Dengue Rapidly Spreading in Brazil:

Tips to Enjoy a Dengue-Free Carnival

January 2024, updated after my husband joined the Dengue club

Dengue fever, a mosquito-borne viral infection, continues to pose a significant public health threat in many parts of the world. Characterized by flu-like symptoms and potential severe complications, dengue has become a global concern, affecting millions of people each year. According to the news, Brazil is now facing a pandemic of illnesses spread by the Aedes aegypti mosquito, which transmits Chikungunya, Zika, and Dengue diseases.

Last week started as a typical Saturday. After enduring several cold and rainy days (freezing 22 °C :D), and finally recovering from a cold while confined to an apartment with a dog and a baby, we were eager to visit Grandma, who lives in a nearby house with a pool 20 minutes away.

My son was looking forward to his set of toys and bikes at Grandma, relishing the freedom to run on the street, playing with cats, picking jabuticaba from a tree, and bringing his youthful energy to the elder members of our family. At 9 am, on the verge of getting into the car, Auntie Tita sent a message on our obligatory family WhatsApp group, saying, "Dan, please don't come here today; your mom is still sleeping, and she feels unwell."

Exchanging glances, we realized something was amiss since she hadn't been awake since 4 am, diligently cleaning around the house as she usually did every day. We promptly called her, and she lamented about joint pain, backache, eye discomfort, headache, nausea, and a temperature above 38 °C.

Our aunts advised us to stay at home, assuring us that they would take care of their sister. Consequently, we altered our plans and returned home.

However, the next day, another aunt began to complain about the same problems. She simply wanted to lie down and rest as much as possible and wasn't even willing to talk with me. She hung up the phone as soon as she provided enough information for my husband. Being a medic, she had already speculated that she might have been bitten by infected mosquitoes that had proliferated massively in their area due to recent heavy rains across the country, primarily in the south – Santa Catarina, Rio Grande de Sul, or in our region, the seaside between São Paulo and Rio de Janeiro.

Now, it has been more than 10 days, and they are feeling better, but they are still recuperating in bed. We haven't seen them in person for quite a while; hopefully, we will be able to visit them this weekend. However, what caught my attention was a warning from my embassy and reports of Dengue cases that made me shiver. Due to the climate changes caused by El Niño, there have been intermittent rainfall and high summer temperatures, creating favourable conditions for disease-carrying mosquitoes to multiply.

In January, the number of dengue cases in Brazil surged to three times the amount recorded in the same period last year, with the country reporting 217,841 probable cases of the disease. Fifteen deaths from dengue have been confirmed, while 149 are under investigation. Data from the Ministry of Health reveal an incidence rate of 107.1 cases per 100,000 inhabitants and a fatality rate of 0.9 percent. The state of Minas Gerais leads in reported cases, followed by São Paulo, the Federal District, and Paraná. (agenciabrasil.ebc.com.br)

Fortunately, my family is experiencing a milder form of dengue. However, in some instances, dengue can progress to a severe and potentially life-threatening condition known as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), characterised by severe bleeding, organ failure, and shock.

I hear stories about a country-mate in Bali, who has been fighting the severe type of Dengue, while my husband starts to complain about a high temperature, feeling sick, and I am sending him to a doctor to do a test. The same my Slovak friend in Rio writes me a messages that he did not sleep due to the itchy body and high temperature. I feel specially aware of the situation and while sending my son to the kindergarten school today, I put extra layer of repellent on his body.

Husband's blood tests indicates that he is having dengue and doctor starts to treat him with following medicine - she prescribes pills for pain and temperature (important NOT to take Ibuprofen type, due to blood reaction), pills for vomiting and nausea, antihistamines for itchy body and tell him to hydrate and rest. 

I call the group of moms here in Caraguatatuba and search for information about the vaccines here in Brazil.

Currently, there are two tetravalent attenuated virus vaccines available in the world. Dengvaxia, applied in three doses, is licensed in several countries and recommended for people between 9 and 45 years old. However, individuals not previously exposed to the virus are at increased risk of developing severe dengue fever after vaccination. The World Health Organization recommends the use of Dengvaxia only in people who have had contact with the virus or, if screening is not available, in endemic areas (with seroprevalence – which is the proportion of cases of infection – of at least 80% at 9 years old). The tetravalent Qdenga received approval in Indonesia and the European Union. In Brazil, the formulation approved by Anvisa in 2023 must be applied in two doses and is recommended for people between 4 and 60 years old. Recently, the Ministry of Health announced its incorporation into the National Immunization Program (PNI) from 2024. Brazil is waiting for approval of the vaccine produced by Butantan that has advantages over the others. “The age distribution that can be vaccinated is wider - it starts in children as young as two years of age. (jornal.usp.br)

It's just one week before Carnival, and many of you may be traveling to Brazil for the world's biggest party. I'm not trying to scare you into canceling your trip—absolutely not. I will be performing with Unidos da Tijuca on Sunday at the Sambadrome in Rio de Janeiro, and I'm excited to be part of the Carnival madness too! Instead, I urge you to be more cautious, especially with yourself. Here are some tips:

• Buy your health insurance before coming to Brazil - state hospitals will never refuse you, they are even for free, but you can get better and faster treatments in private clinics or hospitals. You really don't want to get tired with amount of people around you at the hospital, while feeling ill. 

• It will be hot and sweaty; therefore, long-sleeved t-shirts and trousers might be impractical. However, if possible, opt for light colors over dark ones, as mosquitoes are attracted to dark hues.

• Use repellents—Brazil has numerous pharmacy chains and drugstores where repellents are available. Our family prefers the brand called Exposis, which contains picaridin, or others with DEET. They cost around 15 Euro.

• Consider purchasing an electric tennis racket killer. It's a funny yet useful way to exterminate blood-sucking intruders inside your room.

• Avoid staying in forests, jungles, shadows, ponds, or close to water,especially during early mornings and sunset. Mosquitoes are usually resting during the hot, sunny day and become more active during the evening hunt.

Welcome to Brazil and hope you will enjoy street Blocos or vivid performances at Sambadrome.

Feel free to follow my stories from Carnival via INSTAGRAM @mamainbrazil