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Surtos de sarampo no Brasil: saiba mais sobre a doença

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Pelo menos três estados brasileiros têm surtos confirmados de sarampo este ano. Amazonas e Roraima, juntos, contabilizam cerca de 500 casos confirmados e mais de 1,5 mil em investigação. No outro extremo do país, o Rio Grande do Sul também confirmou seis casos da doença este ano. Já o Rio de Janeiro investiga quatro casos – um deles com resultado preliminar positivo pra sarampo.

Em 2016, o Brasil recebeu da Organização Pan-Americana de Saúde (Opas) o certificado de eliminação da circulação do vírus. A doença, entretanto, voltou a ser motivo de preocupação entre autoridades sanitárias em razão das baixas coberturas vacinais identificadas no país e por ser altamente contagiosa.

Em junho, países do Mercosul fizeram um acordo para evitar a reintrodução de doenças já eliminadas na região das Américas, incluindo o sarampo. Brasil, Argentina, Uruguai, Paraguai e Chile se comprometeram a reforçar ações de saúde nas fronteiras e a fornecer assistência aos migrantes numa tentativa de manter baixa a transmissão de casos.

Confira abaixo os principais tópicos sobre sarampo divulgados pelo Ministério da Saúde.

A doença

O sarampo é uma doença infecciosa aguda, de natureza viral, grave, transmissível e extremamente contagiosa. Complicações infecciosas contribuem para a gravidade do sarampo, particularmente em crianças desnutridas e menores de um 1 ano.

A doença é de distribuição universal e apresenta variação sazonal. Nos climas temperados, observa-se o aumento da incidência no período compreendido entre o final do inverno e o início da primavera. Nos climas tropicais, caso do Brasil, a transmissão parece aumentar depois da estação chuvosa.

O comportamento endêmico do sarampo varia de um local para outro e depende basicamente da relação entre o grau de imunidade e a suscetibilidade da população, além da circulação do vírus na área.

Sintomas

Os sintomas do sarampo incluem febre alta acima de 38,5°C; erupções na pele; tosse; coriza; conjuntivite; e manchas brancas que aparecem na mucosa bucal, conhecidas como sinais de Koplik e que antecedem de um a dois dias antes do aparecimento da erupção cutânea.

Diagnóstico

O diagnóstico laboratorial é realizado mediante detecção de anticorpos IgM no sangue na fase aguda da doença, desde os primeiros dias até quatro semanas após o aparecimento da erupção cutânea.

Transmissão

Ocorre de forma direta, por meio de secreções expelidas ao tossir, espirrar, falar ou respirar. Por isso, a elevada contagiosidade da doença.

A transmissão acontece de quatro a seis dias antes e até quatro dias após o aparecimento do exantema. O período de maior transmissibilidade ocorre dois dias antes e dois dias após o início da erupção cutânea.

O sarampo afeta igualmente ambos os sexos. A incidência, a evolução clínica e a letalidade são influenciadas pelas condições socioeconômicas, nutricionais, imunitárias e àquelas que favorecem a aglomeração em lugares públicos e em pequenas residências.

Prevenção

A vacinação contra o sarampo é a única maneira de prevenir a doença. O esquema vacinal vigente é de uma dose da vacina tríplice viral aos 12 meses e a segunda dose da vacina tetra viral aos 15 meses.

Pessoas com suspeita de sarampo, gestantes, crianças com menos de 6 meses e imunocomprometidos não devem receber a dose. A gestante deve esperar para ser vacinada após o parto.

Caso esteja planejando engravidar, a mulher deve se proteger contra a doença. Um exame de sangue pode dizer se ela já está imune ao sarampo. Se não estiver, ela deve ser vacinada antes da gestação e aguardar pelo menos quatro semanas para engravidar.

Tratamento

Não existe tratamento específico para o sarampo. É recomendável a administração da vitamina A em crianças acometidas pela doença, para reduzir a ocorrência de casos graves e fatais. O tratamento profilático com antibiótico é contraindicado.

Para os casos sem complicação, a orientação é manter a hidratação, o suporte nutricional e diminuir a hipertermia. Muitas crianças precisam de quatro a oito semanas para recuperar o estado nutricional que apresentavam antes da doença. Complicações como diarreia, pneumonia e otite média devem ser tratadas de acordo com normas e procedimentos estabelecidos pelo Ministério da Saúde.

Fonte.: agenciabrasil.ebc.com.br

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