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Health Surveillance and Disease Prevention and Control / Communicable Diseases /
Epidemic Alert and Response
EID Updates

EID Updates:

Emerging and Reemerging Infectious Diseases, Region of the Americas

Vol. 5, No. 13 (4 December 2008)     |     Main Updates index

Febrile Hemorrhagic Syndrome in Brazil

On the first of December 2008, the Ministry of Health of Brazil reported the occurrence of a case of acute hemorrhagic febrile syndrome in a 53-year-old male from Johannesburg, South Africa, with onset of symptoms on 23 November. The patient was hospitalized on 28 November with as suspected case of nephrolithiasis and died on 2 December.

LThe main symptoms reported are described inTechnical Note 03/12/2008 issued on 3 December 2008 by the Ministry of Health, Secretary of Health Surveillance (MS/SVS) of Brazil (in Portuguese).

Clinical-epidemiological investigation of this case is being carried out by a multidisciplinary team led by the Secretariat of Health Surveillance. A differential diagnosis is being carried out for several agents related to hemorrhagic syndrome, such as arenavirus, rickettsiosis, leptospirosis, hantavirus, malaria, and dengue, among others. One of the diagnostic hypotheses being considered is that the patient could have been infected by the new arenavirus recently reported in Zambia and South Africa. Laboratory tests are considering all these diagnostic hypotheses, working in collaboration with a team of professionals from South Africa who are actively involved in the investigation.

Monitoring of the contacts identified in this case is being carried out. Other clinical cases have not been recorded to date.

The Pan American Health Organization is actively supporting the investigation of this case at both the level of its country office in Brazil and at its Regional headquarters.

Technical note: In view of the fact that one of the hypotheses being considered is that the case might be that of infection by the new arenavirus, we reiterate following the recommendation for continued monitoring of contacts as laid down in the WHO guidelines Interim Infection Control Recommendations for Care of Patients with Suspected or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever in document BDP/EPR/WHO[1] dated March 2008, which recommends checking body temperature twice a day. Should fever develop, the contact should be examined by a designated physician.

Source: Technical Note 03/12/2008 published on 3 December 2008 by the Ministry of Health, Secretariat of Health Surveillance (Ministério da Saúde, Secretaria de Vigilância Epidemiológica / MS/SVS) of Brazil (in Portuguese).