A Secretaria de Saúde confirmou na tarde deste terça (24) o primeiro caso de febre amarela em humano no estado. A confirmação acontece após resultado de exame feito na Fiocruz, no Rio de Janeiro. O paciente, um lavrador de 44 anos morador da área rural do município de Ibatiba, no Sul do Estado, começou a manifestar sintomas no dia 12 de janeiro e buscou atendimento num pronto-socorro do município com febre, dor no corpo e vômito. Ele está internado e apresentou melhora no quadro de saúde. Nessa segunda-feira (23), ele recebeu alta da Unidade de Tratamento Intensivo (UTI) e foi para a enfermaria.
O secretário de Estado da Saúde, Ricardo de Oliveira, ressaltou que a transmissão da doença, em todos os casos notificados, ocorreu na área de mata, e que até o momento não há confirmação de febre amarela em área urbana no Espírito Santo.
“O que é recomendado fazer para conter o avanço da doença nós estamos fazendo, que é a vacinação cautelar. A confirmação do caso de febre amarela em humano no Espírito Santo não muda a nossa estratégia, pois antes do resultado dos exames em macacos e em humanos já vínhamos adotando como medida de prevenção a vacinação cautelar, que foi adotada em 37 municípios, considerando a morte de macacos por suspeita de febre amarela em zona de mata dentro do Espírito Santo, além da proximidade geográfica entre esses municípios e a ligação que eles mantêm entre si e com a região capixaba que faz divisa com Minas Gerais por meio da faixa contínua de floresta”, detalhou Oliveira.
O secretário lembrou que, além da vacinação, outra forma de evitar que a febre amarela chegue à área urbana é combatendo o mosquito Aedes aegypti, transmissor da doença nas cidades. Oliveira pediu que todos ajudem, neste momento, intensificando a vistoria de suas casas a fim de eliminar focos de proliferação do mosquito. “Basta escolher um dia fixo e, toda semana, verificar se há locais propícios para proliferação do mosquito dentro de casa e no quintal”, orientou.
A Secretaria de Estado da Saúde (Sesa) recebeu 22 notificações de suspeita de febre amarela, sendo um caso confirmado e três óbitos sob investigação, com quadro indicativo também de leptospirose, febre maculosa, dengue e outras doenças com sintomas semelhantes. Os casos são de zona rural.
Vacina
A Sesa iniciou a vacinação cautelar em 37 municípios. A orientação é que vacinem primeiro quem mora na zona rural destes municípios e depois as pessoas que residem na área urbana. Para o restante do Estado, a recomendação de vacinação continua a mesma: apenas pessoas que vão viajar para regiões silvestres, rurais ou de mata localizadas em áreas de risco para febre amarela, inclusive nestes municípios do Espírito Santo que estão realizando a vacinação cautelar.
A Sesa solicitou ao Ministério da Saúde mais 1 milhão de doses da vacina contra a febre amarela para reforçar a vacinação nos 37 municípios da vacinação cautelar e para os que irão se deslocar para áreas de risco. A previsão é de que as primeiras 500 mil doses cheguem nesta quinta-feira (26).
Quem for viajar para áreas rurais, a Sesa orienta que utilize roupas que protejam contra picadas de insetos, como blusas de mangas compridas, calças e sapatos fechados, e que use repelente ou vacine-se com no mínimo 10 dias de antecedência se for a primeira dose.
Amostras
Até o dia 23 de janeiro, o Laboratório Central do Espírito Santo (Lacen-ES) recebeu 33 amostras de macacos. Até o momento, saíram os resultados de cinco amostras de macacos com febre amarela em Irupi, Colatina, Venda Nova do Imigrante e Laranja da Terra (02). E também até o dia 23 de janeiro, o Lacen recebeu 22 amostras coletadas de humanos com suspeita de febre amarela. Até o momento, um caso foi confirmado para febre amarela.
Febre amarela
Uma pessoa com febre amarela apresenta, nos primeiros dias, sintomas parecidos com os de uma gripe. Entretanto, esta é uma doença grave, que pode complicar e levar à morte. Os sintomas mais comuns são febre nos primeiros sete dias e mal-estar.
A febre amarela silvestre é transmitida pela picada de mosquitos Haemagogus e Sabethes, que vivem em matas e vegetações à beira dos rios. Quando o mosquito pica um macaco infectado, torna-se capaz de transmitir o vírus a outros macacos e ao homem. A forma silvestre da doença é endêmica nas regiões tropicais da África e das Américas.
Nas cidades, a doença é transmitida pelo mosquito Aedes aegypti, o mesmo vetor da dengue, da zika e da chikungunya. Pessoas que fazem ecoturismo ou que entram em matas por algum outro motivo correm o risco de serem picadas pelo mosquito Haemagogus infectado e contrair a doença. De volta à área urbana, essas pessoas podem ser picadas pelo Aedes aegypti, podendo dar início à reurbanização da doença. O último caso de febre amarela urbana no Brasil ocorreu no Acre em 1942.
Uma vez que a febre amarela no meio urbano é transmitida pelo mosquito Aedes aegypti, eliminar depósitos que possam acumular água é uma das medidas de prevenção. Por isso, é importante que a população escolha um dia fixo da semana para combater o mosquito em casa e, assim, impedir a proliferação do vetor eliminando seus criadouros.
Ações
A Secretaria de Estado da Saúde está monitorando a situação epidemiológica. Entre outras ações, está a criação do gabinete de monitoramento; reunião com especialistas; reunião com os prefeitos e secretários municipais de saúde dos municípios; reunião com área técnica da Imunização dos municípios; elaboração do Protocolo de Manejo Clínico; além de capacitações sobre manejo clínico da doença e sobre protocolos de indicação para vacinação.
Além disso, diferentes secretarias e órgãos do Governo do Estado estão atuando em parceria para enfrentar a situação da febre amarela no Espírito Santo.
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