Introduction Ae. aegypti, the commonest cause of Dengue fever in the world, was re-introduced to Brazil in the latter half of the 1970s. Favourable environmental conditions facilitated unchecked territorial expansion of this vector. This study describes the changing epidemiology of Dengue in Brazil 25 years after it re-emerged, exploring the main determinants of disease and outlining the implications for control.
Methods This study analysed serial case reports registered in Brazil since1986, describing the changing incidence and spatial distribution of Dengue.
Results Epidemic waves followed the emergence of each serotype (DENV 1–3), characterised by an increasing incidence (from 64.6 per 100 000 in 1987 to 475.3 per 100 000 in 2010) and severity of disease resulting in high case-fatality (14 896 cases and 1212 deaths). In 2007, an important and sudden change in the age of individuals affected by dengue haemorrhagic fever was observed, with an increasing number of children affected.
Conclusion A change in the age distribution of incident cases must be due to the sequence of circulating serotypes of dengue virus in the population conferring different levels of herd immunity in different age groups. Dengue is a serious public health problem in Brazil. Difficulties controlling the vector in all countries highlights the need for the international scientific community to renew efforts to generate knowledge, allowing improvement and progress in the development of new tools and strategies for dengue prevention.
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