Announcement

**alert** · February 4, 2010, 12:45 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

And the ProMED moderator is likely right - here is a more recent article referring to this as "suspected dengue".

The fact that the "ill" family members were allowed to attend the funeral means that the authorities seem to be convinced that whatever this is isn't contagious, and also that the family members seem to be recovering.

http://www.redebomdia.com.br/Noticias/Dia-a-dia/11437/Dengue+chega+a+1.172+casos+e+Sucen+manda+forca-tarefa

Dengue reaches 1172 cases and municipal government sends task force
Tr?s s?o do tipo hemorr?gico; combate em Rio Preto apela para nebuliza??o Three are of the hemorrhagic type, fighting in Rio Preto calls for nebulization
anuncie! Advertise!

J?lio Cezar Garcia Julio Cezar Garcia
Ag?ncia BOM DIA Agency GOOD DAY

O agravamento do quadro da dengue em Rio Preto, que atingiu 1.172 casos s? este ano, levou a Sucen (Superintend?ncia de Controle de Endemias) a enviar uma for?a-tarefa a Rio Preto para uma a??o intensiva de nebuliza??o dos bairros com maior n?mero de casos da doen?a. The worsening of dengue in Rio Preto, which reached 1172 cases so far this year, led the municipal government (Superintendence for Endemic Disease Control) to send a task force to Black River for an action-intensive spraying of neighborhoods with the highest number of cases disease.

O n?mero de casos divulgado nesta segunda-feira pela Secretaria da Sa?de do munic?pio representa 91% do total do ano passado. The number of cases released on Monday by the Department of Health of the city represents 91% of the total last year. A m?dia ? de 36 casos por dia. The average is 36 cases per day.

A situa??o j? ? considerada como pr?-epid?mica pela Secretaria de Sa?de. S?o necess?rios 1,3 mil casos para caracterizar epidemia na cidade. The situation is already considered as pre-epidemic by the Department of Health are required 1.3 thousand cases to characterize the epidemic in the city.

A a??o de emerg?ncia da Sucen foi solicitada pelo prefeito Valdomiro Lopes (PSB), segundo o ?rg?o estadual. The action of emergency municipal government was requested by Mayor Lim Valdomiro (PSB), according to the state. Os bairros com maior n?mero de casos s?o o Parque Industrial, Anchieta, regi?o central, Jaguar?, Caic e Cristo-Rei. The neighborhoods with the highest number of cases are the Industrial Park, Anchieta, central, Jaguar?, CAIC and Christ the King.

A nebuliza??o contra o mosquito Aedes aegipty, transmissor da doen?a, ser? feita nas ruas e nas ?reas internas (quintais) das resid?ncias a partir de quinta-feira. Nebulization against aegipty Aedes mosquito, which transmits the disease, will be in the streets and in the interior areas (yards) from the home Thursday.

Do total de casos, tr?s s?o do tipo hemorr?gica (a forma mais grave da doen?a) e dois de dengue com complica??es. Of the cases, three are of the bleeding (the most severe form of the disease) and two of dengue complications. O restante ? do tipo cl?ssico. The rest is a classic.

A maior parte dos casos tem como v?timas pessoas entre 20 e 40 anos. Most cases have victims as people between 20 and 40 years. N?o h? registro de ?bitos neste ano. There is no record of deaths this year.
Mirassol?ndia Mirassol?ndia
A m?e, o padrasto ea irm? de Ang?lica Cristina de Alc?ntara, 16 anos, que morreu neste domingo com suspeita de dengue, est?o internados no Hospital de Base em Rio Preto. The mother, stepfather and sister Angelica Cristina Alcantara, 16, who died on Sunday with suspected dengue, are admitted to Base Hospital in Rio Preto.

Fabiana de Alc?ntara, 34, Edimar Ribeiro Mendes, 34, e J?lia Alc?ntara, 11, apresentaram sintomas da doen?a. Fabiana de Alcantara, 34, Edimar Ribeiro Mendes, 34, and Julia Alcantara, 11, showed symptoms of the disease. Ontem, eles foram liberados pelos m?dicos para acompanhar o enterro de Ang?lica. Yesterday, they were released by doctors to attend the funeral of Angelica.

No final da tarde, a fam?lia retornou ao hospital, onde ficar? em observa??o at? que os exames de sangue sejam conclu?dos. In the late afternoon, the family returned to the hospital where you will be monitored until blood tests are completed. A fam?lia mora no bairro Maca?bas, em Mirassol?ndia. The family lives in the neighborhood Maca?bas in Mirassol?ndia. Outras 18 pessoas que moram no mesmo local procuram atendimento m?dico com febre, dor de cabe?a e v?mito. A further 18 people living in the same place seek medical attention with fever, headache and vomiting.

