title: [A challenge for the public health system in Brazil: dengue control].
abstract: This article presents a critical analysis of the traditional strategy used to control Aedes aegypti using "health surveillance patrols", with periodic visits to all urban buildings. The strategy is not viable and/or is administratively unfeasible at present, since it has been proposed since the 1980s but has not been implemented. Brazilian health reform prioritized the expansion of coverage for basic health services, and not measures to control specific diseases. A. aegypti, which was reintroduced and began the reoccupation of its old habitat in 1976, is currently in a process of re-infesting the country until reaching equilibrium. This public health problem relates to the urban environment and is thus a problem that affects everyone, both the population and government, and not merely the health sector. The article highlights the need for joint action in sanitation and the environment. The population's role should also be reshaped as effective and permanent, separating the rights and duties of government and the population, i.e., making a clear distinction between the public and private domains. The danger of resurgence of yellow fever should be considered when establishing a new, feasible strategy for dealing with the dengue problem.
authors.affiliation: Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21041-210, Brasil. mlpenna@ensp.fiocruz.br
authors.forename: Maria Lucia F
authors.initials: ML
authors.lastname: Penna
mesh_terms: D000330:Aedes; D000818:Animals; D001938:Brazil; D003715:Dengue / Q000517:prevention & control*; D006798:Housing; D006801:Humans; D007303:Insect Vectors; D009032:Mosquito Control / Q000379:methods*; D011634:Public Health; D015004:Yellow Fever / Q000517:prevention & control
vernacular_title: Um desafio para a saúde pública brasileira: o controle do dengue.