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Emerging Arboviruses and Public Health Challenges in Brazil

Monday, 5th of September 2016

Emerging Arboviruses and Public Health Challenges in Brazil

Best viewed at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4936892/

Rev Saude Publica. 2016; 50: 36.

Published online 2016 Jun 17. doi:  10.1590/S1518-8787.2016050006791

Emerging arboviruses and public health challenges in Brazil

Tamara Nunes Lima-Camara

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Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country.

Keywords: Arbovirus Infections, epidemiology; Communicable Diseases, Emerging, prevention & control; Insect Vectors; Public Health

 

Infectious diseases have some peculiarities that distinguish them from other human diseases, such as the unpredictable and explosive character on a global level, transmissibility, close relationship with both the environment and human behavior, and the ability to be prevented and eradicated 10 . Most of the pathogens responsible for human infectious diseases have zoonotic origin, i.e., they are kept in nature in cycles involving one vector and one wild animal (e.g., monkey or bird). However, due to anthropogenic actions associated mainly with economic activities, many insect vectors, such as mosquitoes, have become synanthropic, favoring the transmission of pathogens to humans 20 . Thus, over the last 10 years, we have seen the emergence of some diseases transmitted by mosquitoes, especially arboviruses such as Chikungunya, West Nile, and Zika virus, in different countries of the Americas (Figure A and ​andBB).

In addition to the interference and modification of ecosystems by human action, other factors are related to the emergence of arboviruses in those countries, such as disordered urban growth and processes of globalization and expansion of international exchange, as well as climatic changes 16 . The population moves voluntarily for work, study or leisure, or involuntarily, as refugees, after a natural disaster or during a war in their country. These population movements increase the risk of travellers to carry pathogens not yet detected in other areas, or even new serotypes or strains more resistant to a particular virus already known, causing the emergence or reemergence of a disease 1 .

Global warming is also an important factor in the transmission dynamics of pathogens to humans. Global temperature increase affects the mosquito vectors by reducing the development time of the larvae and, thus, increasing rapidly the population of adults. It also decreases the extrinsic incubation period, i.e., the time for the virus to reach the mosquito´s salivary gland, making it suitable to transmit this etiologic agent 11 . Additionally, studies indicate that global warming may expand the distribution of diseases involving vectors, both in altitude and latitude 9 . Although tropical countries present positive social, environmental, and climatic conditions for transmission of new infectious diseases, the circulation of some arboviruses is also being observed in some temperate climate countries.

The aim of this comment was to discuss the recent entry of the arboviruses Chikungunya (CHIKV), West Nile (WNV), and Zikavirus (ZIKV) in Brazil, focusing on the challenges for the Country´s public health.