**alert** · February 4, 2010, 12:50 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

I think we can throw a "- dengue suspected" onto the title of the thread. This story seems to have already gone silent for about two days, as all three articles above are from the 1st or 2nd.

http://www.redebomdia.com.br/Noticias/Dia-a-dia/11343/Garota+de+16+anos+morre+com+suspeita+de+dengue

Monday, February 01, 2010 - 07:01
Garota de 16 anos morre com suspeita de dengue Girl of 16 years dies of suspected dengue
Morte de adolecente de Mirassol?ndia deixa popula??o assustada Death of teenager leaves Mirassol?ndia frightened population
anuncie! Advertise!

Vin?cius Marques Vin?cius Marques
Ag?ncia BOM DIA Agency GOOD DAY

Ang?lica Cristina de Alc?ntara, 16 anos, morreu neste domingo com suspeita de dengue. Angelica Cristina Alcantara, 16, died on Sunday with suspected dengue. Ela morava em Mirassol?ncia. She lived in Mirassol?ncia. A garota reclamava de febre e mal-estar desde quinta-feira. The girl complained of fever and malaise since Thursday. Na sexta-feira, ela foi atendida, medicada e liberada no pronto-socorro da cidade. On Friday, she was treated, medicated and released the emergency room of the city. Na madrugada deste domingo, piorou e come?ou a vomitar. At dawn on Sunday, worsened and began to vomit.

Quando estava sendo transportada para o Hospital de Base de Rio Preto, ela teve de ser atendida em Mirassol porque teve parada card?aca. As she was being transported to the Base Hospital of Rio Preto, she had to be met in Mirassol because she had heart failure.

?N?o sabemos o que aconteceu. "We do not know what happened. Ela piorou muito, teve parada card?aca e respirat?ria?, afirmou Viviani Perp?tuo Garcia Fiamenghi, coordenadora de sa?de de Mirassol?ndia. She became much worse had cardiorespiratory arrest, "said Viviani Perpetual Fiamenghi Garcia, coordinator of health Mirassol?ndia.

Viviani afirmou que a morte na menina foi por volta das 11h20. Viviani said the death of the girl was around 11:20.

O corpo de Ang?lica foi levado para o HB, para passar por aut?psia. Angelica's body was taken for Hb to undergo autopsy. Segundo a assessoria do hospital, a aut?psia indica possibilidade de dengue. According to a spokesperson of the hospital, the autopsy indicates the possibility of dengue. Material foi encaminhado para o Instituto Adolfo Lutz. Material was sent to the Adolfo Lutz Institute. Resultado deve sair em 15 dias. Results must leave in 15 days.

Segundo familiares da adolescente, a irm?, o padastro ea m?e foram internados no HB e ficaram sob observa??o. Relatives said the teenager, sister, stepfather and mother were admitted to the HB and were under observation. Pelo menos 20 pessoas procuraram o pronto socorro de Mirassol?ndia com o mesmos sintomas. At least 20 people sought emergency relief Mirassol?ndia with the same symptoms.

?As pessoas da cidade est?o muito assustadas?, afirmou M?rcia Pereira da Silva, que estava chocada com a morte da sobrinha. "The townspeople are very afraid," said Marcia Pereira da Silva, who was shocked by the death of his niece. ?Ela tinha muitos sonhos, queria se casar. "She had many dreams, wanted to marry. Ia fazer 17 anos na quarta-feira. Would do 17 years on Wednesday.

**alert** · February 4, 2010, 12:56 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

http://translate.google.com/translate?hl=en&sl=pt&u=http://www.apj.inf.br/detalhe_noticia.php%3Fcodigo%3D12503&ei=RQlrS8GcBsHL8Qarx9mBBg&sa=X&oi=translate&ct=result&resnum=5&ved=0CEwQ7gEwBA&prev=/search%3Fq%3DMirassol%25C3%25A2ndia%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:w

Dress

Estudiosa, cheia de vida, alegre, e com muitos sonhos. Studious, lively, cheerful, and with many dreams. Assim a tia descreve a sobrinha. So the aunt describes her niece. ?Ela pretendia se casar no ano que vem. "She wanted to marry next year. O casal j? tinha comprado a casa e alguns m?veis?, relata Helena. The couple had bought the house and some furniture, "says Helena. A adolescente foi enterrada vestida de noiva. The teenager was buried in a wedding dress. Transtornado e se sentindo meio perdido, o noivo da adolescente, Sydnei Soares Pereira, 26 anos, conta que eles namoravam havia um ano e meio. Upset and feeling a bit lost, the groom's teenage Sydnei Soares Pereira, 26 years, says that they were dating for a year and a half. ?Pretend?amos nos casar. "We wanted to get married. O sonho dela era fazer Direito. Her dream was to make law. N?o sei o que vou fazer da minha vida daqui para frente?, disse. I do not know what I do with my life going forward, "he said.

