Dengue Outbreak Vaccination Recommendation

    From:https://www.npr.org/sections/goatsandso … cy-vaccineLocal expat experts in Brazil - do you recommend getting the dengue vaccination before going to Brazil?Is it easy to get immunized in Brazil?  How much does it cost?Thank you.        -@Pablo888

I frequently travel to the USA and have repeatedly asked there and followed the potential dengue vaccinations. As far as I know from that and the CDC, there is only one type of vaccination and it is only available to previously exposed children between 9 to 16 years of age who are at high risk of re-exposure based on where they live or frequent. If you have any other information, please post it for us. Here is a link to their "Dengue Vaccination: What Everyone Should Know". https://www.cdc.gov/vaccines/vpd/dengue … index.html

@rraypo

I believe Brazil is developing a dengue vaccination, but it is not yet available to the public at large...

@rraypo

Thank you for the information.  The CDC web site is very informative - the 4 types of dengue viruses etc.  but offers no recommendations for older folks - like you said.

I guess this means that anyone should avoid contact with a female aedes species mosquito.

Apart from the daily use of mosquito repellent on the skin, what do the locals do to prevent dengue spread?  Mosquito repellent coils at home or other?

Thanks for starting this thread.  With 1 million cases of dengue in 2024 alone I am worried about dengue.  In addition in our area, Campinas, there are a lot more mosquitos then I have seen in previous years.  I dislike using chemical sprays but I probably should start using them more to be safe.  But please anyone share any information if you find any.  There is an article in recent Science Magazine called "Brazil is hoping and waiting for a new vaccine as dengue rages".

Ok so Dengue is largely an urban disease the mosquito that causes it tends to be more active in the day, and centers on areas with standing water, poor drainage, garbage etc. That said this is one of the worst outbreaks historically and all predictions expect dengue to worse with climate change and we've already seen its boundaries expanding. The USA is still doing the studies for Japan's Qdenga vaccine but many countries including Brazil have already done so and approved it. It is recommended up to age 60. Perhaps they just haven't yet completed the studies on older folks to see efficacy. SUS is already giving it though are prioritizing high risk folks I believe but worth checking with your unidade basico. It looks like some private pharmacies are offering it already too. Of note a vaccine developed by Butanta should be coming out next year likely, and it looks excellent. So lots on the horizon.

It might be worth noting that the mosquito does not cause dengue, but spreads it.

It has to bite a person already infected, then spreads it to the next, and so on.

Only 50% of all mosquitoes 'bite' - the females…!

@rnbtg, Thanks for the info.  I am over 60 so I'm out of luck for now.

@rnbtg when i was researching dengue vaccines prior to leaving the United States, it may have been the Mayo Clinic site, it stated that the side effects of the vaccine in persons over 60 years of age tend to be severe and possibly worse than contracting the virus itself.

   03/12/24 @rnbtg, Thanks for the info.  I am over 60 so I'm out of luck for now.
   

    -@Droplover

News reports indicate that the Health Ministry has more doses on order, and hopes to expand the target population as they're produced and received.  So don't give up hope.  Meanwhile, keep up on your mosquito abatement precautions, and stay safe.

@kevinmiller1957

This is the same as I read a while back about Yellow Fever.  That Vaccine also is NOT recommended for those above 60...

Im not aware of studies in the elderly with these vaccines (qdenga and the butantã one) so it wouldnt be side effects, but rather the geriatric population tends to have lower immune response so efficacy is generally the worry. in yellow fever there may be concerns about safety but its a different disease and type of vaccine.

Other things to do:

#Buy a mosquiteiro (cortinado) or mosquito net for your bed. There are hanging ones (from the ceiling). There are those that have a folding framework. My favorite is to have a four-poster bed fabricated and either find or fabricate an appropriate net - I like a LOT of headroom so it doesn't feel like I'm in a pup-tent.

#I'm trying a[n electric] diffuser with citronella [essencial] oil drops. I've never had luck with candles and they are hard to find here. Diffusers and essencial oils are easy.

#Fans - I can't sleep with fans but it works for others and I'll resort to that if I'm in a really buggy place.

#Watch your neighbors' empty lots if there are any breeding areas. I my three neighbors sold their homes to a developer that plan to build something huge some day. He knocked down the homes and left. There were three underground water reservoirs left behind (found 'em when the skeeters got bad). The new owner was unresponsive as was the municipality so I had to hire someone to bust out the bottoms to release the water.

