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Infectious disease rates skyrocket amid Venezuela’s economic crisis

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Research presented at the European Congress of Clinical Microbiology & Infectious Diseases shows that Venezuela’s political and economic crisis is causing a resurgence of infectious diseases, including malaria and many vaccine-preventable illnesses.

Adriana Tami, MD, DTM&H, PhD, associate professor in the faculty of medical sciences at the University of Groningen in the Netherlands, and colleagues noted that over the past 2 decades, Venezuela has fallen into a state of collapse, with hyperinflation rates exceeding 45,000%. This has fueled an ongoing humanitarian crisis, and diseases that were once under control like malaria are now causing epidemics of “unprecedented magnitude,” they said.

The researchers searched both published and unpublished health data and observed a 365% increase in malaria cases between 2000 and 2015. These cases accounted for 53% of all cases reported in the Americas. According to Tami and colleagues, the country surpassed 600,000 malaria cases in 2018, and final estimates could show that more than 1 million people were infected in the country last year.

Most malaria cases were caused by Plasmodium vivax (71%), followed by P. falciparum (20%) and other Plasmodium infections (approximately 9% of these were mixed and P. malariae cases).

Tami and colleagues found that the high incidence of malaria in Venezuela was positively correlated with an increase in illegal mining activities and forest exploitation, both of which are “strongly linked to the ongoing socioeconomic crisis.”

Threat of measles

In addition to an increase in malaria, several vaccine-preventable diseases have re-emerged during the economic and political crisis in Venezuela. In August 2018, officials from the Pan American Health Organization confirmed that endemic transmission of measles was re-established.

Venezuela's political and economic crisis has increased the spread of various infectious diseases, including measles, according to research presented at ECCMID. Source: CDC

A separate study presented at ECCMID, which was also recently published in Emerging Infectious Diseases, illustrated how measles and other vaccine-preventable diseases have spread to vulnerable populations, including the Yanomami, who inhabit the Amazon region at the Venezuelan-Brazilian border.

“High morbidity and mortality rates are expected because these populations are immunologically naive to measles,” Tami said in a press release. “Measles is presumed to have entered the Yanomami communities from Brazil after imported cases from Venezuela brought the disease to border populations of Brazil, before spreading back to Yanomami communities in Venezuela. Further spread of this epidemic wave could devastate the Yanomami people living in the Orinoco highlands of the Amazon, given that humanitarian aid to affected sites is limited or hard to deliver because of the seminomadic characteristics of these indigenous populations and the remoteness of the Yanomami territory.”

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According to Tami and colleagues, diphtheria had not been reported for 24 years in Venezuela before 2016. Between July and November of that year, 183 suspected cases were reported in 16 of the 24 federal entities of Venezuela. By October 2018, the number of cases increased to 2,170, and 287 deaths were reported.

Although polio was eliminated from the Americas in 1971, the researchers raised concerns about the potential emergence of vaccine-derived polioviruses. In 2015, 87% of children were immunized against the virus. By 2017, less than 79% were vaccinated. The minimum recommended level for herd immunity is 80%.

“As Venezuela rapidly becomes a regional nidus for the emergency of vaccine-preventable diseases, it must take decisive action now alongside regional and national partners to target this emerging regional crisis,” Tami and colleagues wrote. – by Katherine Bortz

References:

Paniz-Mondofi AE, et al. Emerg Infect Dis. 2019;doi:10.3201/eid2504/181305.

Paniz-Mondofi AE, et al. Abstract 6923. Presented at: ECCMID; April 13-16, 2019; Amsterdam.

Tami A, et al. Abstract 4243. Presented at: ECCMID; April 13-16, 2019; Amsterdam.

Disclosures: The authors report no relevant financial disclosures.