Familiares informaram ainda que a irm? de 11 anos, o padrasto ea m?e da garota foram internados no Hospital de Base de Rio Preto com sintomas de dengue. Family also informed that the sister of 11 years, the stepfather and mother of the girl were admitted to Base Hospital of Rio Preto with symptoms of dengue. ?A m?e s? foi liberada para o vel?rio da filha?, disse Helena. "The mother was only released to the funeral of her daughter," said Helena. Segundo informa??es da assessoria de imprensa do hospital, os pacientes permanecem internados. According to the spokesperson for the hospital, patients remain hospitalized. O ?rg?o diz ainda que foram realizados todos os exames, o estado de sa?de ? est?vel e eles passam bem. The court also said that were performed all examinations, the state of health is stable and they are doing well.

Outro lado Furthermore

Diferentemente do que foi informado pela fam?lia, a respons?vel pela Coordenadoria de Sa?de de Mirassol?ndia, Viviani Garcia Fiamenghi, afirma que a adolescente teria ido ao centro de sa?de duas vezes antes de ser solicitada a transfer?ncia ao Hospital de Base, uma na quinta-feira ? noite e outra no domingo de madrugada. Unlike what was reported by the family, responsible for the Coordination of Health Mirassol?ndia, Viviani Fiamenghi Garcia said that the teenager had gone to the health center twice before being required to pass the Base Hospital, in a Thursday night and again on Sunday morning.

Ang?lica, segundo ela, teria apresentado sintomas de febre e v?mito na quinta-feira passada e teria sido medicada. Angelica, she said, would have shown symptoms of fever and vomiting on Thursday afternoon and was medicated. Na segunda vez, ela retornou ao Centro de Sa?de com os mesmos sintomas e, mais uma vez, foi medicada e liberada. The second time, she returned to the clinic with the same symptoms and, again, she was treated and released. ?A evolu??o dela foi muito r?pida. "The evolution of it was very fast. Quando retornou ao centro pela terceira vez, ela j? estava com queda de press?o e satura??o e pedimos a transfer?ncia imediata ao HB. When he returned to the center for the third time, she was with pressure drop and saturation and ask the immediate transfer to the HB. Por?m, o quadro piorou, ea m?dica que a acompanhava achou melhor parar em Mirassol, onde ela recebeu os ?ltimos atendimentos.? However, the condition worsened, and the accompanying medical thought it best to stop in Mirassol, where she received the last calls. "

Depois da morte de Ang?lica, segundo a coordenadora do Centro de Sa?de de Mirassol?ndia, outras oito pessoas deram entrada na unidade com os mesmos sintomas da adolescente. After the death of Angelica, according to the coordinator of the Health Center Mirassol?ndia, eight others were admitted to the unit with the same symptoms as a teenager. Todos passaram por avalia??o m?dica e est?o sendo tratados com Paracetamol, at? chegar os resultados dos exames. All had a medical evaluation and are being treated with paracetamol, until the test results. ?Foi feita coleta de sorologia para o NS1, que ? o teste mais r?pido.? At? agora, no munic?pio, apenas um caso de dengue foi confirmado neste ano. "Were collected in serology NS1, which is the test faster." So far, the city, only one case of dengue was confirmed this year. Em 2009, o munic?pio confirmou um caso da doen?a. In 2009, the council confirmed a case of the disease.

**alert** · February 4, 2010, 12:58 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

All the mention here of patients in "fourth" should read in their hospital room - translator error.

https://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/41223.html&ei=RQlrS8GcBsHL8Qarx9mBBg&sa=X&oi=translate&ct=result&resnum=9&ved=0CFoQ7gEwCA&prev=/search?q%3DMirassol%25C3%25A2ndia%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:w

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/41223.html&ei=RQlrS8GcBsHL8Qarx9mBBg&sa=X&oi=translate&ct=result&resnum=9&ved=0CFoQ7gEwCA&prev=/search%3Fq%3DMirassol%25C3%25A2ndia%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:w

The Center for Epidemiological Surveillance of HB notified the Health Department of the City and the Institute Adolfo Lutz the following cases of suspected Dengue:
Caso 1: Um homem de 21 anos, morador de Rio Preto, foi internado dia 02 de fevereiro. Case 1: A man of 21 years, a resident of Black River, was hospitalized on 02 February. Ele est? no quarto, est?vel. He is the fourth stable.

Continuam internados: Still hospitalized:

Paciente 1: Uma crian?a de 11 anos, do sexo feminino, morador de Mirassol?ndia, foi internada dia 31 de janeiro. Patient 1: A child of 11 years, female, resident of Mirassol?ndia, was hospitalized on January 31. Ela est? no quarto e passa bem. She is the fourth and well.
Paciente 2: Uma mulher de 34 anos, moradora de Mirassol?ndia, foi internada dia 31 de janeiro. Patient 2: A 34 year old woman, a resident of Mirassol?ndia, was hospitalized on January 31. Ela est? no quarto e passa bem. She is the fourth and well.
Paciente 3: Uma mulher de 33 anos, moradora de Rio Preto, foi internada dia 31 de janeiro. Patient 3: A woman of 33 years, resident of Black River, was hospitalized on January 31. Ela est? no quarto, com cefal?ia, mas passa bem. She is in fourth, with headache, but is doing well.
Paciente 4: Uma mulher de 74 anos, moradora de Rio Preto, foi internada dia 31 de janeiro. Patient 4: A woman of 74 years, resident of Black River, was hospitalized on January 31. Ela est? no quarto, est?vel. She is the fourth stable.

