Preciso Serre Com Pensado Por is So

8/20/2019 Preciso Serre Com Pensado Por is So

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UNIVERSIDADE DE SÃO PAULOHELENA KEICO SATO

Te e !"#e e$%!&! ' F!()*&!&e &eMe&+(+$! &! U$+,e# +&!&e &e S-P!)* "!#! /%e$ - & % %)* &eD )% # e C+3$(+! . 4#e! &e ( $(e$%#! - Pe&+!%#+!O#+e$%!& # P# 6.D#. G!/#+e* 7 *6

O e*8!.

SÃO PAULO2005


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Sumário


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RESUMO

S!% HK. E %)& & e6e+% &! ,!(+$! ( $%#! #)/9 *! /#e "# &)% &!:e %! - &e )*;e#e ,!(+$!&! &)#!$%e (! "!$;! #e!*+D )% #!& ?@F!()*&!&e &e Me&+(+$!=U$+,e# +&!&e &e S- P!)* .


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A ,!(+$! ( $%#! #)/9 *! 9 ( $%#!@+$&+(!&! e :e %!$%e = !"e !# &e e %)&")/*+(!& !%9 e$% $- %e#e +&e$%+6+(!& $e$;) #e(9 @$! (+& (

!$+6e %! e (* $+(! ( "!% ,e+ ( ! $ e &! #)/9 *! ( $:3$+%! >SRC?. O

/ e%+, &e %e e %)& 9 e %+ !# #+ ( &e +$6e( - ( $:3$+%! "e* , #) &! ,!(( $%#! #)/9 *! e e %+ !# #+ ( &e ( ##3$(+! &e !/ #% = /!+ "e e"#e !%)#+&!&e $! :e %!$%e ) (e% ,e+ e + )$e "!#! #)/9 *!= +&e$%+6+(!$& 6!% #e &e #+ ( ! (+!& ! e %e e,e$% . É ) e %)& &e ( #%e "# "e(%() &!& 6 #! /%+& ! "!#%+# & S+ %e ! E %!&)!* &e N %+6+(! - &e GeV!(+$!&! = + "*!$%!& &)#!$%e ! #e!*+ELISA?= ! %9($+((!"%)#! "!#! I:M e %e %e &e !,+&eJ =2 ?. De %! = J11 >1 =5 ?e#! ) (e% ,e+ $ e$% &! ,!(+$! - = 21 5 > J= ? e#! + )$e = 2 0> = ? %+$;! +%)! - + )$ * :+(! ( $ +&e#!&! +$&e%e# +$!&! e 2 >0=5"e# !$e(e#! # $e:!%+,! !" ! ,!(+$! - . P!#! +&e$%+6+(! - & RN

+$6e(%!& "e* , #) ,!(+$!*= 6 #! ( *e%!&! ! %#! !$:) $e! !"e$! & RN&! :e %!$%e ) (e% ,e+ . F #! +&e$%+6+(!& 2 #e(9 @$! (+& ( ##e!:e$%e "!#! #)/9 *! >I:M? e ! %! ! &e +$6e( - ( $:3$+%! "e* , #) ,!(+$!* 6 + &e

= >2 5J0?. Ne$;) #e(9 @$! (+& !"#e e$% ) !*6 # ! e ( "!% ,e+ (SRC. P!#! +&e$%+6+(!# 6!% #e &e #+ ( ! (+!& ! !/ #% = /!+ "e"#e !%)#+&!&e e e %+ !# #+ ( $! :e %!$%e ) (e% ,e+ e + )$e = 6 #e$%#e,+ %!&! :e %!$%e ) (e% ,e+ e 1 + )$e . A +&!&e 9&+! &

) (e% ,e+ 6 + &e 2 !$ e &! + )$e 2 . A +&!&e :e %!(+ $!* 9&+! ! e#e,!(+$!&! 6 + )+% "#e( (e =1 e !$! "!#! ! ) (e% ,e+ e = "!#! ! + )$e . A !+ #+! 6 + ,!(+$!&! " # &e ( $;e(e# ! "# "#+! :#!,+&e< $ e$% &!,!(+$! - . E #e*! - ' ( ##3$(+! &e !/ #% ! %! ! 6 #! 5= > ? $:#)" &! ) (e% ,e+ e =2 >10 1 ? $ :#)" &! + )$e . P!#! "#e !%)#+&!&e=! %! ! 6 + &e =1 >55 05? $ :#)" &! ) (e% ,e+ e =J >102 1 0 ? $ &!+ )$e . P!#! /!+ "e ! $! (e# ! %! ! 6 + &e 5= > 0J? $ :#)" &!

) (e% ,e+ e = >100 1 1 ? e$%#e ! -e + )$e . N- ; ),e &+6e#e$ !e %!%+ %+(! e$%e +:$+6+(!$%e e$%#e ! / :#)" . E / #! $- %e$;! ;!,+&

!$+6e %! e (* $+(! ( "!% ,e+ ( SRC= / e#, )@ e ) ! ( ##3$(+!


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!) e$%!&! &e /!+ "e ! $! (e# e "#e !%)#+&!&e e$%#e #e(9 $! (+&+$6e(%!& = )!$& ( "!#!& ( ! (#+!$ ! $- +$6e(%!&! %! /9 $! (+&!&e -e ) (e"% ,e+ . N &e* 6+$!* &! !$ *+ e )%+*+

)*%+,!#+!&!= e$%#e%!$% = ! ) (e%+/+*+&!&e "!#! #)/9 *! $- e %e,e ! (+!&! (( ##3$(+! &e /!+ "e e $e ( "#e !%)#+&!&e. E %e #e )*%!& ):e#e )e

! #e( e$&! - &e $- ,!(+$!# :e %!$%e "!#! #)/9 *! !+$&! &e,e e# !$%+&!.P!*!,#! @(;!,e #)/9 *!= $ e &! #)/9 *! ( $:3$+%!= :#!,+&e


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ABSTRACT

S!% HK. R)/e**! ,!((+$e e66e(% +$ "#e:$!$% e$ !$& %;e+# ( $(e"% &)#+$:

,!((+$!%+ $ (! "!+$: +$ S- P!)* = B#!D )% #!& ?@ F!()*&!&e &e Me&+(+$!= U$+,e# +&!&e &e S- P!)* .


