News of a large dengue outbreak are starting to circulate on the Internet. PromedMail reported today that in addition to the 47 confirmed mortalities due to dengue in Rio de Janeiro since the start of the year, an additional 49 cases of death are suspected to be due to the disease. Bloomberg.com also reports that 2053 dengue cases have been reported on a single day (March 20, 2008), which is much higher (cc. 84) cases per hour than was previously reported (51 cases of dengue per hour). This outbreak is very alarming, and surely overwhelms the public health infrastructure of the city. In the same report, Edmilson Migovski, a professor of infectious diseases at the Federal University of Rio de Janeiro is quoted saying that part of the reason of this large outbreak is that the 'virus is becoming more virulent'. Although I haven't seen any report of any dengue serotypes evolving higher virulence, Prof. Migovski might have meant that DHF/DSS is occuring due to pre-existing herd immunity to heterologous serotypes in the population. It would be interesting to know what is the dominant serotype of this outbreak. The Asian variant of DEN-2 is known to cause more serious disease as well as DHF/DSS.
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