#I add a natural contraption - guppy ponds (could be open-top aquariums) - actually Guaru (Poecilia vivípara) is better because it is native and reproduces more heartily. IF mosquitos get their needed blood supply to then go out and lay eggs they'll look close by for water. My little ponds have fish to gobble up whatever they produce.

#Finally, we encourage natural predators of every type. That way you also get to appreciate the diverse critters that have long shared Brazilian homes. They are such a part of day-to-day life here, well, I once knew somebody that would glue little plastic geckos on the inside of their lampshades (would cast a shadow on the shade) back in Wisconsin just to remember "home," which was in São Paulo.

mberigan

@mberigan

The odd thing about vaccinations I have experienced.  Places said online you needed to present you covid card to enter brazil. I had it ready to enter brazil is 2022 and no one asked for it.

They said the same about yellow fever vaccinations for south africa so I got it in the Ukraine and the SA customs agent never asked for it.

03/12/24    @kevinmiller1957
This is the same as I read a while back about Yellow Fever.  That Vaccine also is NOT recommended for those above 60...     

    -@MA22

I had never heard that about the yellow fever vaccine.  Fortunately, that immunity is long-lasting. 

If I were coming to Brazil for the first time at 60 or above and had NEVER  been vaccinated against Yellow Fever, I would want to have a face-to-face with my doctor about getting vaccinated, and maybe get a second opinion from a Tropical Medical Center before deciding against it.  Mortality rates among the never-vaccinated who contract serious cases are way too high to make decisions based on second-hand information.

https://www.technologyreview.com/2024/0 … mosquitos/

Interesting report in the MIT Technology Review:  introducing "altered" mosquitos to reduce the dengue-spreading ones.  Ok, but I don't relish having even MORE whining critters circling around me, even if the chance of getting dengue is reduced.  Incidentally, I'm currently recovering from Chikungunya - NOT a fun way to spend the past week. Still getting my strength back.  Be safe, all!

    @mberigan
The odd thing about vaccinations I have experienced.  Places said online you needed to present you covid card to enter brazil. I had it ready to enter brazil is 2022 and no one asked for it.
They said the same about yellow fever vaccinations for south africa so I got it in the Ukraine and the SA customs agent never asked for it.
   

    -@Canforbra

In late 2019 we flew from Brazil to S Africa, and even though yellow fever does not exist in my area of Brazil, we had to have the vaccination in order to enter S Africa. The jabs were free, and no hassle, but we WERE asked for the certificates before being allowed to check-in to board the plane... Flight was Sao Paulo to Joburg direct with LATAM.

  03/16/24 Incidentally, I'm currently recovering from Chikungunya - NOT a fun way to spend the past week. Still getting my strength back.  Be safe, all!
   

    -@Viajanete

So sorry to hear that!  Get well soon.

@abthree

This was the recomendation from the Tropical Diseases Specialty Center! Healthparners in Minnesota. Not a second hand internet opinion.

For all recommendations, I always read what the CDC has to say:

https://www.cdc.gov/yellowfever/vaccine/vaccine-recommendations.html

During the last outbreak of Yellow Fever in Brazil a few years ago, I was vaccinated with STAMARIL at age 62.  It was a bit of an ordeal because at that time the YF VAX was not available in the US due to production problems, so I had to search out a center that was authorized by the FDA to dispense the emergency authorized STAMARIL.

The CDC recommends if you are over age 60 (among other conditions) you SHOULD discuss with your healthcare provider, because there is an increased risk of developing a reaction.  The full explanation is on the CDC site if you're interested.  IMHO this is aimed mainly at people who don't regularly go to the doctor.  As you age, you are prone to more health issues, and it probably wouldn't be a good idea to just blindly get the vaccination without any real need. 

I'll add, since the outbreak a few years ago the CDC changed their recommendations for Brazil, and now YF VAX  or STAMARIL is recommended for most areas, including Sao Paulo and Rio.

I expect it will be the same all over Brazil, but Pernambuco just announced it is starting now with a free dengue vaccination. First priority group will be children aged 10-14, one dose now and another in 3 months. Starts today on the island, and is free of charge...

@Pablo888

You can get at a local public health clinic if a legal resident. 

Right now, they are in short supply, so get yours in the UK, if you may.

