For several years now, dengue has been present in Argentina, especially at the end of summer and autumn, with increasing epidemic peaks. In 2009, for example, there were 27,681 cases; in 2016, 41,276 cases; in 2020, 58,452 cases, and in 2023, 133,344 cases until epidemiological week 47, according to data from the National Epidemiological Bulletin N°680/23.
Dengue is a viral infection transmitted by the bite of infected female mosquitoes of Aedes aegypti, and also by Aedes albopictus. It adapted to the cold and the altitude, and in our country it has been found from the north to the center of Buenos Aires, La Pampa, Mendoza, San Juan, Neuquén and Río Negro.
Mosquitoes live near our houses. Any container capable of accumulating water can become a breeding ground (such as vases, flower pot holders, and car covers). Of the four dengue serotypes, DEN1 and DEN2 predominantly circulated this year. Only in one neighborhood of Tucumán did DEN3 circulate.
The most common signs and symptoms among the reported cases were fever, headache, myalgia, arthralgia, and retroocular pain, followed by nausea, abdominal pain, vomiting, and diarrhea. To date, 66 cases of deaths have been reported and in 36 the serotype involved could be identified: 27 corresponded to the DENV-2 serotype (75%) and 9 to the DENV-1 serotype (25%).
The Integrated Management Strategy (EGI) for the Prevention and Control of Dengue of the Pan American Health Organization includes epidemiological surveillance, vector and environmental control, patient care, laboratory and vaccines. Recently, a new tetravalent recombinant DNA vaccine against dengue (Qdenga) was approved by Anmat that contains genes for the specific surface proteins of each serotype, inserted into the skeleton of dengue type 2.
The vaccine is indicated for the prevention of dengue in people 4 years of age and older in a dose of 0.5 ml in a two-dose schedule (0 and 3 months), regardless of previous serological status, by subcutaneous injection preferably on the upper arm.
On the other hand, it is contraindicated in the following situations: hypersensitivity to the active ingredients or to any of the excipients or hypersensitivity to a previous dose of Qdenga; people with congenital or acquired immunodeficiencies, including immunosuppressive treatments such as chemotherapy or high doses of systemic corticosteroids within 4 weeks before vaccination, as with other live attenuated vaccines; people with symptomatic HIV infection or with asymptomatic HIV infection when accompanied by evidence of impaired immune function; pregnant or breastfeeding women.
This vaccine gives us one more tool to combat dengue. In research studies, it showed an efficacy of 90.4% in preventing hospitalization due to dengue and 85.9% against dengue hemorrhagic fever, although it varied according to serotypes. Children over 4 years of age and adults who live in areas with risk of transmission, with or without previous infection, and travelers to endemic areas should be considered for indication, taking into account the destination, circulating serotypes, season of the year, time of stay and characteristics of the traveler (higher risk in those who visit family and friends). Remember that to complete the 2-dose schedule in order to achieve adequate immunization prior to the trip, we must consult preferably 3 months before.
It is important to note that the vaccine alone is not enough. The problem is the mosquito, so we must continue with the control and elimination of breeding sites, avoid their bites and use vector isolation methods.
It is an action that is within our reach and we can all do it.
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2023-12-15 04:00:00
#vaccine #tool #combat #dengue #Tribuno
