Luciano Pamplona de Góes Cavalcanti1,+, André Ricardo Ribas Freitas2,3, Patrícia Brasil4, Rivaldo Venâncio da Cunha5
1 Departamento de Saúde Comunitária da Universidade Federal do Ceará, Setor. Prof. Costa Mendes 1608, 5º andar, Fortaleza CE, Brasil.
2 Faculdade São Leopoldo Mandic, Campinas SP, Brasil.
3 Departamento de Vigilância em Saúde da Secretaria Municipal de Saúde de Campinas SP, Brasil.
4 Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brasil.
5 Fundação Osvaldo Cruz, Campo Grande MS, Brasil.
Did death occur DUE TO dengue, or in a patient WITH dengue virus infection? It seems a matter of semantics, but in fact, it underscores how challenging it is to distinguish whether the disease contributed to death, or was itself the underlying cause of death. Can a death be attributed to chikungunya virus, when some deaths occur after the acute phase? Did the virus decompensate the underlying diseases, leading to death? Did prolonged hospitalisation lead to infection, resulting in the patient’s progression to death? Were there iatrogenic complications during patient care? The dengue question, for which there has not yet been a definitive response, resurfaces prominently under the chikungunya surveillance scenario. We are facing an epidemic of a disease that seems to be more lethal than previously thought. The major challenge ahead is to investigate deaths suspected of occurring due to arbovirus infections and to understand the role of each infection in the unfavourable outcome.
Received 15 December 2016
Accepted 4 March 2017