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R)/e**! ,!((+$e + ( $%#!+$&+(!%e& +$ "#e:$!$% e$ &e "+%e %;e (()##e$(e 6 ( $:e$+%!* #)/e**! Q$ e >CRS? +$ %;e (;+*e$ / #$ 6# %;e# ,!((+$!%e&&)#+$: "#e:$!$(Q e#e $ % +&e$%+6+e& +$ "#e,+ ) %)&+e . T;e / e(%+,e 6 %;+

+ % e,!*)!%e %;e #+ 8 6 ( $:e$+%!* +$6e(%+ $ &)e % #)/e**! ,!((+$e ,+#) !$& (()##e$(e 6 + (!##+!:e= "#e !%)#e *!/ #= !$& * /+#%; e+:;% +$ ) (e"%+/*e !$&

+ )$e "#e:$!$% e$ >,!((+$!%e& &)#+$: "#e:$!$(Q?= +&e$%+6Q+$: %;e #+ 8 6!(% #! (+!%e&. T;+ + ! ( #%e "# "e(%+,e %)&Q #e!*+e$ELISA?= I:M@(!"%)#e !$& !,+&+%Q %e %"e#6 # e& % &e%e# +$e + )$e %!%) 6 # #)/e**! +$ ,!((+$!%e& "#e:$!$% e$F# $ %+6+e& e$= 55J0 >J =2 ? e#e %e %e&. F# %;e e= J11 >1 =5

e#e ) (e"%+/*e= 21 5 > J= ? + )$e= 2 0 > = ? e#e ( $ +&e#e&)$&e%e# +$e& !$& 2 >0=5 ? ;!& $e:!%+,e %+%e# . T +&e$%+6Q %;e +$6e(%e& $e

e ( **e(%e& ! "*e $*Q 6# ) (e"%+/*e %;e# (;+*e$ !$& 5J0 > 6 J11? e%e %e&. T e$%Q@ e,e$ $e / #$ ;!& I:M " +%+,e %+%e# +%; ! ( $:e$+%!* +$6e(%

6 = >2 5J0? !$& $ $e ;!& CRS. S+ ;)$e& 6 #%Q@6 )# ) (e"%+/*e e$ !$1 + )$e $e e#e +$,e %+:!%e& % +&e$%+6Q %;e #+ 8 6!(% # ! (+!%e&

+ (!##+!:e= * /+#%; e+:;% !$& "#e !%)#e *!/ #. T;e e$ !:e= e+:;%=:#!,+&+%Q= "!#+%Q= ;Q"e#%e$ + $= 8+$:= ! #e( #&e& 6 # %;+ %)&Q. T;e

e$ !:e ! ,e#Q + +*!# @ 2 Qe!# *& 6 # ) (e"%+/*e !$& 2 6 # + )$$e . T;e ! #+%Q 6 %;e e#e ,!((+$!%e& &)#+$: "#e:$!$(Q /e(!) e %;eQ & $ %

8$ !/ )% %;e+# %!%) . T;eQ e#e ,!((+$!%e& ,e#Q "#e( (+ ) *Q +%; =1 ee8

"#e:$!$(Q +$ %;e ) (e"%+/*e :# )" !$& +%; = ee8 +$ %;e + )$e :# )". T;e+$(+&e$(e 6 + (!##+!:e ! 5. > ? ! $: ) (e"%+/*e e$ !$& .2>10 1 ? ! $: %;e + )$e . P#e !%)#e *!/ # (()##e& +$ =1 >55 05? 6

) (e"%+/*e e$ !$& +$ .J >102 1 0 ? 6 %;e + )$e $e . L /+#%; e+:;%+$(+&e$(e ! 5. > 0J? +$ %;e :# )" 6 ) (e"%+/*e e$ !$& .>100 1 1 ? ! $: %;e + )$e . T;e#e ! $ %!%+ %+(!* &+66e#e$(e /e% ee$ %;e %:# )" . 7e / e#,e ! ;+:; +$(+&e$(e 6 * /+#%; e+:;% !$& "#e !%)#+%Q +$ %;e+$6e(%e& $e / #$ = ;e$ ( "!#e& +%; %;e (;+*e$ $ % +$6e(%e&= !* / #$

) (e"%+/*e %;e# . I$ %;e 6+$!* &e* 6 %;e * :+ %+( #e:#e + $ e &+&$! (+!%+ $ +%; #)/e**! ) (e"%+/+*+%Q !$& %;e "#e&+(% # + (!##+!:e= * /+#


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!$& "#e !%)#e *!/ #. T;e e #e )*% )::e % %;!% %;e #e( e$&!%+ $ % $,!((+$!%e "#e:$!$% e$ !:!+$ % #)/e**! ) % /e ) %!+$e&.


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KeQ #& #)/e**!= ( $:e$+%!* #)/e**! Q$ e= "#e:$!$(Q= #)/e**! ,!((+$e!&,e# e e66e(% = " $%!$e ) !/ #%+ $= "#e !%)#e +$6!$%= * /+#%; e+:;% +$6!$%


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1 INTRODUÇÃO


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1

1 INTRODUÇÃO

De ( /e#%! $ 6+$!* & 9()* VIII= ! #)/9 *! 6 + ( $%# *!&! e , #+"! e &e e$, *,+& $ *%+ 0 !$ = :#! ! ! )%+*+

e ! ) ! & e$ ! /e$+:$! e (#+!$ ! e !&)*% = ! ) e "# " # e ' ,eRN? " #%!& #e &e &e6e+% ( $:3$+% ! !+ #+! &! -e &e %e;!,+! %+& ( $%!% ( "e ! ( #)/9 *! &)#!$%e "#+ e+# ) e:)$& 3 &!:#!,+&eGREGG= 1 1?.

I$+(+!* e$%e ! )! &e ( /e#%! 6 + #e(e/+&! "e*! ( )$+&!&e (+e$% 6+(! ()+%! #e !*,! = ! = " %e#+ # e$%e )%# #e*!% &e e"+&e + * :+


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2

:e$e%+(+ %! = ( $6+# !#! #e!6+# !$& ! ! (+! - e$%#e , #) &! #)/9 *! e !( ##3$(+! &e (!%!#!%! ( $:3$+%! = !*9 &e )%# &e6e+% !+ #e (!*6 # ! e (!#& !(! ( $:3$+%! e &e6+(+3$(+! !)&+%+,! >PLOTKIN ORENSTEIN=

200 ?.

A &e ( /e#%! &e G#e::= (!) ) "# 6)$& + "!(% = " + = "e*! "#+ e+#! ,e


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3

,!(+$! e= e$%#e 1 5 e 1 , #+! (e"! ,!(+$!+ e %!,! e$& %e %!&!>MEWER e% !*.= 1 PLOTKIN e% !*. 1 ?.

