Abstract

TUBOI, Suely Hiromi et al. Outbreak investigation of hemorragic febrile disease in Japeri and Queimados, Rio de Janeiro, 2000. Inf. Epidemiol. Sus [online]. 2001, vol.10, n.1, pp.43-47. ISSN 0104-1673.  http://dx.doi.org/10.5123/S0104-16732001000100005.

In June-September 2000, nine persons from a poor area north of Rio de Janeiro, Brazil, developed a febrile hemorrhagic illness and died. We conducted case finding to determine the outbreak size, and a case-control study to identify disease etiology and risk factors. A case-patient was defined as a resident of the affected area who sought medical care during June-September 6, 2000, presenting with fever, headache, and one or more of the following symptoms: myalgia, arthralgia, diarrhea, hemorrhagic manifestations, or jaundice. Forty-three persons met the case definition and were compared with eighty-six controls matched by area of residence and age group. Twenty-three (53.3%) were males with a median age of 19 years. In univariate analysis, contact with sewage (matched Odds Ratio [mOR]=2.5; p=0.02), contact with rats (mOR=3.0; p=0.006), contact with local creek (mOR=3.3; p=0.009), and mortality of household animals (mOR=2.7; p=0.04), were associated with development of the disease. In multivariate analysis, contact with rats (mOR=4.7; p= 0.03), and contact with local creek (mOR=4.8; 95%; p= 0.04) remained as independent risk factors. Immunohistochemical evaluation of tissue samples from one fatal case was positive for leptospirosis. Further laboratory testing for potential etiologies is pending. Based on the epidemiologic evidence provided by our investigation we recommended implementation of rodent extermination in the affected area, and education of residents to avoid contact with the local creek. Following implementation of these control measures, further cases were not reported. This investigation highlights the value of implementing public health recommendations based on results from epidemiologic investigations when laboratory testing is not immediately available

Keywords : Outbreak; Hemorrhagic Disease.

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