Paciente 5: Um homem de 45 anos, morador de Uchoa, foi notificado hoje, 02 de fevereiro. Patient 5: A man of 45, a resident of Uchoa, was notified today, 02 February. Ele est? na UTI, estado regular, respirando com ajuda de aparelhos. He is in ICU, steady state, with the aid of breathing apparatus.

ALTA M?DICA HIGH MEDICAL
Paciente 1: Um homem de 31 anos, morador de Mirassol?ndia. Patient 1: A man of 31 years, a resident of Mirassol?ndia.

Lu?s Fernando Neves Luis Fernando Neves
Assessoria de Imprensa HB Press HB
Interm?dia Assessoria de Comunica??o Intermedia Communications Department
17-32015000 ramal: 1496 17-32015000 ext 1496

**alert** · February 4, 2010, 01:21 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

http://hisz.rsoe.hu/alertmap/woalert_read.php?glide=EH-20100204-24801-BRA&cat=dis&lang=eng

The same text as the post that started this thread, but RSOE EDIS has made the error of mistakenly listing 20 dead. There is only one death. The original article indicated that 20 were ill, but future articles seem to have lowered that number considerably (and if you note, the article did not say 20 were hospitalized - it said 20 received first aid).

The only other ones that the articles seem to indicate are hospitalized from Mirassolandia are the 11 year old sister, the 31 year old stepfather, and the 34 year old mother. It looks like all four (including the deceased teen) took ill at about the same time, which is consistent with dengue, as it does not spread person to person, but could produce a cluster like this due to exposure to the same infected mosquitos.

**alert** · February 4, 2010, 02:06 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

This outbreak below is from two years ago, but is from the SAME STATE in Brazil, and has enough similarities to the current to post here. The outbreak from two years ago may have been due to a novel picornavirus, which did apparently transmit person-to-person, with 2 deaths in five cases. There might be some slight symptomatic differences (I don't see headache or vomitting on the symptoms list from two years ago, and there is no sign of ear issues this time - and those cases were considered fatalities due to "atypical pneumonia", whereas the terminal event this time is "heart failure"), but symptomatic descriptions in the media can be crude or incorrect.

Also, keep in mind that Pandemic H1N1 should also be considered as a possibility, this time, which was not an option last time.

We anxiously await test results on the current cluster to hopefully confirm dengue and rule out this possibility. The post below is, IMO, one of the five most troubling posts of the past few years when it comes to novel agents.

http://www.promedmail.org/pls/otn/f?p=2400:1202:930981073362450::NO::F2400_P1202_CHECK_DISPLAY,F2400_P1202_PUB_MAIL_ID:X,72306

Archive Number 20080423.1433
Published Date 23-APR-2008
Subject PRO/EDR> Undiagnosed respiratory disease, fatal - Brazil: (Sao Paulo), RFI

UNDIAGNOSED RESPIRATORY DISEASE, FATAL - BRAZIL: (SAO PAULO), REQUEST
FOR INFORMATION
************************************************** *******************

A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 9 Apr 2008
Source: Ministry of Health, Secretariat for Health Surveillance [in
Portuguese, trans. & summ. Mod.JW, edited]
<http://portal.saude.gov.br/portal/arquivos/pdf/nota_doenca_respiratoria0904.pdf>

On 2 Apr 2008, the Secretariat for Health Surveillance (SVS)/Ministry
of Health (MS), through the Center for Epidemiological Surveillance
(CVE)/Coordination Control of Diseases of Sao Paulo, was notified of
the occurrence of cases of respiratory disease in the municipality of
Santos, state of Sao Paulo. Epidemiological surveillance is being
carried out jointly by city, state, and federal health authorities.

The 4 cases initially reported belonged to the same family, with
signs and symptoms of low fever, coryza, throat pain, cough, earache
(3 cases), and otorrhea with purulent exudate from the ears (2
cases); 2 cases had severe clinical evolution and died for reasons
that are being investigated.

Dengue virus and hantaviruses were excluded in all 4 cases and
seasonal influenza and avian influenza viruses, respiratory syncytial
virus, adenovirus, and parainfluenza virus excluded in samples
processed from 3 cases. In 2 cases secretion from the nasopharynx
showed suggestive electron microscopy images of a picornavirus,
agents, which are normally associated with the common cold. Analyses
for other viral agents using the techniques of molecular biology and
virus isolation are being carried out at the Institute Adolfo Lutz.

Besides the family cases, a symptomatic case with an epidemiological
connection to the family was found, who recovered with negative
immunofluorescence tests for respiratory viruses.

