title: Dengue viruses in Brazil, 1986-2006.
abstract: A total of 4,243,049 dengue cases have been reported in Brazil between 1981 and 2006, including 5,817 cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) and a total of 338 fatal cases. Although all Brazilian regions have been affected, the Northeast and Southeast regions have registered the highest number of notifications. DENV-1 and DENV-4 were isolated for the first time in the Amazon region of Brazil in 1981 and 1982. The disease became a nationwide public health problem following outbreaks of DENV-1 and DENV-2 in the state of Rio de Janeiro in 1986 and 1990, respectively. The introduction of DENV-3 in 2000, also in the state of Rio de Janeiro, led to a severe epidemic with 288 245 reported dengue cases, including 91 deaths. Virus strains that were typed during the 2002 epidemic show that DENV-3 has displaced other dengue virus serotypes and entered new areas, a finding that warrants closer evaluation. Unusual clinical symptoms, including central nervous system involvement, have been observed in dengue patients in at least three regions of the country.
authors.affiliation: Flavivirus Laboratory, Department of Virology, Instituto Oswaldo Cruz/ FIOCRUZ, Avenida Brasil 4365, 21040-190, Rio de Janeiro, RJ, Brasil. rita@ioc.fiocruz.br
authors.forename: Rita Maria Ribeiro
authors.initials: RM
authors.lastname: Nogueira
authors.forename: Josélio Maria Galvão
authors.initials: JM
authors.lastname: de Araújo
authors.forename: Hermann Gonçalves
authors.initials: HG
authors.lastname: Schatzmayr
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology*; D006801:Humans