O Governo de Minas trabalha de forma contínua, durante todo o ano, para monitorar e controlar a infestação do mosquito Aedes aegypti e para impedir o avanço da dengue, zika, chikungunya e febre amarela. Nos meses mais quentes, em que há maior incidência da transmissão das doenças, as ações e os cuidados estaduais são intensificadas.
Nesta segunda-feira (13/11), o secretário de Estado de Saúde, Fábio Baccheretti, anunciou a criação da Política Estadual para Vigilância, Prevenção e Controle das Arboviroses. Aprovada por meio da Deliberação CIB-SUS/MG Nº 4.415, de 18 de outubro de 2023, a política 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).
“Para que o estado consiga vencer de uma vez por todas a dengue, a zika, a chikungunya e a febre amarela, é preciso novas estratégias e inovação. E é isso que estamos fazendo em Minas Gerais. Adotamos um conjunto de ações e vamos enfrentar o problema em várias frentes. Isso vai certamente mudar a vida dos mineiros”, avalia Fábio Baccheretti.
O anúncio foi feito durante visita feita às obras da biofábrica para produção do mosquito Aedes aegypti com Wolbachia, em Belo Horizonte, que contou também com representantes do Comitê Pró-Brumadinho, do World Mosquito Program (WMP) e da Vale S.A. A inauguração está prevista para o primeiro semestre de 2024.
“A nova tecnologia é uma estratégia fundamental para vencer de uma vez por todas as doenças causadas pelo Aedes aegypti. Há uma expectativa de que no começo do próximo ano já esteja funcionando e conseguiremos uma nova arma contra as doenças”, destaca o secretário.
Biofábrica Wolbachia
O Método Wolbachia é patenteado pelo World Mosquito Program, iniciativa internacional sem fins lucrativos que trabalha para proteger a comunidade global das doenças transmitidas por mosquitos. Conduzido no Brasil pela Fundação Oswaldo Cruz (Fiocruz), com financiamento do Ministério da Saúde, o método consiste na liberação de mosquitos Aedes aegypti com a bactéria Wolbachia, que impede que os vírus da dengue, zika e chikungunya se desenvolvam no mosquito, contribuindo para a redução da transmissão de arboviroses.
Com a biofábrica em funcionamento, estima-se a produção semanal de dois milhões de mosquitos que, uma vez inseridos no meio ambiente, vão se reproduzir com os Aedes aegypti locais e estabelecer uma população com Wolbachia. Os insetos não são geneticamente modificados e não transmitem doenças.
Dados divulgados em 2021 pelo WMP apontam redução de cerca de 70% dos casos de dengue, 60% de chikungunya e 40% de zika nas áreas onde houve a intervenção entomológica no município de Niterói (RJ). Na Indonésia, dados do WMP apontam redução de 77% dos casos e 86% das hospitalizações.
De acordo com Alessandro Vieira, líder de Comunicação da World Mosquito Program, a principal vantagem do método é impedir a transmissão do vírus, evitando o adoecimento das pessoas. Além disso, sua eficácia permite economia de recursos. “O projeto diminui os gastos públicos com a saúde, porque promove a prevenção ao invés de tratar as doenças”, afirma.
As obras da biofábrica estão sendo executadas pela Vale S.A, como parte do Acordo Judicial, assinado pelo Governo de Minas, o Ministério Público de Minas Gerais, o Ministério Público Federal, a Defensoria Pública de Minas Gerais e a mineradora, que visa reparar os danos decorrentes do rompimento das barragens em Brumadinho. A empresa tem a responsabilidade de construir, equipar e mobiliar a unidade, além de custear seu funcionamento por cinco anos, contados a partir da licença de operação, com investimento total de cerca de R$77 milhões. Além disso, cabe à Vale S.A pagar as despesas de segurança e de conservação do local, no período entre a conclusão da obra e o início da operação.