1.2. S+%)! - e"+&e + * :+(! &! #)/9 *!

A #)/9 *! 9 &e ( ##3$(+! !< $!*= ( !) e$% & $ e# &e (! $6+$!* & +$,e#$ e +$ (+ &! "#+ !,e#!. N "e# & !$%e#+ # ' ,!(+$! - ( ##+!e"+&e +! ! (!&! ! !$ . Ne ! 9" (!= e %! e#! ) ! & e$ ! % "+(! &! +$6 $(+!=!( e%e$& (#+!$ ! e$%#e 5 ! 1 !$ &e +&!&e e= !+ #!#! e$%e= (#+!$ !

e$ #e &e ) !$ &e +&!&e.

N E %!& U$+& = ( ! +$%# &) - &! ,!(+$! - e 1 = / e#, )@) ! :#!$&e #e&) - $ $ e# &e (! &e #)/9 *! e &! SRC. A%9 1 0 (! &e#)/9 *! ( ##+! "#+$(+"!* e$%e e$%#e ! (#+!$ ! e !& *e (e$%e e$ #e &e 15!$ &e +&!&e. A "!#%+# &e 1 0= ! & e$ ! %e !( e%+& "#+$(+"!* e$%e !&)*%,!(+$!& = #+)$& &e "! e $&e e %! ,!(+$! - $- 9 #e!*+PLOTKIN= 2001?

N B#! +* ! ,!(+$! - # %+$e+#! ( $%#! ! #)/9 *!= $ "# :#! ! " /*+( =+$+(+ )@ e e 1 2= $ E %!& &e S- P!)* e= :#!&!%+,! e$%e= 6 + + "*!$%!&

)%# e %!& . N !$ &e 2 000 ! 2 )$+&!&e &! 6e&e#! - = !"*+(!,! ! ,!(+$!

%# "*+(e ,+#!* >( $%#! !#! " = (! ) /! e #)/9 *!?= $ (!*e$& #+ / +( = ! 1e e &e +&!&e.

A #)/9 *! "! ! ! +$%e:#!# ! *+ %! &e & e$ ! &e $ %+6+(! - ( ")* #+! $B#! +* e$%e $! e:)$&! e%!&e &! &9(!&! &e 0. E 1 = !$ e )e "!e$6#e$% ) ! *%+ ! e"+&e +! &e !#! " = 6 #! $ %+6+(!& (e#(! &e 0 000 (! &#)/9 *!= e$& )e $ "e# & 1 @2001 ( ##e#! )#% &e %! & e$ ! e , #+

e %!& & B#! +*.

A %! ! &e +$(+&3$(+! &e #)/9 *! $! " ")*! - e 2 001= (;e: ) ! 5 100 000


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4

)*;e#e = $! 6!+ ! e% #+! &e 15 ! 1 !$ e ! = 100 000 )*;e#e = $! 6!+ ! e% #+! &e20@2 !$ . Ne e "e# & / e#, )@ e ) !) e$% "# :#e +, $ $ e# &e (!&e $ e &! #)/9 *! ( $:3$+%! >SRC?= &e 200 "!#! 00 (! = #e6*e%+$&!) e$% &! (+#()*! - & , #) $! " ")*! - !&)*%!= /e ( +$(#e e$% &!e %#!%9:+! &e ,+:+* $(+! "!#! ! &e%e( - &e (! ) "e+% .

O e 6 # !%)!+ e %- &+#+:+& ' + "*e e$%! - &e ) ! ,+:+* $(+! !%

e % & e %!& = ( ! #e!*+MASSADI e% !*.= 1 5?. P!#! !$)%e$ - &e %! +%)! - ! ( /e#%,!(+$!+ $! !%+,+&!&e &e # %+$!= $ !$ e:)+$%e = &e,e#+! !$%e#@ e e*e,!&e ; :3$e! . N e$%!$% = (e#(! &e 0 ! 0 & )$+( "+ & E %!& = $-!%+$:+#! ! e%! "# " %!= )e e#! ,!(+$!# 5 &! (#+!$ ! ( ) !$ &e +&!&e( ! ,!(+$! %# "*+(e ,+#!*. E e 6!% = !*+!& ' 6!*;! ,!(+$!* >5 ?= ( $%#+/) #! "!#! !( )* &e ) (e% ,e+ . >CVE= 1 CVE= 2001? >G# 6+( 1?.

N !$ &e 2000 ( ##e) ) ! e"+&e +! $ E %!& &e S- P!)* e= '

e e*;!$ ! & )e e ,e#+6+( ) ( ! e"+&e +! & !#! " = e 1 = ; ),e&e * (! e$% / e#, )@ e ) &e * (! e$% &! 6!+ ! e% #+! &e +$(+&3$(+! &! & e"!#! ! " ")*! - &e !&)*% ,e$ . A !+ # "# " # - & 2 55 (!


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5

( $6+# !& = ( ##e) e "e ! &e 20 ! 2 !$ &e +&!&e >5J= ?= #+ ( &!& e(+ e$% 6 + %! /9 !+ # $e %! 6!+ ! e% #+! >2 = (! 100 000 ;!/? >G# 62 ?. Ne e e !$ 6 #! $ %+6+(!& 1 (! &e #)/9 *! e :e %!$%e = e$&1 e 2 $! 6!+ ! e% #+! e$%#e 15@1 !$ e 20@2 !$ = #e "e(%+,! e$%e>G#

?. De$ +$! @ e= ( (! ( $6+# !& &e #)/9 *!= )!$& ; "#e e$ ! &e!*6 # ! e ( $:3$+%! e "e* e$ ! "#e e$ ! &e !$%+( #" I:M e "e( 6+( e

(! ( "!% ,e* )!$& #e )*%!& *!/ #!% #+!+ - +$ )6+(+e$%e "!#! ( $6+#

& &+!:$ %+( e RN !"#e e$%!# &)! &! ( "*+(! e #e*!(+ $!&! $ +%e 1 ) ! & +%e 1 ! (+!&! ' )%#! & +%e 2 >CVE= 1 ?


