Serotype 4 of the dengue virus (Denv-4), which resurfaced in Roraima in 2010, 31 years after it was first identified in the same state, is once again causing concern, with cases recorded in Amazonas, Pará, Bahia, Pernambuco, Rio de Janeiro, Piauí, and São Paulo in recent years. As of June 2023, all the dengue serotypes together had caused 503 deaths nationwide, according to the Brazilian Ministry of Health. The Denv-4 serotype causes symptoms similar to the others (headaches, aching joints, fever, diarrhea, and vomiting) and the treatment is similar (rest, fluid intake, and antipyretics). Since the majority of the population has not had contact with serotype 4, the risk of an epidemic is high. Denv-4 has replaced other serotypes in places where it has been reported, including in Peru, India, and various Pacific islands. It can damage the lungs, heart, and brain. The kidneys also suffer, according to a study by the Oswaldo Cruz Foundation (FIOCRUZ) in Rio de Janeiro. Kidneys from mice infected with Denv-4 extracted from a human showed local inflammation, with increased glomeruli (capillaries that receive and filter blood arriving in the kidneys), infiltration of immune cells, cell death, and hemorrhaging (Memórias do Instituto Oswaldo Cruz, May 8).
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