Outbreak of Acute Diarrheal Diseases in Cruzeiro do Sul/Acre, Northern Brazil, September–October 2021

  • Water or foodborne
  • Occupational and environmental health
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Background: In September 2021, an unexpected increase in hospitalizations due to acute diarrheal diseases (ADD) was observed in the municipalities of Acre, mainly in Cruzeiro do Sul. An epidemiological investigation was carried out to describe the profile of the cases, identify the etiological agent and the factors associated with the illness.
Methods: A case-control was carried out in a 1:1 ratio, considering cases as patients treated for ADD in the health services of Cruzeiro do Sul in September–October 2021, and as controls those treated for other causes in the municipality in the same period. Simple random sampling was carried out based on health service records to select the population. A semi-structured questionnaire with sociodemographic, clinical, environmental, and behavioral questions was applied via face-to-face or telephone interviews. Categorical variables were presented by absolute and relative frequency and quantitative variables by measures of central tendency and dispersion. The bivariate analysis considered a confidence level of 95% and a significance level of less than 5% (p-value <0.05). The p-value ≤0.20 results were taken to logistic regression.
Results: Of the 78 selected cases, 51.3% (95% CI=39.7–62.8) were female, 38.5% (95% CI=27.7–50.1) were between 1–4 years old, 96.2% (95% CI=89.2–99.2) had non-dysenteric ADD, 70.5% (95% CI=80.3–40.9) had fever, and 70.5% (95% CI=80.3–40.9) had vomiting. The median sick days was 4.5 (interquartile range 4.0). “Old 1–4 years old” (aOR 8.7; 95% CI=2.9–26.1; p-value <0.001) and “not cleaning the water tank every 6 months” (aOR 3.3; 95% CI=1.5-7.4; p-value=0.003) were associated with the occurrence of ADD.
Conclusions: Cases were more frequent in female children. It was not possible to identify the etiologic agent, although the clinical characterization suggests a viral infection. Illness was associated with age and failure to clean the water tanks. Health education on preventive measures, including cleaning of water tanks, was recommended.

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