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6

1? (!%!#!%! :*!)( ! >+$%e#"#e%!# ( ) ! !$+6e %! - ?=(!#&+ "!%+! ( $:3$+%!= )#&e


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8

A rubl% & *r%/sm * $% +#r "#/*%*# $ r'*# "#m /$ ví$u#s /3'"*%$#s+#r m' # $%s #*í"ul%s $' s'"r' B's $% /%s#3%r / ' A *r%/sm ss # +#r

m' # $' #b '*#s "#/*%m /%$#s & +#u"# 3r' F'/*' O /$ ví$u# /3'"*%$#

+#$' *r%/sm * r % $#'/ % "'r"% $' " /"# $ %s %/*'s %*& 5 % , $ %s %+9s #

%+%r'" m'/*# $# '1%/*'m%

N% rubl% "#/ G/ *% # vírus & *r%/sm * $#! +#r v % +l%"'/*ár %! $m ' +%r% # 3'*# As "r %/ %s "#m rubl% "#/ G/ *%! +#$'m 'l m /%r # vírus

+'l% ur /% ' s'"r' B's /%s#3%rí/ '%s +#r um +'rí#$# su+'r #r % um %/#!

m%s % 'l m /% # & m% #r /#s +r m' r#s m's's $' v $%

O +'rí#$# $' /"ub% # & $' >2 % 2 $ %s


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9

1.5. P!% :e$+! e "!% * :+! &! #)/9 *! ( $:3$+%!

A" ,+#e +! !%e#$! ( ##e ! +$6e( - &! "*!(e$%! e ,+#e +! 6e%!* (( $ e Ye$%e +$6e( - &e *%+"* #:- . A !*6 # ! e :e#!* e$%e ( ##e

)!$& ! +$6e( - !( e%e ! :e %!$%e $! "#+ e+#! +% ! 12 e !$! &e :e %! - .O , #) &! #)/9 *! +$+/e ! +% e e !) e$%! $ e# &e 6#!: e$% &e

(# e ()*%)#! &e %e(+& e /#+ $ #+ = e " # + #:- !( e%+6+(! ;+" "* +( . O/ e#,!@ e %! /9 ! "#e e$ ! &e $e(# e (e*)*!#= "# (e+$6*! !% #+ e ,! ()*+%e.

A %e#!% :e$+(+&!&e & , #) &! #)/9 *! 9 e,+&e$%e= $ e$%!$% = e(!$+ !+$&! $- e % % %!* e$%e e (*!#e(+& . A #e"*+(! - ,+#!* " &e *e,!# '

!$ # !*+&!&e +% ( $+!+ e !*%e#! e & e )e*e% (e*)*!#= e

#e(e$%e e e$%e= %e @ e +$,e %+:!& ! " +/+*+&!&e & , #) "# , (!# ! #(e*)*!# " # !" "% e >PUGACHEV FREW= 1 J LEE BO7DEN= 2 000?.

U ! ,e< 6e% +$6e(%!& = , #) "e# + %e " # % &! ! :e %! - e !%9 (e#(! ) !$ !" $! (+ e$% . O , #) &! #)/9 *! " &e !(!##e%!# &!$ e$ # e e

*%+"* #:- !+$&! e &e e$, *,+ e$% ( + %e ! $e#, (e$%#!*= ( #!+ %e ! !)&+%+, = ()*!#= e%(. A e %e$ - & !( e%+ e$% &e"e$&e# &! 9" (

+$6e( - )!$% !+ "#e( (e= !+ #e e#- &!$ / e#,!& >CHERRW= 1 JCOOPER e% !*.= 2000?.


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10

1. . R+ ( &e +$6e( - 6e%!* e &e6e+% ( $:3$+% .

A +$6e( - !%e#$! " &e (!) !# !/ #%! e$% "#e( (e ) %!#&+ =e /#+ "!%+!= #e %#+ - & (#e (+ e$% 6e%!*= "!#% "#e !%)# = /+% +$%#

!*6 # ! e ( $:3$+%! = /+% $e $!%!* e !"!#e(+ e$% %!#&+ &e )%# &e6>COOPER= 2000?.

MILLER e% !*. >1 J2?= e ) e %)& "# "e(%+, &e :e %!$%e +$6e(%!&"e* , #) &! #)/9 *!= / e#, ) )e )!$& ! & e$ ! ( ##e) $ "#+ e+# %#+ e %#e&e :#!,+&e< J1 >1 1 ? & 6e% e %!,! +$6e(%!& . N e:)$& %#+ e %#e ;) ! #e&) - "!#! > 0 1 J?= e*e,!$& @ e $ ,! e$%e "!#! 5 > ? $%e#(e+# %#+ e %#e. N 6+$!* &! :e %! - ! "*!(e$%! "e# +%e ! "! !:e & , #) &R)/9 *! >MILLER e% !*= 1 J2?.

Se ! +$6e( - ( ##e# $ "#+ e+# %#+ e %#e &e :e %! - = #+ ( &e $&! #)/9 *! ( $:3$+%! >SRC? 9 (e#(! &e J5 = " #9 = e "e# & e e %e$&e# !%9 20

e !$! = #+ ( (!+ "!#! 20 . )!$& ! +$6e( - ( ##e !" ! 20[. e !$! &e:e %! - $- ; #e*!% &e $e$;) ! !$+6e %! - ( "!% ,e* ( ! SRC= $!*+%e#!%)#! >MILLER e% !*= 1 J2?.


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11

C "!#!$& e e e %)& ( )%# ")/*+(!& $! *+%e#!%)#!=

/ e#,! @ e !*:) ! &+6e#e$ ! = e #e*! - ' %! ! &e +$6e( -

- C#!& (8@7!% $ e% !*= / e#,!#! )e 2 & RN 6+*; &e -e (R)/9 *! $ "#+ e+# %#+ e %#e e %!,! +$6e(%!& e= $ e:)$& %#+ e %#e

%! ! (!+) "!#! 2 >CRADOCK@7ATSON e% !*= 1 J0?.

- Pe(8;! e% !*.= / e#,!#! )e (e#(! &e J5 &! (#+!$ ! = $! (+&! &e -e+$6e(%!&! $! "#+ e+#! +% e !$! &e :e %! - = !"#e e$%!#! !*:)\&e6e+% ]= !%9 )!%# !$ &e +&!&e $! e !$! )/ e Ye$%e &! [. ' 12

e !$! 52 &! 1 ! . ' 20[. e !$! 1 e= !" ! 20[. e !$!= $e$;) !(#+!$ ! !"#e e$%!,! )!* )e# %+" &e "!% * :+! >PECKHAM e% !*.= 1 J5?.

- E$&e# e% !*= ,e#+6+(!#! e*e,!&! %! ! &e !*6 # ! - )!$& ! +$6e( -!%e#$! ( ##e) $! "#+ e+#! e !$! &e :e %! - . Se ! +$6e( - !%e#$!( ##e) $! "#+ e+#! &e 11 e !$! &e :e %! - = &e 11 ! 12 e !$! = &e 1

! 1 e !$! = &e 15 ! 1 e !$! = ! %! ! &e !*6 # ! - 6 #! &e 100> ?= 50 >2 ?= 1 >2 12? e 50 > 1 ?= #e "e(%+,! e$%e. Ne e e %6 #! +&e$%+6+(!&! !*6 # ! e (!#& !(! e &e6+(+3$(+! !)&+%+,! $! (#+!$+$6e(%!&! $! "#+ e+#! 11 e !$! &e :e %! - . A &e6+(+3$(+! !)&+%+,! 6 +

$+(! !*%e#! - / e#,!&! )!$& ! +$6e( - ( ##e) e$%#e ! 11[. ! 1 [.e !$! &e :e %! - . Ne$;) &e6e+% 6 + +&e$%+6+(!& $!