@sprealestatebroker, just spent the past week with @peter_itamaraca in Itamaracá.  Mosquitoes were very active even near the beaches.  I don´t know how effective the mosquito repellent worked but my son and I gave blood to the cause of mosquito reproduction.  I squished a few mosquitoes in the hotel room and they were gorged.

I hope that we did not anything in return.

PS:  Writing this note while being stuck in GRU as the 1.5 hr transit time to go from Terminal 2 to Terminal 3 was not sufficient.... and I missed my connection.  GRU is such a difficult airport to navigate for connections.  Good thing that I have access to the Latam Lounge or this would have been a long 10 hour unexpected wait.   Grey day in Sao Paulo....

    04/21/24  @sprealestatebroker, just spent the past week with @peter_itamaraca in Itamaracá.  Mosquitoes were very active even near the beaches.  I don´t know how effective the mosquito repellent worked but my son and I gave blood to the cause of mosquito reproduction.  I squished a few mosquitoes in the hotel room and they were gorged.
I hope that we did not anything in return.

    -@Pablo888

How did it go?  Is Brazil still on your list, or was it one-and-done?  Not pretending to be the least bit neutral, I hope the former!

How did it go?  Is Brazil still on your list, or was it one-and-done?  Not pretending to be the least bit neutral, I hope the former!
   

    -@abthree

@abthree, I am keeping my fingers crossed that I have done all the paperwork done on my side to be able to complete all the requirements to apply for the CRNM.  All the bits still need to be done online, bank transfers, etc...

If everything goes well, you will see more of me - hopefully in person.....

Now, that I have started 1% of the journey, there is still 99% to plan for and experience....

Esperando pero melhor....

    @sprealestatebroker, just spent the past week with @peter_itamaraca in Itamaracá.  Mosquitoes were very active even near the beaches.  I don´t know how effective the mosquito repellent worked but my son and I gave blood to the cause of mosquito reproduction.  I squished a few mosquitoes in the hotel room and they were gorged.
I hope that we did not anything in return.

PS:  Writing this note while being stuck in GRU as the 1.5 hr transit time to go from Terminal 2 to Terminal 3 was not sufficient.... and I missed my connection.  GRU is such a difficult airport to navigate for connections.  Good thing that I have access to the Latam Lounge or this would have been a long 10 hour unexpected wait.   Grey day in Sao Paulo....
   

    -@Pablo888

Well, some of these coastal communities have estuaries.  Rivers that flow into the coastal region. 

And as such, they do have marshlands, and as such, these type of echosytstems are breeding ground for mosquitoes.   Of all kinds.

Same  takes place within areas surrounded by  lakes.  It reminds me of Lakeville and Carver, MA  areas with lots of ponds, lakes and bogs. The bogs were filled with water at the fall, by the harvest time,  so lesser the risk with mosquitoes.  The lakes, well, it was a mosquito summer's fest.

You can control your own spots for mosquito infestation, such as making sure there are no containers holding rain water, or have them shut with a lid.   

You can also get a vacine, but supplies vary from one  local community health center to another. 

Now you cannot control what goes at your neighbor's.  At best you can call the City Sanitation and file a complaint against "dead water".  Assuming your neighbor fails to act upon it. Which in turn will create animosity agains thee neighbor.

And if there is a lawn, there's water somewhere.  A container, a discarded tire.

And unlike in the US, if you want door screens, you either need to custom order or make them on your own. Your Home Improvement Center is more unlikely to have it on stock. At best, a special order. 

Guarulhos and its airport always struck me as a odd place for airfields, but there it is.

And unlike in the US, if you want door screens, you either need to custom order or make them on your own. Your Home Improvement Center is more unlikely to have it on stock. At best, a special order. 

I've always thought it was a bit odd that there are no screens on the windows or doors in Brasil.  They aren't that expensive, and considering the number of insects, one would think it would be a popular item to sell.  Apparently, it's a cultural thing, but I don't get it.

    From:
https://www.npr.org/sections/goatsandso … cy-vaccine

Local expat experts in Brazil - do you recommend getting the dengue vaccination before going to Brazil?

Is it easy to get immunized in Brazil?  How much does it cost?

Thank you.
   

    -@Pablo888

I have a 1500 sf open basement and a 11 ceiling,.  with a ramp towards the street good for a van driveway. 

Thinkering about making a place to manufacture such screens. 

All the makers for these screens here do not come any close to what is being made in the US. 

Same for window panes.  No one with double plated glass panes. 

A damn shame,