Dengue and Coronavirus, a Double Battle

Beds have been set up in the hallways of the Pepe Portilla Pediatric Hospital for patients with fever. (Juan Carlos Fernández/Archive)

14ymedio bigger14ymedio, Havana, April 2, 2020 — “I began feeling very bad, weak, and when I saw that I was getting a rash, I knew it was dengue,” says Manuel, 46, from Camagüey. Dengue continues unabated, but now it competes with the propagation of the coronavirus, which has priority.

Manuel lives in Reparto Garrido, where, in the last weeks, numerous cases of dengue have beem diagnosed, which was confirmed by a source in the Ministry of Public Health in the province. “They’re not being hospitalized unless the patient is very serious because all the hospital beds are being reserved for people with coronavirus,” added Manuel.

“They are requiring that anyone in the house with dengue stay under a mosquito net. But this is complicated by the fear of COVID-19,” he explains. “Now, in addition to preventing a mosquito bite and spreading the virus to my family, I have to maintain strict hygenic measures. But I can barely move from my bed, so I’m using alcohol to wash my hands, but I don’t have much left and there isn’t any in the pharmacy.”

In the middle of last year, when the incidence of dengue reached worrisome levels on the Island, the Pedro Kourí Institute of Tropical Medicine hosted an international course about dengue, zika and other emerging arboviruses that created a national project to combat the Aedes aegypti mosquito with the application of ionizing radiation.

The method, known as insect sterilization, consists of irradiating the males in their pupal state and freeing them so that when they mate with wild females, they don’t produce young. But they didn’t specify the date of putting the strategy into practice nor its extent on the national territory.

In October 2019, it was announced that the health authorities on the Island were promoting the breeding of guppies as an alternative measure against the Aedes aegypti mosquito. An experiment of this type was launched in the province of Cienfuegos, as an “economical and effective variant” to eradicate the plague, because one single fish can devour between 60 and 150 insect larvae in a day.

However, the new strategies in the fight against the mosquito coincided with a fall in the frequency of fumigation, especially by the lack of fuel that forced them to reduce the zones where it was applied. “We are only authorizing fumigation in the houses and surrounding areas where a case of dengue is detected, but we don’t have enough to do it effectively,” a Camagüeyan medical source told 14ymedio.

“Now, with the rise in temperature, an outbreak of dengue is beginning, and the situation can get worse because it’s been months since we’ve had a fumigation campaign on the national level,” says the source. “It’s really difficult to struggle against two viruses at the same time, and although dengue is an old acquaintance in Cuba, now we are in a very unfavorable situation to confront it.”

The Panamerican Health Organization (PHO) warned in the middle of March of the need to take measures to minimize the consequences of dengue, which already had left 156 dead so far this year. In a recent report, it pointed out that the region was facing the “worst epidemic” in the history of the continent.

“It is estimated that there will be an elevated incidence for the whole region in 2020. The first quarter is very complex for the Southern Cone, and we began the year with situations of high transmission in Paraguay, Bolivia, Brazil, Colombia, Costa Rica, Honduras, Mexico and Peru,” said Marcos Espinal, Director of the PHO Department of Transmissible Disease and Environmental Health Determinants.

“After two years of low incidence in 2017 and 2018, we had a year in 2019 with 3.1 million cases of dengue, the largest figure in history,” he explained. “But so far this year, more than 661,818 cases have been reported, of which 1,820 were diagnosed as serious.”

The experts have asked that the recommendations of the authorities be followed, principally washing your hands. Both dengue and coronavirus can be confronted by taking the same measures; in the case of dengue, it’s essential to focus on eradicating the source.

The symptoms of dengue are high fever, muscle aches, vomiting and diarrhea, while coronavirus causes a dry cough, difficulty breathing and general pain, but ruling out one or the other is always a medical question,” said Espinal.

Translated by Regina Anavy


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