Marli B. M. de Albuquerque Navarro

Emerging and reemerging diseases in Brazil: data of a recent history of risks and uncertainties

This article discusses the emergence and reemergence of infectious diseases on the basis of a review of the literature. It shows the critical situations faced worldwide and in special Brazils susceptible position due to its complexity, mostly represented by the mega-biodiversity of the country and its socio-economic problems directly affecting public health. It approaches the discussions around the issue with emphasis to the recommended investments in the health sector, directed to surveillance and to strengthening the epidemiological, laboratorial and clinical bases and centered on preventive and control measures in the affected areas including Biosafety.

Health surveillance, biosafety and emergence and re-emergence of infectious diseases in Brazil.

The present paper presents compulsory notification data for infectious diseases and epidemiologic ones recorded at the Center for Strategic Information and Health Surveillance (CIEVS) for the period of March 2006 to April 2007. Data is presented in accordance with geographic distribution, time and risk classification of the etiologic agents found, according to Ministry of Health regulations. The importance of this epidemiologic surveillance system is presented, debating the main topics required for quality improvement and information analysis. It is concluded, from the analysis of epidemiologic events and their relation to risk management, that the compulsory notification system in Brazil is incomplete, irregular, delayed and, in a large percentage of cases, notification cannot be completed and the agent may not be identified. Quality of data varies from one region to another and from county to county within the same region. There is a high proportion of cases in which the etiologic agent is unknown and, in such cases, a high lethality is expected, establishing a high risk exposure condition for those health professionals involved in health surveillance. From these data, the study points out the need to improve the surveillance system and strengthens the idea of building maximum containment laboratories.

Forum on Science and Health Training Program for Neglected and Re- Emerging Diseases

This paper analyzes the impact of initiatives toward raising awareness, refreshing and training by organizing and conducting forums and training courses aimed at health care professionals and community leaders who work in some cities of Rio de Janeiro (extending that initiative to a city in Minas Gerais). It addresses the topic of “neglected and reemerging diseases”, which has been previously deemed of interest to interlocutors involved in that proposal, especially representatives of municipal health secretariats and civil associations of a communal nature. It should be noted that thematic contents and methodological and pedagogical strategies value objective communication that is easy to understand, without compromising scientific quality. Another aim was to expand scientific information as support to amplify communication with the government in order to help develop public policies, which translate as healthcare actions targeting neglected diseases. Our conclusion is that it is vital for healthcare professionals, community leaders and government representatives to take part in such events in order to discuss and develop collective proposals based on qualified information about the identified themes as local health priorities to minimize the impact and progress of those diseases.

Hospital seguro frente aos desastres: uma reflexão sobre biossegurança e arquitetura

One of the biggest challenges in todays society is facing adversity caused by disasters. Health facilities, especially hospitals, are considered essential in these situations. This article discusses the principles of architectural design of hospitals safe from disasters, as proposed by the World Health Organization and the Pan American Health Organization. Designing a safe hospital requires multidisciplinary efforts, involving administrators, architects, engineers, physicians, and nurses. The planning of each hospital demands the analysis of specific risks and safety concerns. The concept of biosafety should also be addressed in planning safe hospitals. The balance between architectural aspects and biosafety provides an understanding of work-associated risks, facilitating the adequate planning of spaces to support response actions to emergencies. In short, the planning of a safe hospital requires the synthesis of various types of expertise, including those relating to biosafety and architecture. These principles should support the appraisal of safe hospitals and architectural planning with a focus on preparing facilities to function at full capacity even in the face of adverse situations.

Febre maculosa no Brasil: estudo da mortalidade para a vigilância epidemiológica

Brazilian Spotted Fever is an infectious disease, typically characterized by mild to severe fever that if not properly treated, may reach a lethality rate of 85%. Brazilian Spotted Fever is caused by Rickettsia rickettsii that is transmitted through tick’s saliva. In Brazil, the most important vector is the Amblyomma cajennense. This study discusses the number of deaths due to infection by Rickettsia in Brazil, projecting the needs for knowledge expansion and dissemination on the possible occurrence of Brazilian Spotted Fever; and discusses the symptoms, differential diagnosis and epidemiological data. The methodology consisted in identifying the deaths by Rickettsia in Brazil, from 2005 to 2010, using the Mortality Information System. Seventy five cases were studied. There was a concentration of deaths in the southeast and south of the country, and a lethality rate of 24.8%. The results will help to raise awareness among professionals, and will help to understand the importance of combining clinical, epidemiological and laboratory data to facilitate recognition of the disease and early treatment.