A municipal surveillance team is carrying out an active search for
new cases among household and close contacts, as well as a
retrospective review of hospitalizations and deaths from atypical
pneumonia of acute evolution.

The guidelines for precautionary measures directed against contact,
droplets, and aerosols, washing hands, and organizing the flow of
care for possible cases, were strengthened.

The system of municipal surveillance is on alert for the
identification of new cases through the monitoring of contacts
already identified.

**alert** · February 5, 2010, 01:15 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

Bleepin' translator. I have been informed by someone whose Portuguese is far better than my own that the expression "alta medica" in post #5 which refers to the stepfather (that the translator writes as "high medical" which I interpreted as ICU) actually more likely means "medically discharged". Nice translation error there, dude. I have seen alto/a in Spanish and Portuguese before to mean discharged, so that wouldn't surprise me.

**alert** · February 5, 2010, 03:54 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

Dengue confirmed. Send this to ProMED, and rename and move the thread. So much for needing 15 days to determine. I actually wasn't sure we'd ever get the confirmation on this one.

This introduction of dengue type 1 would cause an increase in hemorrhagic dengue, which is much more common when someone is infected with a second subtype of dengue. No indication whether this poor 16-year-old girl had the hemorrhagic dengue, or died of "regular" dengue.

https://redebomdia-com-br.translate.goog/Tag/MEC?_x_tr_sch=http&_x_tr_sl=pt&_x_tr_tl=en&_x_tr_hl=en

http://translate.google.com/translate?hl=en&sl=pt&u=http://redebomdia.com.br/Tag/MEC&ei=DoVsS8atO4fSNfyX2NYE&sa=X&oi=translate&ct=result&resnum=2&ved=0CD8Q7gEwAQ&prev=/search%3Fq%3Dmirassol%2Bdengue%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:d

Dengue reaches 1440 cases and hemorrhagic breaks record
Tipo mais grave da doença atinge 4 pessoas, quantidade anual inédita Most severe type of disease affects 4 people, annual quantity unprecedented
anuncie! Advertise!

Daniele Trindade Daniele Trinity
Agência BOM DIA Agency GOOD DAY

Rio Preto está com 1.440 casos de dengue confirmados, quarto deles do tipo mais grave e fatal, a hemorrágica – pela primeira vez a cidade registra quatro casos em um ano e 2010 está apenas em fevereiro. Black River is at 1,440 confirmed dengue cases, one quarter of them from the most severe and fatal, hemorrhagic - the first time the city has four cases in one year and 2010 is only in February. Os número, divulgados nesta quinta-feira, também já colocam o município em estado de epidemia (1.300 casos, no mínimo). The numbers, released Thursday, has also put the city in a state of the epidemic (1300 cases, at least). Pior, nos 35 primeiros dias do ano, os casos já superam os 1.231 registrados nos 12 meses de 2009 . Worse, in the first 35 days of the year, the cases already exceed the 1231 registered in the 12 months of 2009.

No ano passado foram dois registros de dengue hemorrágica e de uma morte. Last year, two reports of DHF and one death.

Mas as mortes já começaram na região. But the killings have started in the region. Nesta quinta-feira a Coordenadoria de Mirassolância recebeu laudo confirmando que foi a dengue a acusa da morte de Angélica Cristina Alcântara, de 16 anos, no domingo. On Thursday the Coordination Mirassolância received report confirming that dengue was accused of the death of Angelica Cristina Alcantara, 16, on Sunday.

“Nunca tivemos tantos casos em um só mês. "We never had so many cases in a single month. Mas um dos motivos é a intensidade das chuvas ea introdução do vírus 1 da dengue, que a maioria das pessoas ainda não contraiu”, diz Luciano Garcia Lourenção da Vigilância Epidemiológica de Rio Preto. But one of the reasons is the intensity of the rains and the introduction of dengue virus 1, which most people have not contracted, "says Luciano Garcia Lourenção Epidemiological Surveillance of Black River.

O número de casos divulgado nesta quinta-feira pela Secretaria da Saúde do município representa 16% a mais do total do ano passado. The number of cases released on Thursday by the Department of Health of the municipality is 16% more than last year's total. E uma média de 42,3 casos por dia. And an average of 42.3 cases per day.

Os bairros mais casos são o Parque Industrial, Anchieta, região central, Jaguaré, Caic e Cristo Rei. Como reforço nas ações preventivas e de controle ao Aedes aegypti, a prefeitura começa neste sábado, o Arrastão do Cidade Limpa. The neighborhoods are where the Industrial Park, Anchieta, central, Jaguaré, CAIC and Christ the King How to strengthen the preventive and control of Aedes aegypti, the city begins on Saturday, the trawler's Clean City.

Disease killed teen
Laudo do Instituto Adolfo Lutz, divulgado nesta quinta-feira pela Coordenadoria de Saúde de Mirassolândia, confirmou que a morte da adolescente Angélica Cristina de Alcântara, de 16 anos, no domingo, foi provocada mesmo pela dengue. Report of the Institute Adolfo Lutz, released Thursday by the Health Coordinator of Mirassolândia, confirmed the death of teenager Angelica Cristina Alcantara, 16, on Sunday, it was caused by dengue.