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(#+!$ ! +$6e(%!&! !" 1 e !$! &e :e %! - = e (e% !*:) ! (#e%!#& &e (#e (+ e$% +$%#!@)%e#+$ >ENDERS e% !*= 1 J?.

1. . M!$+6e %! e (* $+(!

1. .1. R)/9 *! " @$!%!*

N! #)/9 *! " @$!%!*= ! "e ! +$6e(%!&! " &e# !"#e e$%!# ) e !$%e !()* @"!")*!# &+ (#e% = e ( "!#! - ( !#! " e ! e (!#*!%+$!= (

&)#! - &e %#3 &+! e &+ %#+/)+ - (# $+ @(!)&!*. ^ e&+&! )e !%+$:e e+$6e#+ #e = ,!+ \(*!#e!$& ] $! 6!(e e !+$&! "e# !$e(e ( !*e (e$%e !"e$! $

%# $( . N! (#+!$ ! :e#!* e$%e $- ; "# = ! e !& *e (e$%e e !&)*%(e#(! &e ) ! (+$( &+! !$%e & +$ (+ & e !$%e != / e#,!@ e 6e/#e /!+ != %( #+


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1. .2. R)/9 *! ( $:3$+%!

O , #) &! #)/9 *!= +$6e(%!$& ) ! )*;e# :# ,+&! $- + )$e " &e# !%)!# $!

"*!(e$%! e ) 6e% e #+ ( &e +$6e( - ( $:3$+%! e &! SRC &e"e$&e# &! +&!&

:e %!(+ $!* e )e ( ##e) ! +$6e( - . O #+ ( &e +$6e( - e &! SRC &e(#e (e (

!) e$% &! +&!&e :e %!(+ $!*. A" ! +$6e( - !%e#$!= " &e#- ( ##e# ! e:)+$%e

+%)! e 6e% $- +$6e(%!& = #e!/ # - & 6e% = )e " &e# !( $%e(e# )!

+$6e( - "e* , #) &! #)/9 *! !( e%e e /#+- )+% $ +$ (+ &! :e %! - = !/ #%

e " $% $e = $!%+ #%!*+&!&e= +$6e( - &! "*!(e$%! e e$, *,+ e$% & 6e% = +

&! "*!(e$%! e & 6e% >COOPER e% !*.=2000?.

A SRC e$, *,e , #+! !*6 # ! e $! &e"e$&3$(+! &! 6! e &! :e %! - e( ##e) ! ,+#e +!.


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· =%/ 3's*% # "lí/ "%s $% SRC ??7. COOPER '* %l ! 2000! REEJ'* %l! 2000@

Os RN "#m SRC +#$'r # %+r's'/*%r m%/ 3's*% B's "lí/ "%s l# # %#/%s"'r A *%1% $' m#r*%l $%$' /# +r m' r# %/# $' v $% & 'l'v%$%! $'v $#) m #"%r$ *' ' % #u*r%s %l*'r% B's "%r$í%"%s! +/'um#/ % /*'rs* " %l!

*r#mb#" *#+'/ %! '/"'3%l *' ' ('+%* *'

· =%/ 3's*% B's *r%/s *9r %s

Al u/s RN /3'"*%$#s +#$'r # %+r's'/*%r! l# # %# /%s"'r!('+%*#'s+l'/#m' %l %! "*'rí" %! %/'m % ('m#lí* "%! '1%/*'m% má"ul#;+%+ul%r! *r#mb#" *#+'/ %! +/'um#/ % /*'rs* " %l! m #"%r$ *'! $ %rr&r%$ #lus"G/" % 9ss'% ' b% 1# +'s# u%/$# (á m%/ 3's*% B's "lí/ "%s!"#m "#m+r#m'* m'/*# $' vár #s s s*'m%s! 'r%lm'/*' (á m%l3#rm% B's

r%v's

· =%/ 3's*% B's +'rm%/'/*'s

Um% r'"'/*' r'v s # $% l *'r%*ur% r'l%" #/#u %s +r /" +% s m%/ 3's*% B's"lí/ "%s $% SRC $'3 " G/" % %u$ * v%! "%r$ #+%* % "#/ G/ *%


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Tabela 1 D+ %#+/)+ - & &e6e+% e #e(9 @$! (+& ( SRC &!& ( "!#!%+, e$%#e e % "# "e(%+, e #e*!%!& e *+,# %e % >REEF e% !*.= 2 000?.

Manifestações clínicas Número RN avaliados Relato em

de estudos !"# livros te$to !"

De6+(+3$(+! !)&+%+,! 10 J 11 > 0? J0@ 0

C!#&+ "!%+! ( $:3$+%! 5 100 > 5?

@ Pe# + %3$(+! & &)(% !#%e#+!* 5 >20? 0

@ E %e$ e ")* $!# "e#+69#+(! >12? 25__

M+(# (e6!*+! 1 >2 ? R!#

C!%!#!%! 1 5 >25? 5

B!+ "e >`2.500:? 2 5 22 >2 ? 50@J5

He"!% e "*e$ e:!*+! 1 >1 ? 10@20

P #")#! 5 11 5 >1 ? 5@10

Re%!#& e$%!* 2 2 15 >1 ? 10@20Me$+$: e$(e6!*+%e 5 >10? 10@20

R!&+ *) (3$(+! e! > ? 10@20

Re%+ $ "!%+! 2 >5? 5

>M &+6+(!& &e REEF e% !*= 2000?* $ . &e RN ( e,e$% $ e# &e RN !,!*+!& > ?* +$(*)+ ;+" "*! +! &e !#%9#+! ")* $!#= e %e$ e )"#!,!*,)*!#= e %e$ e &! , *,)*! e e %e$ e &#! "e#+69#+( .

· De6+(+3$(+! !)&+%+,!

É ! !$+6e %! - !+ ( ) $ RN ( SRC > 0 ?. C!) !&! " # !*%e#! e&e:e$e#!%+,! &! ( (*e! e $ #:- &e C #%+ >$e)# e$ #+!*?= " &e e# &e :#!),!#+!& e :e#!* e$%e 9 /+*!%e#!*. D+6e#e$%e e$%e &! !*%e#! e ()*!#e(!#& !(! = )e :e#!* e$%e e !$+6e %! e ! +$6e( - "e* , #) &! #)/9 *!

( ##e !%9 ! J[. e !$! &e :e %! - = #:- &e C #%+ " &e e# !( e%+& !%9 1J) 20[. e !$! . De$%#e ! !$+6e %! e ( $:3$+%! = 9 ! )e !+

6#e )e$%e e$%e ( ###e ( &e6e+% $+( . Pe ! ( &e6+(+3$(+! !)&+%+( "# e%+ e$% &!


