Ampliação das ações de vigilância laboratorial e epidemiológica no diagnóstico das doenças de transmissão hídrica e alimentar como estratégias integradas de prevenção à saúde

Abstract

Waterborne and foodborne diseases (DTHA) are part of the global scenario of diseases with a major impact on health and the economy. In Brazil, the Central Public Health Laboratories participate in the investigation of DTHA outbreaks and other diseases. In the DTHA outbreaks that occurred in Minas Gerais between 2012 and 2022, out of 376 involving food, only 45.2% had their causal agents identified and of the 73 involving water consumption, 36%. The low percentage of identification was possibly due to the gaps identified in this study (incomplete completion of the survey forms to guide analyzes and methodologies for the research of new pathogens) that compromised the identification of the causal agents. Given this scenario, the objective of this work was to strengthen laboratory and epidemiological surveillance actions, introducing a new analytical parameter: the search for viral agents by molecular biology (RT-PCR). Of the 15 outbreaks involving food that occurred in the state between January and July 2023, three were directed to research of these viral agents, two rotaviruses were identified. When monitoring the quality of fresh water consumed by the Maxakali indigenous community, located in Vale do Mucuri, MG, between March and August 2023. The viral agents were not detected, but the presence of total coliforms and Escherichia coli, Salmonella enterica ssp. enterica, Pseudomonas aeruginosa and Aeromonas hydrophila at points of consumption. Although research into viral agents was adopted to assess the quality of drinking water in Maxakali indigenous communities due to constant ADD outbreaks, they were not isolated, but the monitoring carried out revealed that all villages presented a high risk of outbreaks occurrin, because they do not meet the potability standard (presence of E. coli), and because of the presence of enteropathogens. The intervention measures adopted were able to mitigate the risk, contributing to improving the quality of life of this vulnerable population. The introduction of research into viral agents to expand laboratory diagnosis of water and food involved in DTHA outbreaks was a promising strategy for elucidating inconclusive cases.