Angélica morreu a caminho do Hospital de Base de Rio Preto. Angelica died en route to the Base Hospital of Rio Preto. Ela apresentava todos os sintomas de dengue como mal-estar pelo corpo, febre e vômitos. She had all the symptoms of dengue fever and malaise in the body, fever and vomiting.

O padastro Edimar Ribeiro Mendes, 34, a mãe Fabiana de Alcântara, 34, ea irmã Júlia Alcântara, 11, também apresentaram sintomas da doença e foram internados no HB. The stepfather Edimar Ribeiro Mendes, 34, mother Fabiana de Alcantara, 34, and sister Julia Alcantara, 11, also showed symptoms of the disease and were admitted to the HB. O padastro recebeu alta nesta quarta-feira, a mãe ea irmã continuam internadas, mas devem receber alta neste final de semana. The stepfather was discharged on Wednesday, the mother and sister are still hospitalized, but must be discharged this weekend

**alert** · February 5, 2010, 04:00 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil

Ooh. Dengue is confirmed, but they are also testing for "gripe suina" (i.e. Pandemic H1N1). A co-infection is possible, and has been reported from elsewhere in the world (although there is no sign of respiratory symptoms here). It is unlikely that they will find either leptospirosis or rotavirus as a coinfection, though.

I also rule out the possible picornavirus now.

And the person who PM'd me was right - the stepfather has been discharged.

http://translate.google.com/translate?hl=en&sl=pt&u=http://www.bomdiajundiai.com.br/Tag/Mirassol&

http://translate.google.com/translate?hl=en&sl=pt&u=http://www.bomdiajundiai.com.br/Tag/Mirassol%25E2ndia&ei=DoVsS8atO4fSNfyX2NYE&sa=X&oi=translate&ct=result&resnum=10&ved=0CGIQ7gEwCQ&prev=/search%3Fq%3Dmirassol%2Bdengue%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:d

Report confirms that dengue has killed student Mirassolândia
Coordenadoria de Saúde, porém, ainda aguarda resultados de outros exames Health Coordination, however, still awaiting results of other tests
anuncie! Advertise!

Agência BOM DIA Agency GOOD DAY

O Instituto Adolfo Lutz confirmou nesta quinta-feira a morte por dengue da estudante Angélica Cristina de Alcântara, 16 anos, de Mirassolândia, na região de Rio Preto. Institute Adolfo Lutz confirmed on Thursday the death of dengue student Angelica Cristina Alcantara, 16, of Mirassolândia in the region of Rio Preto.

A Coordenadoria de Saúde de Mirassolândia, porém, ainda aguarda o resultado de outras sorologias, como as de Influenza A (rripe suína), lectospirose e rotavírus. The Coordination of Health Mirassolândia, however, still awaiting the results of other serological tests, such as Influenza A (RRIP fever), lectospirose and rotavirus.

Angélica Cristina morreu no domingo, quando estava sendo levada para o Hospital de Base, em Rio Preto. Angelica Cristina died on Sunday while being taken to the Base Hospital in Rio Preto. Ela apresentou febre alta, vômitos e mal-estar. She had high fever, vomiting and malaise.

Fabiana de Alcântara, 34, Edimar Ribeiro Mendes, 34, mãe e patrasto, respectivamente, além da irmã Júlia Alcântara, 11, apresentaram sintomas da doença e foram internados no Hospital de Base. Fabiana de Alcantara, 34, Edimar Ribeiro Mendes, 34, mother and patrasta, respectively, and the sister Julia Alcantara, 11, showed symptoms of the disease and were admitted to Base Hospital. O padastro recebeu alta na última quarta. The stepfather was discharged on Wednesday. A mãe ea irmã da jovem continuam internadas. The mother and young sister are still hospitalized. Outros 18 moradores de Mirassolândia também apresentaram sintomas da doença. Another 18 residents Mirassolândia also showed symptoms of the disease.

**alert** · February 5, 2010, 04:05 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil - Dengue confirmed

This might indicate that the mother has been discharged as well. Post #9 did say that the other two family members would be discharged this weekend.

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/41564.html&ei=DoVsS8atO4fSNfyX2NYE&sa=X&oi=translate&ct=result&resnum=17&ved=0CH8Q7gEwEA&prev=/search&

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/41564.html&ei=DoVsS8atO4fSNfyX2NYE&sa=X&oi=translate&ct=result&resnum=17&ved=0CH8Q7gEwEA&prev=/search%3Fq%3Dmirassol%2Bdengue%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:d

Bulletin of the Base Hospital - 04/02/2010 Suspected Influenza

nelsonleal nelsonleal
February 5th, 8:59 February 5th, 8:59 Continua internado: In hospital:

Paciente 1: Uma criança do sexo masculino de 7 meses, moradora de Mirassol, foi internada no dia 29 de janeiro. Patient 1: A male child of 7 months, Mirassol resident, was hospitalized on January 29. Ela está em isolamento e passa bem. She is in isolation and well.

