Abstract
Co-epidemics of COVID-19 and dengue in dengue-endemic countries represent a serious public health concern. In Brazil, São Paulo state ranks first for cases and deaths from COVID-19, and dengue is endemic in most regions of the country. In 2020, an outbreak of dengue occurred in western São Paulo. We determined the spatiotemporal distribution of dengue in the context of COVID-19 cases in Presidente Prudente, a mid-sized city in western São Paulo. To illustrate the burden of both infections, a case report of a doctor and his family, infected with dengue and COVID-19, is presented. There were three clusters of dengue and COVID-19 in the periphery. A dengue cluster was found in a region where there were no corresponding COVID-19 cases. Meanwhile, there were COVID-19 clusters where dengue activity was lower. In 2020, the COVID-19 epidemic emerged when dengue reached its seasonal peak, resulting in a simultaneous outbreak of both diseases. Lower rates of dengue were found in the city compared with 2019, and the fear of patients with mild dengue symptoms about remaining in hospital and acquiring COVID-19 infection may be the main cause. Simultaneous spatial clusters of dengue and COVID-19 in environmentally and socioeconomically vulnerable areas can guide public health authorities in intensive interventions to improve clinical diagnosis, epidemiological surveillance, and management of both diseases. The patient and his family were first infected with dengue and he then carried COVID-19 to his family, reinforcing the risk of health care workers spreading the virus to the community. We highlight the epidemiological significance of presenting a case report and spatial analysis of COVID-19 in the same study in the context of a dengue outbreak.
Highlights
We highlight the epidemiological significance of presenting a case report and spatial analysis of COVID-19 in the same study in the context of a dengue outbreak
A 61-year-old doctor lives with his family in Presidente Prudente in the countryside of São Paulo state, which is considered dengue-endemic
We showed that an outbreak of dengue was occurring in Presidente Prudente in the last few years, and in 2020, clusters of dengue and COVID-19 occurred mainly in regions of the periphery
Summary
Co-epidemics of COVID-19 and dengue in dengue-endemic countries represent a serious public health concern. In Brazil, it is a dangerous combination for the public health system, which is already working above its capacity [1]. Brazil ranks third for the number of patients infected and second for mortality rate worldwide [2]. São Paulo state, the most populous state of Brazil, and its capital, São Paulo, including the metropolitan area, ranks first for the number of cases and deaths from COVID-19 [3,4]. Individuals living in closed settings, including nursing homes and prisons, and those with an occupational health risk, health care workers (HCWs), have increased vulnerability to the transmission of COVID-19. Several thousand HCWs globally have been reported to be infected [5]
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