De acordo com o termo de compromisso firmado entre as partes, os mosquitos Aedes aegypti com a bactéria Wolbachia pipientis produzidos na biofábrica serão destinados aos 22 municípios da Bacia do Rio Paraopeba. A expectativa da SES-MG é que ocorra a expansão da produção de mosquitos para todo território estadual.
Atuação SES
Entre as ações da SES-MG também está o Plano Estadual de Contingência para Enfrentamento das Arboviroses (PEC-Arbo) com foco em dengue, chikungunya, zika e febre amarela, para o período de dezembro de 2023 a novembro de 2025, aprovado pela Deliberação CIB-SUS/MG Nº 4.414, de 18 de outubro de 2023.
Está previsto ainda, de acordo com a Resolução SES/MG Nº 9.035, de 26 de setembro de 2023, o investimento de R$30,5 milhões anuais, sendo R$ 15,6 milhões repassados às prefeituras e R$ 14,9 milhões aos consórcios municipais de saúde para a aquisição de drones que vão auxiliar no combate à proliferação do Aedes aegypti no estado.
“Com os drones, os técnicos poderão ver onde tem locais com água parada e, assim, jogar larvicida ou avisar as autoridades sobre locais de risco para o mosquito. Os 853 municípios terão acesso a esse serviço”, salienta Fábio Baccheretti.
O subsecretário de Vigilância em Saúde da SES-MG, Eduardo Campos Prosdocimi, destaca que a Secretaria está se preparando para enfrentar o próximo período sazonal das arboviroses com ações efetivas e inovadoras, que possuem enorme potencial para atingir bons resultados no combate às arboviroses. “As ações serão capazes de mobilizar a atuação mais efetiva das regionais de saúde. Temos uma nova política e um novo plano de contingência, muito mais gerencial e eficaz, para que os municípios consigam realizar ações locais. O uso inovador de drones e a inauguração da biofábrica da Wolbachia, intensificam ainda mais os cuidados e vão impedir a proliferação do mosquito transmissor”, ressalta.
Dentre as ações contínuas da Secretaria de Estado de Saúde, destacam-se também o monitoramento semanal de casos, a elaboração de boletim epidemiológico e o planejamento de solicitação de inseticida, junto ao Ministério da Saúde, para o envio aos municípios, além de reuniões periódicas com as Unidades Regionais de Saúde para discutir e orientar sobre as medidas de prevenção e controle das arboviroses.
Cenário das arboviroses em Minas Gerais
Até 6/11/2023, foram registrados 388.510 casos prováveis (casos notificados exceto os descartados) de dengue no estado. Desse total, 288.522 casos foram confirmados e 181 óbitos constatados.
Em relação à febre chikungunya, foram registrados 89.774 casos prováveis da doença e, desse total, 71.756 casos foram confirmados, sendo 41 óbitos.
Já em relação à zika, foram registrados 136 casos prováveis, 28 confirmados e nenhum óbito.
Os dados estão disponíveis no Painel de Monitoramento de Casos de Arboviroses. Nele, o usuário realiza buscas por tipo de doença, período, semana epidemiológica, macrorregião, microrregião, regional de saúde e município. Os dados têm como fonte o Sistema de Informação de Agravos de Notificação (Sinan) e são atualizados semanalmente.
A SES-MG divulgou, no dia 7/11, os resultados do terceiro Levantamento Rápido de Índices para Aedes aegypti (LirAa/LIA), que apresenta a classificação de risco para transmissão das arboviroses causadas pelo mosquito nos municípios mineiros, direcionando as ações do programa de controle das doenças para as áreas mais críticas e melhorando o aproveitamento de recursos humanos e materiais.
De acordo com os dados enviados por 798 municípios mineiros, entre 7 e 25/8, 648 deles apresentaram o Índice de Infestação Predial pelo Aedes aegypti (IIP) igual ou menor que 0,9 e, por isso, receberam a classificação satisfatória, indicando situação de baixo risco de transmissão de arboviroses. Há 144 municípios em situação de alerta e seis permanecem em situação de risco, com IIP maior que 4,0.
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