Boletim 2 – Suspeitos Dengue Bulletin 2 - Suspected Dengue

O Núcleo de Vigilância Epidemiológica do HB notificou à Secretaria de Saúde do Município e ao Instituto Adolfo Lutz o seguinte caso de suspeita de Dengue: The Center for Epidemiological Surveillance of HB notified the Health Department of the City and the Institute Adolfo Lutz the following cases of suspected Dengue:
Caso 1: Uma criança do sexo feminino, de 12 anos, moradora de Rio Preto, foi internada dia 03 de fevereiro. Case 1: A female child, age 12, resident of Black River, was hospitalized on 03 February. Ela está no quarto e passa bem. She is the fourth and well.
Continuam internados: Still hospitalized:

Paciente 1: Uma criança de 11 anos, do sexo feminino, morador de Mirassolândia, foi internada dia 31 de janeiro. Patient 1: A child of 11 years, female, resident of Mirassolândia, was hospitalized on January 31. Ela está no quarto e passa bem. She is the fourth and well.
Paciente 2: Uma mulher de 74 anos, moradora de Rio Preto, foi internada dia 31 de janeiro. Patient 2: A woman of 74 years, resident of Black River, was hospitalized on January 31. Ela está no quarto, estável. She is the fourth stable.
Paciente 3: Um homem de 45 anos, morador de Uchoa, foi notificado hoje, 02 de fevereiro. Patient 3: A man of 45, a resident of Uchoa, was notified today, 02 February. Ele está na UTI, estado regular, respirando com ajuda de aparelhos. He is in ICU, steady state, with the aid of breathing apparatus.
Paciente 4: Um homem de 21 anos, morador de Rio Preto, foi internado dia 02 de fevereiro. Patient 4: A man of 21 years, a resident of Black River, was hospitalized on 02 February. Ele está no quarto, estável. He is the fourth stable.

ALTA MÉDICA HIGH MEDICAL [Discharged?]

Paciente 1: Uma mulher de 33 anos, moradora de Rio Preto, foi internada dia 31 de janeiro. Patient 1: A woman of 33 years, resident of Black River, was hospitalized on January 31. Ela está no quarto, com cefaléia, mas passa bem. She is in fourth, with headache, but is doing well.
Paciente 2: Uma mulher de 34 anos, moradora de Mirassolândia, foi internada dia 31 de janeiro. Patient 2: A 34 year old woman, a resident of Mirassolândia, was hospitalized on January 31. Ela está no quarto e passa bem. She is the fourth and well.

Luís Fernando Neves Luis Fernando Neves
Assessoria de Imprensa HB Press HB
Intermídia Assessoria de Comunicação Intermedia Communications Department
17-32015000 ramal: 1496 17-32015000 ext 1496
17-96091841 - 17-33532083 17-96091841 - 17-33532083

**alert** · February 6, 2010, 01:43 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil - Dengue confirmed

The mother has definitely been discharged, as today's report lists only the 11-year old sister as still in hospital.

This source may actually be an interesting resource, as he seems to post daily updates on suspected dengue cases (and flu too!!!) in that area.

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/42503.html&ei=1LdtS_67MMi0tgeHwazaDQ&sa=X&oi=translate&ct=result&resnum=4&ved=0CEgQ7gEwAw&prev=/search&

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/42503.html&ei=1LdtS_67MMi0tgeHwazaDQ&sa=X&oi=translate&ct=result&resnum=4&ved=0CEgQ7gEwAw&prev=/search%3Fq%3Dmirassol%2Bdengue%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:d

Boletim – 05/02/2010 Influenza Núcleo de Vigilância Epidemiológica do HB Bulletin - 05/02/2010 Influenza Center for Epidemiological Surveillance of HB

nelsonleal nelsonleal
February 6th, 11:01 February 6th, 11:01 Alta Médica: High Medical:
Paciente 1: Uma criança do sexo masculino de 7 meses, moradora de Mirassol, recebeu alta na tarde de ontem, 04 de fevereiro. Patient 1: A male child of 7 months, resident Mirassol, was discharged yesterday afternoon, February 04.

