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Outbreak of Beriberi in an Indian Population of the Upper Amazon Region, Roraima State, Brazil, 2008

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  • Field Epidemiology Training Program, Secretariat of Health Surveillance, Ministry of Health, Brasilia, Distrito Federal, Brazil; Secretaria Estadual de Saúde de Roraima, Boa Vista, Roraima, Brasil; Conselho Indígena do Estado de Roraima, Boa Vista, Roraima, Brasil; Fundação Nacional de Saúde do Estado de Roraima, Ministério da Saúde, Boa Vista, Roraima, Brasil; Fundação Nacional de Saúde do Brasil, Ministério da Saúde, Brasília, Distrito Federal, Brasil; Unidade Regional de Saúde de Imperatriz, Maranhão, Brasil; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Edema, parasthesias, and paresis affected 10 residents of an Indian community in Roraima state; three died. Mining with mercury occurs locally; caxirí, a traditional alcoholic drink, is consumed daily. We conducted a 1:2 unmatched case-control study; a case was an Indian from Uiramutã county (population of 9,127) who presented ≥ 1 of lower extremity edema, paresthesias, paresis, or weakness. Controls were asymptomatic Indians randomly selected from the population. We identified 90 cases (prevalence of 1%) and 180 controls; all were enrolled. Among cases, 79% were male, and the median age was 31 years. Ethnicity was Macuxí, and 49% had income. Cases had lower extremity edema (85%), upper extremity paresthesias (84%), and lower extremity weakness and pain (78%). Risk factors were male sex (odds ratio [OR] = 6.8; P < 0.001), age 31–40 years (OR = 5.63; P < 0.001), and consumption of caxirí (OR = 2.7; P < 0.003). Mercury exposure was not a risk. Thiamine therapy produced complete rapid clinical recovery in all cases, confirming the diagnosis of beriberi. We recommend surveillance, thiamine supplementation, and nutritional intervention.

Author Notes

*Address correspondence to Matheus P. Cerroni, Field Epidemiology Training Program, Secretariat of Health Surveillance, Ministry of Health, Esplanada dos Ministerios, Bloco G, Edificio Sede, Sala 156, Brasilia, Distrito Federal, Brazil 70058900. E-mail: mtcerroni@gmail.com

Authors' addresses: Matheus P. Cerroni, Jean C. S. Barrado, and Aglaer A. Nobrega, Field Epidemiology Training Program, Secretariat of Health Surveillance, Ministry of Health, Brasilia, Distrito Federal, Brazil, E-mails: mtcerroni@gmail.com, jean.barrado@gmail.com, and aglaer.nobrega@saude.gov.br. Alysson B. M. Lins, Secretaria Estadual de Saúde de Roraima, Boa Vista, RR, Brazil, E-mail: alyssonlins@hotmail.com. Iolanda P. da Silva, Conselho Indígena do Estado de Roraima, Boa Vista, Roraima, Brasil, E-mail: mtcerroni@gmail.com. Robson R. Mangueira, Fundação Nacional de Saúde do Estado de Roraima, Ministério da Saúde, Boa Vista, Roraima, Brasil, E-mail: robmd34@hotmail.com. Rômulo H. da Cruz, Fundação Nacional de Saúde do Brasil, Ministério da Saúde, Brasília, Distrito Federal, Brasil, E-mail: Romulo.rhc@gmail.com. Sandra M. F. Mendes, Unidade Regional de Saúde de Imperatriz, Maranhão, Brasil, E-mail: mendesmesquita@gmail.com. Jeremy Sobel, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: jsobel@cdc.gov.

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