Statistics and Epidemiology of Brazilian Spotted Fever in São Paulo, Brazil

Abstract

 Brazilian spotted fever (FMB) was first recognized in the state of São Paulo in 1929. After a silent period, it was possible to see the disease reemerge with laboratory confirmation of the first cases, occurring in Pedreira, in 1987, followed by registers of the disease in Campinas and in São João da Boa Vista, Piracicaba, Salto, Mogi das Cruzes, Santo André, São Bernardo, Diadema, Ribeirão Pires, Mauá and the capital of the state. In 2002, this disease was included in the compulsory notification list in the state of São Paulo, but reporting systems were only set up in 2007. During the period from 2003 to 2008, 240 cases of FMB were confirmed in the state, with 71 deaths and registering lethality levels varying from 21,9% to 40,0% during the same period. Epidemiologic investigation charts were analyzed for all confirmed cases according to the technique guidelines of the Epidemiologic Surveillance Center (2002), according to the following characteristics: sex, age, place in which the person was infected, clinical aspects, activity related to the infection. FMB occurred in 61 cities of the state of São Paulo, 23 of whitch located in the region of Campinas. The disease had higher frequency among males, in the age bracket over 10 years of age. Confirmation criteria were serologic for 69% of the cases. It was not possible to determine risk situation for 17,5% of the cases (higher percentages in the patients who died). It is possible to observe that exantema percentages were higher for the persons who were cured (43,5%). There was an increase in the number of cities with the transmission of the disease. It is necessary to confirm if an expansion of transmission areas is occurring or this is only an effect of a better case detection in areas in which the disease was previously unknown.