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6!*!= " &e e# ( $6)$&+&! ( "!(+e$%e ( #e%!#& e$%!*. A &e6+(+3$!)&+%+,! > 0 ? 6 + ( "# e%+ e$% !+ 6#e Ye$%e e$%#e RN ( SR>REEF e% !*= 2000?.

A S (+e&!&e B#! +*e+#! &e Pe&+!%#+! #e( e$&! ! %#+!:e !)&+%+,! )$+,e# !* "!#! RN. )!$% !+ "#e( (e &+!:$ %+( e ! +$%e#,e$ - = e*; # e#

&e e$, *,+ e$% &! 6!*! e &! *+$:)!:e . I$+(+!* e$%e ! !)&+ - 9 !,!*+!&! "e*!e + - &e $&! % !( %+(! (! #e )*%!& e ! !$ # !* 9 #e!*+BERA?.

M!$+6e %! e (!#& !(!

A !$ # !*+&!&e (!#& !(! = e "!#%+()*!# ! (!#&+ "!%+! ( $:3$+%! = !(;!& (* +( &! SRC. A !+ #+! & !( e%+& %3 &e6e+% &e \6*e "e(+!* e$%e "e# + %3$(+! & &)(% !#%e#+!*= e %e$ e &! !#%9#+! ")*e %e$ e &! , *,)*! ")* $!#. N RN ( ( "# e%+ e$% )*%+ + %3 +( =

+ #(!&+%e 6#e )e$%e e$%e 9 ! (!) ! &e /+% . C $ +&e#!$& @ e ! )! e*e,!&6#e Y3$(+!= #e( e$&!@ e ! #e!*+


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M!$+6e %! e ()*!#e

A "#+$(+"!+ !*%e#! e - (!%!#!%!= +(# 6%!* +! +(# ( #$e!= #e%+"+: e$%!# e :*!)( !. A !+ #+! &! (!%!#!%! 9 /+*!%e#!* e e %- "#e e$%e !$! (+ e$% . P &e e# )+% &+ (#e%! = #e )e#e$& e ! e 6%!* * :+( !()#!&O %#!%! e$% (+# #:+( %e #e )*%!& +$ !%+ 6!% #+ = &e,+& !+$6*! !% #+ +$%e$ . A #e%+$ "!%+! 9 ! !$+6e %! - ()*!# !+ ( ) = !6e%!!()+&!&e ,+ )!*= e :e#!* e$%e 9 /+*!%e#!*.

C#e (+ e$% +$%#!@)%e#+$ #e%!#&!&

O RN ( !$+6e %! e (* $+(! &! SRC= $! (e ( "e ` 2.500: e=:e#!* e$%e= $- - "#e !%)# . A" $! (+ e$% )+% ( $%+$)! (

&+6+()*&!&e &e :!$;!# "e .

M!$+6e %! e $e)# * :+(!

P &e ;!,e# +(# (e6!*+! e e$+$: e$(e6!*+%e ! $! (+ e$% e= !+ %!#&+! e$%e!%#! $ &e e$, *,+ e$% $e)# " +( % # e #e%!#& e$%!*.

M!$+6e %! e %!#&+!

V #+! - ! ;+" %e e )e " &e e "*+(!# ! ( ##3$(+! &e !$+6e %! e %!#&+e &e( ##3$(+! &! +$6e( - "e* , #) &! R)/9 *! "e# + %3$(+! ) #e!%+,! - &!+$6e( - ,+#!*= "#e e$ ! &e + )$ ( "*e e !)% @!$%+( #" . H #e*!%

e$& (#+$ "!%+! = &e6+(+3$(+! !)&+%+,!=


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)%+*+

"# ,!,e* e$%e " # % &! ! ,+&!.

1.J. . E,e$% !&,e#

) ! ,!(+$! /e % *e#!&! e " )( #e!% :3$+(!. N e$%!$% !*:) ! "e !,!(+$!&! " &e#- !"#e e$%!# #e! e * (!+ >& #= e&e != #)/ # e (!* #?= 6e/#e ee !$%e ! >e$%#e 5X e 12 X &+! !" ! ,!(+$! - ?= *+$6!&e$ "!%+! >e$%#e 5X e 12X &+!?=& # !#%+()*!# > e 21X &+!? e #e! e + e&+!%! &e ;+"e# e$ +/+*+&!&e

1.J. . C $%#!@+$&+(! e :e#!+ .

P # e %#!%!# &e ) ! ,!(+$! !%e$)!&!= 9 ( $%#!@+$&+(!&! e :e %!$%e = $! "e( + )$ &e6+(+3$(+! ( $:3$+%! ) !& )+#+&! >e (e% ! (#+!$ ! +$6e(%!&! "e* ,HIV ! +$% %+(! ?= $! )e*! ( $e "*! +! !*+:$! = $! "e ! e %#!%! e$%( ( #%+( +&e e & e e*e,!&! >e )+,!*e$%e ! "#e&$+ $! $! & e &e 2 : 8: &

) !+ =


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" # !+ &e )! e !$! ? ) )/ e%+&! ! %e#!"3)%+(! + )$ &e"#e #!> )+ + %e#!"+!= #!&+ %e#!"+!= e%(? ) ( ;+ % #+! &e #e! - !$!6+* %+(! e!$%e#+ #e ) ! )!* )e# ( " $e$%e &! ,!(+$!.

1.'.(. %acinação contra rub&ola em mul)eres *r+vidas

E 1 1= Ce$%# &e C $%# *e &e D e$ ! >CDC? & EUA + "*!$% ) )+ %e ! &e $ %+6+(! - &e :e %!$%e )e 6 #! ,!(+$!&! e e !$%e ) !" !

( $(e" - = "!#! e:)+ e$% &! :e %! - e !,!*+! - & ( $(e"% >CDC= 1 J1?.

N "e# & &e 1 ! 1 J ! ,!(+$! )%+*+CDC= 1 J PLOTKIN= 200 ?.

C ! (e"! RA2 = J :e %!$%e 6 #! ,!(+$!&! +$!&,e#%+&! e$%e. F +" ,e* !,!*+!# 5 2 RN 6+*; &e ! -e e $e$;) !"#e e$% ) !$+6e %! e(* $+(! ( "!% ,e+ ( ! SRC. F #!


