Dengue epidemic worsens in Rio de Janeiro

RIO DE JANEIRO, Brazil — An outburst of dengue has killed at least 47 people — and perhaps twice that — in Rio de Janeiro state this year, officials said Thursday, announcing a hot spot in a hemispheric outbreak of the disease that sickened nearly 1 million people in 2007.

State officials said 51 cases are being reported every hour as the outbreak strains public hospitals' capacity.

"What we see today in Rio de Janeiro is a catastrophe," said Edmilson Migovski, a professor of infectious diseases at the Federal University of Rio de Janeiro. "The death toll is rising because the virus is becoming more virulent, and at the same time people who were infected once are getting infected again."

Experts fear the virus could grow deadlier and more widespread, in part because tourism and migration are circulating four different strains across the Americas. Travelers can get information on the disease and about precautions through the U.S. Centers for Disease Control, www.cdc.gov

Brazil had more than half of the 900,782 cases of dengue in the Americas last year, according to the Pan American Health Organization. Of the hemisphere's 317 deaths, 158 came in Brazil, including 31 in Rio state.

But while federal officials say overall numbers were down in early 2008, they have jumped in Rio state. State officials say dengue has already killed 47 people, and is suspected of killing another 49 whose deaths are under investigation. The state, which has 16 million inhabitants, has seen more than 32,000 dengue cases this year, officials said.

"I am treating it as an epidemic because the number of cases is extremely high," state Health Secretary Sergio Cortes said.

Migovski said that the problem may actually be worse: "An emergency room doctor who has to attend 40 or 50 patients in a morning is not going to be able to inform officials about all the cases."

Health officials across the Americas are trying to coordinate their fight against dengue, which has steadily gained strength since the early 1980s. Known as "bonebreak fever," dengue is spread by the Aegis aegypti mosquito and can incapacitate patients for over a week with severe headaches and joint pains.

A deadly hemorrhagic variant that causes internal and external bleeding accounts for fewer than 5 percent of cases but has shown signs of growing — often affecting people who have recovered from a less-severe form.

Experts fear the virus could grow deadlier and more widespread, in part because tourism and migration are circulating four different strains across the Americas.