Boletim 2 – Suspeitos Dengue Bulletin 2 - Suspected Dengue
O Núcleo de Vigilância Epidemiológica do HB notificou à Secretaria de Saúde do Município e ao Instituto Adolfo Lutz o seguinte caso de suspeita de Dengue: The Center for Epidemiological Surveillance of HB notified the Health Department of the City and the Institute Adolfo Lutz the following cases of suspected Dengue:
Caso 1: Um homem de 61 anos, morador de Rio Preto, foi notificado hoje, 05 de fevereiro, como suspeito de Dengue. Case 1: A man of 61 years, a resident of Black River, was notified today, 05 February, on suspicion of dengue. Ele está na UTI, estado grave, respirando com ajuda de aparelhos. He is in intensive care, critical condition, breathing with the help of machines.
Caso 2: Uma mulher de 28 anos, moradora de Rio Preto, foi notificada hoje, 05 de fevereiro, como suspeita de Dengue. Case 2: A woman of 28 years, resident of Black River, was notified today, 05 February, as suspected dengue. Ela está no quarto e passa bem. She is the fourth and well.
Continuam internados: Still hospitalized:
Paciente 1: Uma criança de 11 anos, do sexo feminino, morador de Mirassolândia, foi internada dia 31 de janeiro. Patient 1: A child of 11 years, female, resident of Mirassolândia, was hospitalized on January 31. Ela está no quarto e passa bem. She is [in her room] and well.
Paciente 2: Uma mulher de 74 anos, moradora de Rio Preto, foi internada dia 31 de janeiro. Patient 2: A woman of 74 years, resident of Black River, was hospitalized on January 31. Ela está no quarto, estável. She is the fourth stable.
Paciente 3: Um homem de 45 anos, morador de Uchoa, foi notificado hoje, 02 de fevereiro. Patient 3: A man of 45, a resident of Uchoa, was notified today, 02 February. Ele está na UTI, estado regular, respirando com ajuda de aparelhos. He is in ICU, steady state, with the aid of breathing apparatus.
Paciente 4: Um homem de 21 anos, morador de Rio Preto, foi internado dia 02 de fevereiro. Patient 4: A man of 21 years, a resident of Black River, was hospitalized on 02 February. Ele está no quarto, estável. He is the fourth stable.
Paciente 5: Uma criança do sexo feminino, de 12 anos, moradora de Rio Preto, foi internada dia 03 de fevereiro. Patient 5: A female child, age 12, resident of Black River, was hospitalized on 03 February. Ela está no quarto e passa bem. She is the fourth and well.

Luís Fernando Neves Luis Fernando Neves
Assessoria de Imprensa HB Press HB
Intermídia Assessoria de Comunicação Intermedia Communications Department
17-32015000 ramal: 1496 17-32015000 ext 1496
17-96091841 - 17-33532083 17-96091841 - 17-33532083

**alert** · February 9, 2010, 06:10 AM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil - Dengue confirmed

And the younger sister gets discharged as well. Likely the end of the story and this thread. The only possible things remianing are a ProMED post (which I'm not sure whether we'll see - these news sources may not be ProMED worthy, but we could get a direct email from the Adolfo Lutz Institute), and the presumably negative results of H1N1 testing on the deceased girl (which again we might not see).

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/42503.html&ei=1LdtS_67MMi0tgeHwazaDQ&sa=X&oi=translate&ct=result&resnum=4&ved=0CEgQ7gEwAw&prev=/search&

http://translate.google.com/translate?hl=en&sl=pt&u=http://nelsonleal.livejournal.com/42503.html&ei=1LdtS_67MMi0tgeHwazaDQ&sa=X&oi=translate&ct=result&resnum=4&ved=0CEgQ7gEwAw&prev=/search%3Fq%3Dmirassol%2Bdengue%26hl%3Den%26lr%3D%26tbo%3Dp%26num%3D20%26tbs%3Dqdr:d

HB NOTA DE RIO PRETO

nelsonleal nelsonleal
February 9th, 8:46 February 9th, 8:46 Seis pessoas estão internadas no HB com suspeita de Dengue, todas estáveis. Six people are hospitalized in HB with suspected dengue, all stable.
A criança do sexo feminino, de 11 anos, moradora de Mirassolândia, recebeu alta hoje, 08 de fevereiro. A female child, aged 11, resident of Mirassolândia, was released today, 08 February.

Luís Fernando Neves Luis Fernando Neves
Assessoria de Imprensa HB Press HB
Intermídia Assessoria de Comunicação Intermedia Communications Department
17-32015000 ramal: 1496 17-32015000 ext 1496
17-96091841 - 17-33532083 17-96091841 - 17-33532083

**alert** · February 28, 2010, 12:24 PM

Re: ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil - Dengue confirmed

From a ProMED Portuguese summary of Dengue in Sao Paulo state. This was definitely a pure dengue death - no H1N1 involved.

http://www.promedmail.org/pls/otn/f?p=2400:1001:3454948995524256::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1050,81534

Ao todo, 28 mortes est?o sendo investigadas no Estado, sendo que outros dois
casos j? foram confirmados --um em Mirassol?ndia e outro em S?o Jos? do Rio
Preto, informou a Sucen.

In all, 28 deaths are being investigated in the state, and the other two
cases have been confirmed - one in Mirassol?ndia and another in Sao Jose do Rio
Black, said the municipal government.

Announcement

ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil - Dengue confirmed

ProMED: Undiagnosed fatal illness in Mirassolandia, Brazil - Dengue confirmed

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment

Comment