A pandemic covid-19 made clearer the need for the so -called sentinel system, which monitors pathological agents to avoid outbreaks or even predict future epidemics. In addition to viruses such as Sars-CoV-2, however, it is also important to monitor fungi and bacteria that have not yet been effectively treated and can spread. This is the theme of the 4th FAPESP 60th Anniversary Conference, “Global Health Challenges”.
The event was moderated by Helena Nader, professor at the São Paulo School of Medicine of the Federal University of São Paulo (EPM-Unifesp) and member of the Superior Council of FAPESP.
7;s very important to have sentinel systems that allow a pandemic, at the beginning of its outbreak, to be quickly detected and fought. But all of this requires interaction, cooperation, which is not always natural,” Luiz highlights. Eugênio Mello, scientific director of FAPESP, at the opening of the event.
Andrea Dessen, a researcher at the Center National de la Recherche Scientifique (CNRS), France, has warned that, historically, not only viruses cause pandemics, but also bacteria.
However, since the 1960s, several new antibiotics have been discovered and now there is a group of bacteria known for their excellent ability to escape existing treatments.
“The United Nations estimates that now there are 700,000 deaths a year because of antibiotic resistance, but if we do nothing, by 2050 it will be 10 million per year ”, said the researcher, who is organizing a project supported by FAPESP at the National Center for Research in Energy and Materials (CNPEM), within the scope of São Paulo Head of Excellence Program (SPEC).
The researcher recalled that there are six reasons given by the World Health Organization (WHO) for antibiotic resistance: over -prescription, unfinished treatment, overuse in animals (which consume 80% of the volume of these drugs in the world), inadequate control of infections in hospital environments, lack of sanitation and hygiene and lack of antibiotics on the market.
Tracked for viruses
Ester Sabino, professor in the Faculty of Medicine of the University of São Paulo (FM-USP) and researcher at the Institute of Tropical Medicine (IMT-USP), recalled the Joint Brazil-UK Center for Arbovirus Discovery, Diagnosis, Genomics and The Epidemiology (CADDE), supported by FAPESP and coordinated by it, was created with the idea of ??tracking new arboviruses (pathogens transmitted by arthropods, a type of invertebrate animal). The emergence of covid-19, however, has expanded the scope of the project.
The sentinel work carried out by the center involves monitoring blood banks to check for the presence of viruses and, in the case of Sars-CoV-2, the population’s antibody rates and the sequence of the isolated virus. from people who seek health services. health. The idea is to prove the emergence of several variants, including the Delta, which has reached 100% in the city of São Paulo.
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“We expected a dengue epidemic last year and it didn’t come. He was probably an action -sensitive disease. We observed a drop in cases when mobility was reduced due to [restrição impostas para conter a] Covid-19. But this year the most worrying is chikungunya, which may come when it comes to moving people. There are already cases in Santos and elsewhere ”, the researcher said.
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“We need SUS [Sistema Único de Saúde], universities and public authorities who understand what is being said to better determine policies. And it must be done before epidemics occur so that we can do something in time to improve our response, “he said.
In this regard, Arnaldo Colombo, professor of EPM-Unifesp, said that the impact of fungal infection is a quiet crisis on biodiversity, food security and human health.
Today, these pathogens threaten wild species such as amphibians and constitute 30% of the agents that appear as pathogens in plants, including grains, with the ability to compromise about 20% of what is harvested in different regions of the world.
Agricultural activity is also caused by infection of farm workers, who come into contact with one source of many species of fungi: the soil. Both in recurrent skin lesions and in lung infections, fungi are related agents for these diseases, but very few have been diagnosed.
An estimate presented by researchers showed that 1.2 million people with fungal pneumonia are treated as if they had tuberculosis.
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Conversely, however, advances in medicine, such as intensive care units, chemotherapy treatments and organ transplants have also brought in new disease -causing fungi. Mycose opportunities, as they are called, reach 1.8 million cases per year worldwide, with 20% to 70% dying.
Although, fungal pathogens are less known and not even ignored by the doctors themselves. A survey conducted at 129 medical centers in Latin America showed that only 9% of them had diagnostic training for fungal infections.
“It is important to discuss economic models that are more compatible with the health of the planet, such as sustainable development. We are late in the presence of global warming, which has led to the acquisition of pathogens at temperatures of 37 degrees Celsius and , therefore, infect us ”, the researcher pointed out.
“We need to invest in global health centers that work on the concept of unique health to understand the natural history of the pathogen before it reaches humans,” he said.
Moreover, Colombo defended that fungicides could be replaced by other pest control techniques, to prevent the emergence of resistant fungi. Finally, it is important to invest in developing diagnostic platforms and not just drugs.
“We need to learn to manipulate the human microbiome more effectively to contain dysbiosis [morte de microrganismos, muitas vezes benéficos, que vivem no corpo humano] mandatory use of antibiotics and, without a doubt, there is room to improve programs for the rational use of antimicrobials in the hospital environment and in the community, ”he concluded.