Health

Understand the difference between zika, dengue and chikungunya

1/18/2017

Transparent image

Fabíola Sinimbú - Agência Brasil

The year 2017 began with 855 Brazilian cities in alert or risk of dengue fever, chikungunya and zika, according to the last Fast Index Survey for Aedes aegypti (LIRAa) of the Ministry of Health. With this scenario, already It is possible to point out a need to redouble the care of the nurses in the vector of these diseases, in order to prevent a growing number of cases.

According to data from the Ministry of Health, in the year 2016 the number of dengue cases remained stable when compared to the previous year. As of December 10, almost 1.5 million probable cases were registered throughout Brazil, compared to just over 1.6 million cases in the previous year.

Zika virus fever only entered the National List of Compulsory Notification of Diseases, Injuries and Public Health Events in February 2016, so there are no official data comparing with the year 2015, when the disease was first identified in Brazil . Since it began to be notified until the last bulletin was published in December 2016, almost 212,000 probable cases of Zika fever have been reported in the country.

The cases of chikungunya fever were the ones that grew the most during the last year, with an increase of about 620% compared to 2015. In 2016, there were just over 263,000 cases, compared to 36,000 in the previous year. According to Health Minister Ricardo Barros, the trend is for the number of cases of this disease to continue rising in 2017.

Although the vector is the same, Aedes aegypti, and the three diseases originate in the same continent, Africa; For the Oswaldo Cruz Foundation (Fiocruz), the difficulty of accurate diagnosis may represent a risk for patients. The problem occurs because the clinical signs caused by these viruses are also very similar, but the treatment is quite different.

Generally, all three diseases cause fever, headaches, joint pains, nausea and rash (rash or red patches on the body). However, there are some striking symptoms that differ them.

The differences between dengue, chikungunya and zika

Zika

Symptoms related to the Zika virus usually manifest in a mild manner and the patient may even be infected and do not present any symptoms (only one in four infected people has clinical manifestation of the disease). But a clinical sign that may appear as early as the first 24 hours and is considered a hallmark of the disease is skin rash and itching, that is, red patches on the skin that cause intense itching. There are also reports of patients who have difficulty sleeping because of the intensity of these itches.

Unlike dengue and chikungunya, the picture of fever caused by the Zika virus is usually lower and the pains in the joints lighter. The disease still causes conjunctival hyperemia (irritation that leaves the eyes red, but without secretion and without itching), muscle aches, headache and back pain.

Quite rarely, reports of death from zika are generally related to the worsening of the patient's state of health, already suffering from other diseases. In 2016, six deaths from Zika virus were confirmed in laboratories: four in Rio de Janeiro and two in Espírito Santo.

The disease is associated with neurological complications such as Guillain-Barré syndrome and the occurrence of microcephaly and cerebral malformation in neonates infected with the virus during pregnancy. In 2016, there were 16,864 probable cases of Zika-infected pregnant women, of which 10,769 were confirmed by clinical-epidemiological or laboratory criteria.

Of these, 10,574 cases of stillbirth, miscarriage or fetus with suspected microcephaly or central nervous system (CNS) suspicions were reported, of which 3,144 (29.7%) remain under investigation and 7,430 have already been investigated, of which 2,289 were confirmed And 5,141 discarded.

Cases of microcephaly in Brazil

(Click on the state to know how many cases of microcephaly were notified and confirmed in each unit of the federation, from November 8, 2015 to December 17, 2016)

Source: Ministry of Health

Chikungunya

The severe pains in the joints, also called arthralgia, are the main clinical manifestation of chikungunya. These pains can manifest in all joints, especially in the palms of the feet and hands, such as fingers, ankles and wrists. In some cases, the pain in the joints is so strong that it actually prevents movement and can last for months after the fever goes away.

Confirmation of the diagnosis is made from the clinical analysis of blood samples and the treatment against chikungunya fever is symptomatic, ie analgesics and antipyretics are indicated to alleviate the symptoms, always under medical supervision. Measures like drinking plenty of water and resting also help in recovery.

Anti-inflammatories and even physical therapy may be indicated to the patient if joint pain persists even after the fever has ceased.

Chikungunya is considered milder than dengue, and deaths occurring by its manifestation are very rare. Deaths, however, can occur due to complications in patients with pre-existing diseases. In 2016, six deaths were confirmed by chikungunya fever, three in the state of Bahia, the other three in the states of Sergipe, São Paulo and Pernambuco.

Dengue

The four dengue serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) cause the same symptoms, and it is not possible to distinguish them solely by the clinical picture. The main symptom of the disease is high fever accompanied by severe headaches (headache). Eye pain, fatigue and intense muscle and bone pain are also part of the classic dengue picture.

Another common symptom is the rash, predominantly reddish patches on the thorax and upper limbs, which momentarily disappear under the pressure of the hands. The rash usually arises from the third day of fever. Diarrhea, vomiting, coughing, and nasal congestion may also be present in the table and may commonly lead to confusion with other viruses.

The classic dengue picture lasts from 5 to 7 days, disappears spontaneously and the patient usually heals without sequelae.

In the case of hemorrhagic dengue, the situation becomes more complicated. The disease, which is more common in patients with a second episode of dengue, of a different serotype than the first, causes changes in blood clotting, diffuse inflammation of the blood vessels, and thrombocytopenia (platelet count decline). Due to platelet collapse and vessel inflammation, patients are prone to bleeding that does not cease spontaneously, intense and continuous abdominal pain, cold, clammy and clammy skin; Hypotension (shock); Lethargy and difficulty breathing (pleural or fluid leakage in the lungs).

Among the three diseases, dengue has been considered the most dangerous by the number of deaths. In 2016, 826 cases of severe dengue and 8,166 cases of dengue fever with alarm signs were confirmed; Of which 6.8% resulted in death, with a total of 609 confirmed deaths throughout the year. In the same period of 2015, 972 deaths were confirmed, representing a 4.3% proportion of severe cases or with alarm signals.

Edition: Amanda Cieglinski

Source: Agência Brasil

Our news is removed in full from our partners' websites. For this reason, we can not change the content of these even in cases of typos.

This article was translated by an automatic translation system, and was therefore not reviewed by people.