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+&e$%+6+(!&! 2 2 :e %!$%e ) (e% ,e+ ' #)/9 *!. e 6 + " ,e* !,!*+!# (*+$+(! e212 RN. Ne$;) !"#e e$% ) !$+6e %! e (* $+(! ( "!% ,e+ ( SRC. D + RN!"#e e$%!#! ;+" " &+!= ! e %! !$+6e %! - $)$(! 6 + #e*!(+ $!&! ( ! SRC.F + " ,e* #e!*+HI? e=

" %e#+ # e$%e= 9% & &e e$ELISA? >1 J ?.

A*9 &+ = $e e e "e# & = 6 #! #e!*+1 ?= e$ )!$% "!#! ! ,!(+$!&! ( ! (e"! Ce$&e;+* e HPV@6 + &e 20 >1 J5? >CDC= 1 J ?.

N Re+$ U$+& = $ "e# & &e 1 J1 ! 1 0= %! /9 6 + #e!*+ =2 ? e#! ) (e% ,e+ $ e$% &!,!(+$! - . De ! 0 :e %! e 6 + " ,e* !,!*+!# 2 $! (+& ,+, >J = ?= 2$!%+ #% > = ? e 2 !/ #% e " $% $e > = ?. A"e$! ) RN >5=0 = 1 2! +$% %+( = !"#e e$% ) # * :+! #e!:e$%e "!#! R)/9 *! >1 20? > TOOKEW e%1 1?

N! A*e !$;!= $ "e# & &e 1 1 ! 1 J = 25 :e %!$%e 6 #! ,!(+$!&!( ! (e"! RA2 e 1 &e*! > =0 ? e#! ) (e% ,e+ .


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Ne$;) RN &e$%#e 12 !,!*+!& = !"#e e$% ) # * :+! #e!:e$%e. O %e %e*!/ #!% #+!* )%+*+HI? >ENDERS= 1 J5? > )!

uadro 1 Ge %!$%e ) (e% ,e+ ,!(+$!&! ( $%#! ! #)/9 *! >(e"! RA 2 ?= e !,!*+! - (* $+(! &e) #e(9 @$! (+& .

-aís estantes Nascidos vivos RN com /R0 RN# com *M2

suscetíveis e$aminados

EUA 2 2 212 @ 2 15 >1= ?Re+$ U$+& 0 2 @ 1 20 >5=0 ?

A*e !$;! 1 12 @ 0 12 >0=0 ?

T %!* 1J 250 @ 1J >1= ?

_$ e# &e RN ( I:M #e!:e$%e $ e# &e RN )e ( *;e#! !$:)e

U e %)& (!$!&e$ e !,!*+ ) )*;e#e ,!(+$!&! ( ! (e"! RA2&)#!$%e ! :e %! - ) $ %#3 e e "#e(e&e$%e 5 >5J=2 ? &e*! e#!

) (e% ,e+ "!#! #)/9 *!. A :e %!$%e 6 #! ( "!#!&! ( )%#! e " %! ! e&+(! e$% $- %e#!% :3$(+ >( !*+(+*!% = "e$+(+*+$!= ;+ %! $+( = !(e%! +$ 6e$? ) )e ;!,+! #e!*+RRb0= IC 5 = 0= 2@2= ? ) /!+ "e >"b0= ? >BAR@OZ e200 ?.


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De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+ A*e !$;! ! ,!(+$! )%+*+SECRETARIA DE ESTADO DASAcDE DE SÃO PAULO= 1 J?C $ +&e#!$& ! e "e#+3$(+! &! #e:+ $!* &eC! "+$! &)#!$%e ! (! "!$;! &e ,!(+$! - ( $%#! ! Fe/#e A !#e*!= )!$& =!"e !# &! #+e$%! e "!#! $- ,!(+$!# )*;e#e :# ,+&! = J0 :e %!$%e 6 #!,!(+$!&! = 6 + + "*!$%!& e % & e %!& &e S- P!)* = ) S+ %e ! E %!&)!* &N %+6+(! - &e Ge %!$%e ,!(+$!&! >SENGV?. O / e%+, &e %e + %e ! 6!( "!$;!# ! :e %!$%e ,!(+$!&! ( $%#! ! #)/9 *!= +&e$%+6+(!# ! ) (e% ,e+ e!,!*+!# RN +$6e(%!& "e* , #) ,!(+$!*.

Le,!$& @ e e ( $%! )e $ e# &e RN +$6e(%!& "e* , #) ,!(+$!*&e (#+% $! *+%e#!%)#! $- 9 )+% :#!$&e e )e ! &+ " $+/+*+&!&e !%)!* &e 9%

*!/ #!% #+!+ "e# +%+# ) ! &e%e( - !+ e$ ,e* e e "e( 6+(! &e :e %!$%


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) (e% ,e+ e & RN +$6e(%!& "e* , #) ,!(+$!* e %e e %)& 6 + &e e$, *,+&) ! e*; # !,!*+! - & e6e+% &! ,!(+$! ( $%#! ! #)/9 *! /#e "# &)%( $(e"%)!*.

De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+

A*e !$;! ! ,!(+$! )%+*+SECRETARIA DE ESTADO DASAcDE DE SÃO PAULO= 1 J?C $ +&e#!$& ! e "e#+3$(+! &! #e:+ $!* &eC! "+$! &)#!$%e ! (! "!$;! &e ,!(+$! - ( $%#! ! Fe/#e A !#e*!= )!$& =!"e !# &! #+e$%! e "!#! $- ,!(+$!# )*;e#e :# ,+&! = J0 :e %!$%e 6 #!,!(+$!&! = 6 + + "*!$%!& e % & e %!& &e S- P!)* = ) S+ %e ! E %!&)!* &N %+6+(! - &e Ge %!$%e ,!(+$!&! >SENGV?. O / e%+, &e %e + %e ! 6!( "!$;!# ! :e %!$%e ,!(+$!&! ( $%#! ! #)/9 *!= +&e$%+6+(!# ! ) (e% ,e+ e!,!*+!# RN +$6e(%!& "e* , #) ,!(+$!*.

