An update on the epidemiological situation of spotted fever in Brazil

 

Stefan Vilges de Oliveira^1 2 3, Jessica Noronha Guimarães¹, Guilherme Carneiro Reckziegel¹, Bidiah Mariano da Costa Neves⁴, Keline Medeiros de Araújo-Vilges², Lidsy Ximenes Fonseca¹, Fernanda Voietta Pinna¹, Simone Valéria Costa Pereira¹, Eduardo Pacheco de Caldas¹, Gilberto Salles Gazeta³, Rodrigo Gurgel-Gonçalves⁵

 

1 Secretariat of Health Surveillance, Brazilian Ministry of Health, Brasília, DF, Brazil.

2 Graduate Program in Tropical Medicine, University of Brasília, Brasília, DF, Brazil.

3 National Reference Laboratory of Vectors of Rickettsioses, Oswaldo Cruz foundation, Rio de Janeiro, RJ, Brazil.

4 Graduate Program in Infectious and Parasitic Diseases, School of Veterinary Medicine, University of Brasília, Brasília, DF, Brazil.

5 Laboratory of Medical Parasitology and Vector Biology, School of Medicine, University of Brasília, Brasília, DF, Brazil.

 

ABSTRACT

 

Background

Spotted fever is a tick-borne rickettsial disease. In Brazil, its notification to the Ministry of Health is compulsory. Since 2007, cases of spotted fever have been integrated to the Notifiable Diseases Information System, and epidemiological analyzes are part of the routines on surveillance programs.

 

Methods

This descriptive study updates epidemiological information on cases of spotted fever registered in Brazil between 2007 and 2015.

 

Results

In Brazil, 17,117 suspected cases of the disease were reported and 1,245 were confirmed in 12 states, mainly in São Paulo (550, 44.2 %) and Santa Catarina (276, 22.2 %). No geographic information was registered for 132 cases (10.6 %). Most of the infected people were men (70.9 %), mainly in rural areas (539, 43.3 %), who had contact with ticks (72.7 %). A higher number of suspected cases were registered between 2011 and 2015, but the number of confirmed cases and the incidence were relatively low. Moreover, 411 deaths were registered between 2007 and 2015, mainly in the southeastern region of the country, where the case-fatality rate was 55 %. Lack of proper filling of important fields of notification forms was also observed.

 

Conclusions

The results showed expansion of suspected cases of spotted fever and high case-fatality rates, which could be related to diagnostic difficulties and lack of prompt treatment. These factors may comprise limitations to the epidemiological surveillance system in Brazil, hence improvement of notification and investigation are crucial to reduce morbidity and mortality due to spotted fever in Brazil.

 

Key words: Rickettsial diseases; Epidemiology; Information system; Tick-borne disease

 

Funding

SVO received financial support from the Coordination for the Improvement of Higher Education Personnel (CAPES). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

 

Received: March 17, 2016.

Revised: July 19, 2016.

Accepted: August 22, 2016.

 

Correspondence: stefanbio@yahoo.com.br

 

Authors’ contributions

RGG, GSG and SVO conceived and designed the experiments. SVO and JNG performed the experiments. SVO, JNG, GCR, BMCN, KMAV, LXF, FVP, SVCP, EPC, GSG and RGG analyzed the data. SVO contributed materials/analysis tools. RGG, GSG and SVO wrote the manuscript. All authors read and approved the final manuscript.

 

Competing interests

The authors declare that they have no competing interests.

 

doi: 10.1186/s40409-016-0077-4