En un esfuerzo por contener la propagación de la fiebre amarilla y evitar una posible urbanización del virus, Colombia intensificó sus acciones de vigilancia epidemiológica con el desarrollo del Segundo Taller Nacional de Vigilancia Epizoótica y Vectorial, realizado del 14 al 16 de mayo en Mocoa, Putumayo. La actividad, liderada por el Ministerio de Salud y Protección Social (MSPS), el Instituto Nacional de Salud (INS), el Ministerio de Ambiente, la OPS/OMS y Panaftosa, marca un nuevo capítulo en la respuesta del país ante esta enfermedad reemergente.
La fiebre amarilla, transmitida por mosquitos en entornos selváticos y urbanos, ha mostrado señales preocupantes de resurgimiento. En 2024, se notificaron 23 casos y 13 muertes, con una letalidad del 56,5 %. En lo corrido de 2025, hasta el 6 de mayo, ya se han confirmado 62 casos y 25 fallecimientos, lo que representa una letalidad preliminar del 40,3 %, según datos del INS. Los focos activos se concentran principalmente en los departamentos de Tolima, Antioquia, Cundinamarca y Meta.
Vigilancia territorial desde el terreno: Putumayo como punto estratégico
Durante tres días, más de diez equipos territoriales de salud fueron capacitados en técnicas avanzadas para la identificación, diagnóstico y control del virus. La formación, bajo el modelo de Una Sola Salud, incluyó ejercicios prácticos como la toma de muestras en primates fallecidos y la recolección de vectores en campo, con énfasis en el cumplimiento riguroso de protocolos de bioseguridad y vacunación del personal.
Uno de los momentos clave del taller fue la evaluación de un caso real: un mono hallado muerto en el Centro de Educación Ambiental (CEA) de Mocoa. Esta actividad permitió a los equipos replicar en condiciones reales los protocolos de vigilancia epizoótica, esenciales para detectar tempranamente el virus en reservorios animales y anticipar su circulación en humanos.
El caso del Tolima: lecciones de una reemergencia centenaria
El brote registrado en 2024 en el departamento del Tolima, donde no se presentaban casos desde hacía más de 100 años, se ha convertido en una referencia nacional sobre la importancia de la vigilancia integrada. Wilder Pérez, del programa de zoonosis del Putumayo, explicó cómo el aprendizaje adquirido en un taller previo facilitó una respuesta rápida ante señales de alarma: “Encontramos tres monos muertos en la misma zona. Gracias a la formación previa, activamos de inmediato la toma de muestras, evitando que los cuerpos fueran enterrados sin análisis. Esa acción fue clave para iniciar una respuesta oportuna”.
La detección temprana permitió no solo confirmar el brote, sino desplegar campañas de vacunación, análisis entomológicos y control del área afectada. Para el Ministerio de Salud, este ejemplo valida la necesidad de replicar esquemas de vigilancia epizoótica en todo el país, especialmente en zonas con antecedentes de circulación viral.
Una salud, múltiples actores: cooperación binacional y regional
La estrategia nacional de vigilancia cuenta con el acompañamiento técnico de organismos multilaterales y expertos de países con experiencia en el manejo de fiebre amarilla. Renato Vieira, asesor en salud pública veterinaria de Panaftosa, destacó la importancia de trabajar bajo una visión intersectorial: “La vigilancia efectiva no puede dividirse entre salud humana y salud animal. Son una sola. Nuestra experiencia en Brasil muestra que cuando estos sectores trabajan juntos, la respuesta es más eficaz, especialmente en zonas con desafíos geográficos y ecosistemas similares”.
Por su parte, Mauricio Cerpa, asesor internacional de emergencias en salud de la OPS/OMS, señaló que el acompañamiento va más allá de la vacunación: “Hemos apoyado desde la coordinación y liderazgo hasta el manejo clínico y la comunicación de riesgo. Pero sin participación comunitaria, no hay control sostenible”.
Riesgo de urbanización: todos los casos provienen del ciclo selvático
Actualmente, todos los casos reportados están vinculados al ciclo silvestre de transmisión, es decir, asociados a picaduras de mosquitos que habitan zonas boscosas y que infectan tanto a primates como a humanos que ingresan o habitan en estos entornos. Esta condición mantiene abierta la alerta sobre el posible paso del virus a entornos urbanos, donde su propagación sería más difícil de controlar.
Mayra Alejandra Vargas, del Ministerio de Ambiente, explicó el trasfondo ecosistémico del problema: “Mientras no exista bienestar en los ecosistemas, no habrá salud humana. Lo que afecta a los primates nos afecta a nosotros. Por eso debemos trabajar desde la conservación, no desde la reacción”.
Acciones clave para la contención y prevención
La estrategia nacional contra la fiebre amarilla se enfoca en cinco líneas prioritarias:
- Fortalecimiento de la vigilancia integrada: a través del monitoreo de fauna silvestre y vectores en territorio.
- Capacitación técnica y operativa de equipos locales: en protocolos de toma de muestras, bioseguridad y análisis laboratorial.
- Ampliación de la cobertura de vacunación: especialmente en zonas de riesgo, incluyendo comunidades rurales y trabajadores ambientales.
- Coordinación intersectorial e internacional: integrando salud, ambiente, academia y cooperación técnica regional.
- Participación comunitaria y comunicación de riesgo: como pilares para la detección oportuna y la prevención efectiva.
Una estrategia que salva vidas y ecosistemas
La fiebre amarilla, aunque prevenible con una sola dosis de vacuna, sigue representando un desafío para los sistemas de salud públicos de América Latina. La experiencia de Colombia en el fortalecimiento territorial de la vigilancia desde Putumayo demuestra que la clave está en la anticipación, la articulación y la acción decidida.
Al consolidar un modelo replicable de vigilancia epizoótica y vectorial, el país se prepara no solo para controlar el brote actual, sino para prevenir futuras emergencias. La implementación de un enfoque ecosistémico y territorial refuerza la comprensión de que la salud humana no puede desligarse del entorno natural.
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