Arbovirus and COVID-19: The Need for the Big Picture

In June, Pan American Health Organization (PAHO) and WHO published the latest epidemiological update on dengue and other arboviruses. They say there were more than 16 million reported cases of arbovirus disease in the WHO region of the Americas during the first months of 2020 (epidemiological weeks 1 to 21). I will. Most of these (about 97%) were dengue fever, and the rest were Chikungunya (>2%) and Zika (<1%). This prevalence is much lower than what was reported at the same time in 2019. A major contributor to this overall decline was the significant reduction in cases of Chikungunya and Zika viruses, but also in cases of dengue.

Only a small percentage (0.2%) of all cases of dengue are classified as severe dengue, and the number of cases reported in these cases compared to the same period in 2019 compared to the whole case. It has decreased. Mostly in Brazil, most of the serious cases were reported in Honduras. Most reports of Chikungunya and Zika came from Brazil, making it the most populous county in the region. The size of these diseases in 2020 is smaller than the size in 2019, but it’s not trivial. Other years will have some comfort taken from the reduction in incidents, but the issue is uncertain given the ongoing COVID-19 pandemic.

Pandemics place a heavy burden on the health systems of Latin American countries and, therefore, also impact the government’s ability to treat individuals with arboviral diseases. In addition, the need to reallocate resources for a pandemic response put more pressure on public health programs addressing the arbovirus. In an epidemiological update, PAHO and WHO outline recommendations for Member States to promote the best possible use of resources, as there is likely to be a shift to a pandemic response. They recommend that the program aims to reduce infections and identify predictors of severe dengue at the primary care level. The purpose is to reduce hospitalization, an additional burden on hospitals already burdened with pandemics.

Outlook articles by Annlies Wilder-Smith and colleagues at about the same time as the PAHO and WHO updates. American Journal of Tropical Medicine and Hygiene We investigated the challenges that the COVID-19 pandemic poses globally in the control of dengue fever. They point out that the largest burden of dengue is in Southeast Asia (the WHO estimates that most of the global infectious diseases are about 390 million annually). So the concerns outlined by PAHO and WHO about South America are orders of magnitude greater in Southeast Asia. Wilder-Smith et al. also pointed to a surge in dengue cases in South America and some countries in Southeast Asia when the COVID-19 pandemic affected. The difficulty of distinguishing dengue from COVID-19 in the early stages of these diseases probably complicated the COVID-19 response because COVID-19 patients who were misdiagnosed as dengue were not isolated. Conversely, failure to recognize dengue fever may prevent early lifesaving hydration.

In connection with the arbovirus and COVID-19 considerations, there is concern that blood-sucking insects may be vectors for SARS-CoV-2 infection. In the case of mosquitoes, these fears have been envied by studies by Yang Jiang Fan and colleagues. From the beginning, they reveal that the story of transmission through this route is speculative and that WHO emphasizes “no information or evidence” of transmission via mosquitoes. But in this era of hard-line empiricism, they provide the first evidence to assess this possibility. They tried to infect Aedes aegypti, Aedes aegypti,and Culex pipiens Not successful with SARS-CoV-2. Without an infection step, the infection cannot proceed.

SARS-CoV-2 infection is entering the pandemic stage where it is considered along with other infections and the many ways in which they may interact. Besides arbovirus disease, there is concern about the upcoming Northern Hemisphere influenza season. These potential interactions underscore the importance of warnings about focusing efforts on tackling COVID-19, excluding all others. Perhaps once considered a resource allocation problem entirely, but to understand the COVID-19 pandemic and the factors that may form it in the future, we can factor other infections into the debate. Is essential.