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Agência Minas Gerais | Estado intensifica ações para enfrentamento da dengue e outras arboviroses

O Governo de Minas apresentou as ações de enfrentamento às arboviroses (dengue, zika e chikungunya) nesta sexta-feira (16/2). 

A Secretaria de Estado de Saúde de Minas Gerais (SES-MG) contabilizou a destinação de mais de R$ 150 milhões a todos os municípios do estado no enfrentamento às doenças provocadas pelo mosquito Aedes aegypti, além de promover um Dia D contra arboviroses, a capacitação de equipes de saúde e a implementação da abertura por 24 horas da sala de hidratação do Hospital Júlia kubitschek (HJK), em Belo Horizonte.

Cenário atual

Diante da situação de emergência, declarada em janeiro, a expectativa de que Minas Gerais vivencie o ano com maior número de casos de dengue da série histórica em 2024, em comparação com anos epidêmicos anteriores.

De acordo com o Painel de Monitoramento das Arboviroses, foram notificados 194.801 casos prováveis de dengue em Minas Gerais até 16/2, dos quais 67.592 estão confirmados. Há 105 óbitos em investigação e 18 confirmados. Em relação à chikungunya, até o momento, foram notificados 23.628 casos prováveis, sendo 15.727 confirmados para a doença. Há 16 óbitos em investigação e um óbito confirmado.

O secretário de Estado de Saúde, Fábio Baccheretti, analisou o cenário atualizado das arboviroses urbanas no estado. “Nossa previsão é de uma curva ascendente. Ainda não temos os dados desta última semana epidemiológica, mas nunca vivenciamos uma inclinação tão forte de dengue na nossa história. Já ultrapassamos o pico da previsão e não temos dúvidas que este vai ser o pior ano da nossa história de dengue”, apontou o secretário.

Ele demonstrou preocupação com a situação epidemiológica da Região Metropolitana de Belo Horizonte (RMBH). “Neste momento, a capital mineira e a região metropolitana vivem o momento mais crítico em número de atendimentos e a expectativa é que isso dure mais algumas semanas. Vamos continuar tendo muitos casos, mas esse pico de atendimento tende a começar a diminuir em meados de março. Temos alguns municípios que começaram a ter casos antes de Belo Horizonte e agora a demanda nas Unidades de Pronto Atendimento (UPA) está menor que há duas semanas, e esse é o comportamento comum da dengue”, informou Fábio.

Secretário explica cenário em Minas (Fabio Marchetto / SES-MG)

Para o secretário, o aumento de incidência do sorotipo denv2 e o retorno da circulação do sorotipo denv3 são motivos de preocupação, uma vez que a maioria das pessoas está sem imunidade para esses sorotipos, logo uma infecção pode gerar casos mais graves. “Nossos esforços devem ser concentrados no atendimento qualificado, pois o óbito por dengue é evitável. Na maior parte dos casos, o tratamento é feito com hidratação no tempo certo e por isso estamos investindo cada vez mais na capacitação dos profissionais de saúde para que o tempo de identificação dos casos graves seja agilizado”, reforçou.

“Geralmente, o paciente procura atendimento quando está com febre alta, dor no corpo na fase mais aguda, e não é esse o ponto que mais nos preocupa. A conversão do paciente para a dengue hemorrágica acontece a partir do quinto dia dos sintomas, quando a febre cede. Nesse momento, pode ocorrer o choque, com queda de pressão, momento em que é necessário o tratamento com soro na veia e medicamento para aumentar a pressão arterial. É importante garantir que o paciente retorne ao atendimento na Unidade Básica de Saúde (UBS) após o quinto dia dos sintomas, para que a equipe observe como está sendo a recuperação, garantindo que não haja piora ou sinais de agravamento da dengue”, pontuou o secretário de Saúde de Minas.

Sala de hidratação

Para ampliar o atendimento e apoiar a assistência à população, a SES-MG informou que, por meio da Fundação Hospitalar do Estado de Minas Gerais (Fhemig), passa a manter aberta por 24 horas a unidade de hidratação (reposição volêmica) no HJK, na região do Barreiro. O local, aberto em 2/2, conta com 21 poltronas para atendimento a pacientes que precisam receber hidratação venosa e 30 cadeiras para hidratação oral.

A unidade de hidratação possui sala de triagem, dois consultórios médicos, duas salas de reposição venosa e espaço para hidratação oral e a capacidade de atendimento pode chegar a até 300 pessoas por dia. A maternidade do HJK também passou a ser referência municipal no atendimento a gestantes com dengue, chikungunya ou zika. 

A abertura da unidade de hidratação integra ações previstas no Plano de Contingência da Fhemig para doenças causadas pelo Aedes aegypti, que prevê a ativação progressiva dos serviços, conforme a demanda do município de Belo Horizonte (gestor pleno da saúde) e a situação epidemiológica.