A RELAÇÃO HOMEM-NATUREZA E A PERSPECTIVA HISTÓRICA E CULTURAL DA RELEVÂNCIA DO FATOR CLIMÁTICO NO CONTEXTO DAS DOENÇAS

Esta reflexão apresenta algumas questões relativas à saúde e meio ambiente, uma vez que a ocorrência de doenças ligadas às condições climáticas vem demandando novas formulações nas políticas de saúde. Entre as principais questões apontadas, destaca-se a pressão política e sua relação com o processo decisório relacionado ao fenômeno das mudanças climáticas em termos globais e seu impacto sobre a saúde humana e ambiental. Considerando o impacto humano, destaca-se a questão da Saúde Pública, abrangendo os aspectos socioeconômicos, tais como a capacidade produtiva do país e possíveis impactos de desastres naturais ou fenômenos metereológicos que estabelecem preocupações com a saúde das populações.

Bioterrorismo, riscos biológicos e as medidas de biossegurança aplicáveis ao Brasil

A historia registra o uso de patogenos como potencializadores de recursos belicos. Considerando os eventos belicos da contemporaneidade, observa-se a formulacao de projetos voltados para elaboracao tecnologica sofisticada. Nessa categoria se incluem as armas biologicas, vinculadas aos programas de carater coercitivo conhecidos como guerras biologicas, que pertencem a logica da ameaca assimetrica, nao definindo territorio e gerando repercussoes economicas, politicas e sociopsicologicas devastadoras. Esses eventos demandam a elaboracao de planos que contemplem o risco, incluindo a capacitacao de recursos humanos, investimentos na identificacao de materiais empregados em bioterrorismo e tambem em equipamentos de seguranca. Objetiva-se neste artigo discutir a associacao entre patogenos, seu potencial de risco e eficacia para o emprego em estrategias de bioterrorismo, destacando as medidas de biosseguranca necessarias. Utiliza-se a revisao integrativa para a construcao de analises de contextos de risco. O levantamento bibliografico compreendeu o periodo 1990/2010, nas bases de dados ISI, LILACS, SciELO e PubMed. Demonstra-se a importância do envolvimento e da capacitacao dos profissionais na identificacao de agentes biologicos com potencial de risco, considerando que o bioterrorismo pode resultar na sobrecarga dos sistemas de saude. A biosseguranca orienta os procedimentos que devem ser adotados para a contencao dos patogenos, visando ao controle dos riscos.

Inovação tecnológica e as questões reflexivas do campo da biossegurança

O artigo reflete sobre os processos construtores de novas tecnologias advindas da dinâmica da producao de novos conhecimentos cientificos, que envolvem demandas de mercado, associadas aos interesses industriais, ao consumo e as expectativas sociais diante das inovacoes tecnologicas, o que impoe a comunidade cientifica e academica, novos desafios na elaboracao de saberes, principalmente, naqueles apoiados na perspectiva da complexidade com a concorrencia de multiplas areas e campos de conhecimento, incluindo enfaticamente o da biosseguranca. Atraves dessa dinâmica analitica discute-se a essencialidade da biosseguranca e sua interface com as inovacoes tecnologicas e a bioetica que se estabelecem pelas vertentes da politica em beneficio das acoes preventivas, voltadas para promocao da qualidade de processos tecnologicos inovadores direcionados para a saude.

Biossegurança e sistemas de informação: a rede e o gerenciamento de risco

The present paper points out internets role within modern society, regarding the debate on the building of a society of risk. The wide possibilities of this tool as a processor for management and risk assessment and the importance of building a cognitive solidarization practice between the disciplines of Biosafety and Science Information have been addressed. Risk assessment shall also be carried out, whether by the organization of information or through quantitative and qualitative data.

Biossegurança e desastres: conceitos, prevenção, saúde pública e manejo de cadáveres

O artigo discute a complexidade dos desastres, realcando situacoes de risco e a essencialidade do suporte da Biosseguranca, uma vez que, em episodios com vitimas fatais, os procedimentos formulados por este campo devem ser adotados no manejo de cadaveres, sobretudo quando da ocorrencia de soterramento com busca de corpos. Contextualiza a magnitude dos desastres caracterizados pelas chuvas e suas consequencias (deslizamentos, soterramento), enfatizando o fenomeno do aquecimento global e as mudancas climaticas e seus impactos sobre as comunidades, em especial as mais pobres, valorizando a analise do conceito de vulnerabilidade a partir do cenario da urbanizacao, da degradacao do meio ambiente causada pelo manejo inadequado dos recursos naturais, da contaminacao ambiental, das politicas publicas ineficientes, sublinhando o baixo investimento em infraestrutura. Sublinha o conceito de desastre como fenomeno imprevisivel, subito e violento, que causa grande numero de mortos e destruicao. Enfatiza as problematicas sociais, sanitarias, juridicas e operacionais quando do registro de um numero elevado mortes ocorridas ao mesmo tempo ou em curto espaco de tempo. Traz para a analise a contribuicao da Biosseguranca como orientadora dos planos de emergencia voltados para os desastres, realcando o risco biologico e as medidas necessarias para o manejo de cadaveres.