: 117,896,554

Source: FUNASA; adapted from Vasconcelos and cols., 2001

slide13

Human Yellow Fever areas

Minas Gerais 2001 / 2002 / 2003

Primate occurrence - 2002

Serro

Sabinópolis

Santa Vitória

Alvorada de Minas

Pitangui

Leandro-Ferreira

Municipalities with cases of FA 2001/2003

Municipalities with cases of FA 2001/2003 and epizootic transmission

Municipalities with cases of FA 2001/2003

Itaúna

Municipalities with cases of FA 2001/2003 and epizootic transmission

Divinópolis

Municipalities with cases of FA 2001/2003

Source: FUNASA

Area of epizootic transmission and yellow fever

slide15

Yellow fever - Brazil, 1990 - 2007*

Endemic area

Transition area

Safe area

Potencial risk area

* Initial data

Source: SVS/MS

slide17

Yellow Fever – epizootic transmission and human

Cases, Brazil 1999 - 2006

Source: SVS/MS

leishmaniasis
Leishmaniasis
  • Transmitted by insects
  • Cutaneous and visceral diseases
  • Most cases reported in the North
  • Predominantly rural transmission
  • Urban cases in the Southeast and Northeast
wild reservoir
Wild reservoir

Rattus rattus

Nectomys squamipes

Bolomys lasiurus

visceral leishmaniasis
Visceral Leishmaniasis

Deadliness of visceral leishmaniasis in Brazil, 1994 to 2004

Source: SVS/MS

schistosomiasis
Schistosomiasis
  • Aquired through contact with fresh water
  • Still prevalent in Minas Gerais, Bahia and other NE states
  • Cause of acute and chronic disease and complications like portal hypertension syndrome
slide34

Endemic Areas of Schistosomiasis in Minas Gerais

Concentrated Areas of Schistosomiasis in Minas Gerais

Source: SVS/DVE/SES/MG

fresh water exposure
Fresh water exposure

Women in Jequitinhonha river

chagas disease
Chagas disease
  • Vector-borne disease
  • High prevalence in Bahia, Minas Gerais, São Paulo, Goiás
  • Presently, low incidence among children and young adults
  • Changes in the epidemiology (food borne transmission)
chagas disease sero prevalence among students in minas gerais

Year

# Municipalities

Sample Size

Positive Samples

% Prevalence

Chagas disease sero-prevalence among students in Minas Gerais

Source: CCZ/DVE/SE/SES-MG

acute chagas disease food acquired 2007

State

Municipality

Cases

Deaths

Death rate

Transmission

Transmitted by

Acute Chagas disease, food acquired, 2007
snakes spiders etc
Snakes, spiders, etc.
  • Accidents are rare among travelers
  • Most cases are reported in farm land
  • Pay attention while walking in the country
slide48

Coefficient of annual occurance of snake incidents per 100,000 inhabitants, by region of Minas Gerais State, 2001 to 2005

Source: CCZ/DVE/SE/SES-MG

slide49

Per 100,000 inhabitants

* Partial data subject to change

Coefficient of annual occurance of poisonous animal incidents per 100,000 inhabitants, Minas Gerais state, 1986 to 2004*

Source: CCZ/DVE/SE/SES-MG

human plague in brazil 1980 to 2005
Human plague in Brazil, 1980 to 2005

Source: CDTV/CGDT/DEVEP/SVS/MS

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