Le,!$& @ e e ( $%! )e $ e# &e RN +$6e(%!& "e* , #) ,!(+$!*


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&e (#+% $! *+%e#!%)#! $- 9 )+% :#!$&e e )e ! &+ " $+/+*+&!&e !%)!* &e 9%*!/ #!% #+!+ "e# +%+# ) ! &e%e( - !+ e$ ,e* e e "e( 6+(! &e :e %!$%


De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&

#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+ A*e !$;! ! ,!(+$! )%+*+SECRETARIA DE ESTADO DASAcDE DE SÃO PAULO= 1 J?C $ +&e#!$& ! e "e#+3$(+! &! #e:+ $!* &eC! "+$! &)#!$%e ! (! "!$;! &e ,!(+$! - ( $%#! ! Fe/#e A !#e*!= )!$& =!"e !# &! #+e$%! e "!#! $- ,!(+$!# )*;e#e :# ,+&! = J0 :e %!$%e 6 #!,!(+$!&! = 6 + + "*!$%!& e % & e %!& &e S- P!)* = ) S+ %e ! E %!&)!* &N %+6+(! - &e Ge %!$%e ,!(+$!&! >SENGV?. O / e%+, &e %e + %e ! 6

!( "!$;!# ! :e %!$%e ,!(+$!&! ( $%#! ! #)/9 *!= +&e$%+6+(!# ! ) (e% ,e+ e


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!,!*+!# RN +$6e(%!& "e* , #) ,!(+$!*.Le,!$& @ e e ( $%! )e $ e# &e RN +$6e(%!& "e* , #) ,!(+$!*

&e (#+% $! *+%e#!%)#! $- 9 )+% :#!$&e e )e ! &+ " $+/+*+&!&e !%)!* &e 9%*!/ #!% #+!+ "e# +%+# ) ! &e%e( - !+ e$ ,e* e e "e( 6+(! &e :e %!$%


De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+ A*e !$;! ! ,!(+$! )%+*+SECRETARIA DE ESTADO DASAcDE DE SÃO PAULO= 1 J?C $ +&e#!$& ! e "e#+3$(+! &! #e:+ $!* &eC! "+$! &)#!$%e ! (! "!$;! &e ,!(+$! - ( $%#! ! Fe/#e A !#e*!= )!$& =!"e !# &! #+e$%! e "!#! $- ,!(+$!# )*;e#e :# ,+&! = J0 :e %!$%e 6 #!

,!(+$!&! = 6 + + "*!$%!& e % & e %!& &e S- P!)* = ) S+ %e ! E %!&)!* &


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N %+6+(! - &e Ge %!$%e ,!(+$!&! >SENGV?. O / e%+, &e %e + %e ! 6!( "!$;!# ! :e %!$%e ,!(+$!&! ( $%#! ! #)/9 *!= +&e$%+6+(!# ! ) (e% ,e+ e!,!*+!# RN +$6e(%!& "e* , #) ,!(+$!*.

Le,!$& @ e e ( $%! )e $ e# &e RN +$6e(%!& "e* , #) ,!(+$!*&e (#+% $! *+%e#!%)#! $- 9 )+% :#!$&e e )e ! &+ " $+/+*+&!&e !%)!* &e 9%*!/ #!% #+!+ "e# +%+# ) ! &e%e( - !+ e$ ,e* e e "e( 6+(! &e :e %!$%

) (e% ,e+ e & RN +$6e(%!& "e* , #) ,!(+$!* e %e e %)& 6 + &e e$, *,+&

) ! e*; # !,!*+! - & e6e+% &! ,!(+$! ( $%#! ! #)/9 *! /#e "# &)%( $(e"%)!*.

De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+ A*e !$;! ! ,!(+$! )%+*+SECRETARIA DE ESTADO DASAcDE DE SÃO PAULO= 1 J?C $ +&e#!$& ! e "e#+3$(+! &! #e:+ $!* &e

C! "+$! &)#!$%e ! (! "!$;! &e ,!(+$! - ( $%#! ! Fe/#e A !#e*!= )!$& =


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!"e !# &! #+e$%! e "!#! $- ,!(+$!# )*;e#e :# ,+&! = J0 :e %!$%e 6 #!,!(+$!&! = 6 + + "*!$%!& e % & e %!& &e S- P!)* = ) S+ %e ! E %!&)!* &N %+6+(! - &e Ge %!$%e ,!(+$!&! >SENGV?. O / e%+, &e %e + %e ! 6!( "!$;!# ! :e %!$%e ,!(+$!&! ( $%#! ! #)/9 *!= +&e$%+6+(!# ! ) (e% ,e+ e!,!*+!# RN +$6e(%!& "e* , #) ,!(+$!*.

Le,!$& @ e e ( $%! )e $ e# &e RN +$6e(%!& "e* , #) ,!(+$!*&e (#+% $! *+%e#!%)#! $- 9 )+% :#!$&e e )e ! &+ " $+/+*+&!&e !%)!* &e 9%

*!/ #!% #+!+ "e# +%+# ) ! &e%e( - !+ e$ ,e* e e "e( 6+(! &e :e %!$%) (e% ,e+ e & RN +$6e(%!& "e* , #) ,!(+$!* e %e e %)& 6 + &e e$, *,+&

) ! e*; # !,!*+! - & e6e+% &! ,!(+$! ( $%#! ! #)/9 *! /#e "# &)%( $(e"%)!*.

De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+ A*e !$;! ! ,!(+$! )%+*+SECRETARIA DE ESTADO DA


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SAcDE DE SÃO PAULO= 1 J?C $ +&e#!$& ! e "e#+3$(+! &! #e:+ $!* &eC! "+$! &)#!$%e ! (! "!$;! &e ,!(+$! - ( $%#! ! Fe/#e A !#e*!= )!$& =!"e !# &! #+e$%! e "!#! $- ,!(+$!# )*;e#e :# ,+&! = J0 :e %!$%e 6 #!,!(+$!&! = 6 + + "*!$%!& e % & e %!& &e S- P!)* = ) S+ %e ! E %!&)!* &N %+6+(! - &e Ge %!$%e ,!(+$!&! >SENGV?. O / e%+, &e %e + %e ! 6!( "!$;!# ! :e %!$%e ,!(+$!&! ( $%#! ! #)/9 *!= +&e$%+6+(!# ! ) (e% ,e+ e!,!*+!# RN +$6e(%!& "e* , #) ,!(+$!*.

Le,!$& @ e e ( $%! )e $ e# &e RN +$6e(%!& "e* , #) ,!(+$!*&e (#+% $! *+%e#!%)#! $- 9 )+% :#!$&e e )e ! &+ " $+/+*+&!&e !%)!* &e 9%*!/ #!% #+!+ "e# +%+# ) ! &e%e( - !+ e$ ,e* e e "e( 6+(! &e :e %!$%


De !( #& ( ! A&,+ #Q C +%%ee $ I )$+ACIP?= e2001= :#)" ! e # & Se#,+ &e S! &e P /*+(! & EUA= !$!*+ ) &!&#e*!%+, ! J0 RN &e )*;e#e ) (e% ,e+ ! #)/9 *! e ,!(+$!&! &)#!$%e !:#!,+&e< ) $ %#3 e e "#e(e&e$%e $ E %!& U$+& = I$:*!%e##!= S)9(+ A*e !$;! ! ,!(+$! )%+*+

+&!&e e ( "#e(!) - = &e !( #& ( ! N # ! & P# :#! ! E %!&)!* &e


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I )$+


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