Dia D 

A SES-MG também coordenará o Dia D de conscientização e combate à arboviroses em todo o estado, por meio das 28 Unidades Regionais de Saúde (URS). A ideia é promover o movimento Minas Unida no Combate ao Mosquito no dia 24/2. O movimento, ao qual já aderiram 160 municípios mineiros de todas as regiões, realizará mutirões comunitários para eliminar os focos de Aedes aegypti.

Estão planejadas ações de mobilização para orientar e conscientizar a população que a responsabilidade diária de manter ambientes dentro das casas é também do cidadão. “Esse é um momento para sensibilizar toda a população e precisamos que todos nos ajudem a disseminar a importância de não deixar entulhos e água parada. É preciso destacar o papel de cada cidadão nesse processo, para que consigamos diminuir os números dessa doença que está nos afligindo muito em 2024”, alertou o secretário Fábio Baccheretti, que lembrou que as prefeituras que ainda não fazem parte do movimento podem procurar sua respectiva URS para isso.

Para prevenir a proliferação do mosquito causador da dengue e chikungunya, é fundamental a adoção de ações de proteção coletiva, como remoção de locais onde há acúmulo de água e eliminação de criadouros de mosquitos, além do tamponamento de caixas d’água e realização da limpeza das calhas.

Para a proteção individual contra a picada do mosquito, recomenda-se o uso de repelente, inclusive por pessoas com sintomas ou já diagnosticada com dengue ou chikungunya, uma vez que o mosquito pode se infectar ao picá-la e transmitir a doença para outros indivíduos.

Em caso de sinais e sintomas suspeitos de dengue, chikungunya ou zika, recomenda-se buscar o atendimento médico. As UBSs são a porta de entrada para esses pacientes em todo o estado.

Atuação em Minas

A SES-MG está pagando, neste mês de fevereiro, um incremento de R$32,2 milhões aos municípios mineiros para o combate da dengue, zika e chikungunya no estado. O valor se soma aos R$80,5 milhões repassados em dezembro, enquanto outros R$32,2 milhões serão pagos no mês de julho.

A secretaria também está investindo R$ 30,5 milhões para que os municípios contratem o serviço de drones que serão utilizados na identificação, monitoramento e tratamento dos focos e criadouros do Aedes aegypti, permitindo uma atuação mais direcionada e eficaz por parte das Secretarias Municipais de Saúde. Foram repassados R$15 milhões em 2023 e o restante será pago já nos próximos meses.

Em 27/1 , o Governo de Minas havia publicado o decreto que declara a situação de emergência em Saúde Pública no Estado, em razão do cenário epidemiológico das arboviroses, autorizando a adoção de medidas administrativas que se façam necessárias, tais como a requisição de bens ou serviços e flexibilização para aquisição direta de produtos, insumos e materiais. 

A partir do decreto, foi implantado o Centro de Operação de Emergência (COE), estrutura de governança no âmbito da SES-MG pela qual se executarão as medidas de enfrentamento da situação de emergência em Saúde Pública pelas arboviroses, incluindo monitoramento e gestão da emergência.

Em novembro de 2023, a SES-MG publicou a Política Estadual para Vigilância, Prevenção e Controle das Arboviroses, que se configura como um conjunto de ações com a finalidade de prevenir e controlar a ocorrência dessas endemias na população e garantir o acesso a serviços de saúde, de forma oportuna, resolutiva, equânime, integral e humanizada, no âmbito do Sistema Único de Saúde em Minas Gerais (SUS-MG). Em paralelo, foi publicado o Plano Estadual de Contingência para Enfrentamento das Arboviroses com vistas a organizar as ações de enfrentamento em caso de surtos ou epidemia no estado de Minas Gerais. 

A SES-MG também dá suporte na elaboração e acompanhamento dos Planos Municipais de Contingência (PMC). 

Além do monitoramento constante dos casos, incluindo os casos graves, incidência e óbitos, a SES-MG também direciona as ações de controle pelo Levantamento Rápido de Índices para Aedes aegypti (LirAa/LIA), realizado trimestralmente e que aponta, entre outros, o Índice de Infestação Predial pelo Aedes (IIP).

Também são promovidas reuniões periódicas do Comitê Estadual de Enfrentamento das Arboviroses para deliberar sobre o cenário epidemiológico no estado e as ações a serem realizadas por cada eixo que o compõe, além de encontros regulares com os Comitês Regionais de Enfrentamento das Arboviroses, visando o planejamento de ações e o repasse de orientações, e com as Unidades Regionais de Saúde para alinhamento estratégico. A SES-MG distribui ainda inseticidas e equipamentos para viabilizar as atividades de controle vetorial nos municípios.

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