When the only remedy is prevention

When the only remedy is prevention

By Osvaldo Nicolás Pimpignano

Let's campaign to prevent and control dengue

From the understanding of the problem, we are all in a position to become multipliers of prevention, it is enough to assume our commitment to society to act as defenders of our quality of life and protectors of the environment.

Knowing that there is no vaccine or cure for Dengue fever, the only possible way is prevention. Although no indigenous cases were recorded this year, the situation in neighboring countries indicates that preventive measures should be taken. The disease is transmitted by a mosquito and there are no vaccines. You have to fight the vector and know the symptoms to consult in advance. The transmitting mosquito does not discriminate, it bites anyone, and it can live anywhere that accumulates clean water, whether in a poor neighborhood where containers and disused tires are found, in an abandoned warehouse or in the park of a luxurious mansion.

The mosquito does not recognize social barriers, and reaches even the most elegant residential areas

The Pan American Health Organization (PAHO) warns about the need to prevent dengue as the only way to control it. It is one of the worst health enemies in the Americas, where the number of cases grew eleven times from 1980 to 2003. In Argentina it is estimated that "although there are no exact figures, around two thirds of the population would be in variable risk levels, depending on the area of ​​the country, of contracting the disease. Cases are also known in Paraguay and Brazil. " Dengue is an infectious disease caused by a virus. Its main vector is the Aedes Aegypti mosquito, an insect of urban habits that prefers a warm climate and whose main breeding sites are sources of clean stagnant water. The disease manifests itself in two primary forms, dengue fever or classic dengue, and dengue hemorrhagic fever. In the first case, symptoms include sudden onset of high fever, pain behind the eyes, headache, pain in the muscles and joints, with nausea and vomiting. Because of these symptoms, it is commonly referred to as "bearded vulture disease." Dengue hemorrhagic fever, which can be fatal, has symptoms similar to the classic one, to which are added severe and continuous stomach pains, bleeding in different parts of the body and vomiting. The northern provinces of the country are the ones that could be most affected in the event of an outbreak, but the warm climate shift to the south places our area at risk. A report from the Ministry of Health comments that "as of 1998, dengue re-emerged in the region and there were four outbreaks: two in Salta (1998-2002), one in Misiones and one in Formosa (both in 2000). and imported cases were also notified in other provinces, mainly Buenos Aires. " At present, "the population at risk of becoming ill from dengue in those provinces, where an emergency plan is being implemented, is more than 250,000 inhabitants. On the other hand, a plan was launched that reaches more than 8 million of people, to reduce the risk of dengue in the Buenos Aires suburbs ".

Why is prevention the only remedy?

Because we have various ingredients for an epidemic to occur in our country. First of all, there are Aedes aegypti active in our region. Second: a serotype with high virulence exists in our borders and, third, there was a crossover of serotypes, which suggests the possibility of cases of dengue hemorrhagic fever, which is the most dangerous. "Large cities have high rates of Aedes aegypti, to which is added the presence of people who enter our country from areas where cases have already been registered. " The maximum activity of the mosquito is observed during April and May, but the risk begins in January, this year especially due to the frequency of summer rains that "renew" the accumulations of stagnant clean water. Fighting the vector is not an easy task, for this reason the need to carry out tasks of permanent elimination of these water reservoirs where the mosquito larvae hatch. It is essential to be attentive to the characteristic symptoms of the disease, similar to those of the flu but without coughs or colds. Dengue hemorrhagic fever is the most serious, in this case mortality is related to early consultation. The important thing is not to interpret dengue as a flu condition, not to self-medicate, especially not to take aspirin, since these are a good anticoagulant that aggravate bleeding and, fundamentally, consult a doctor. The severity of an epidemic has the governments of the region attentive. For example, in February 2002, the Brazilian government decided to mobilize military air and ground units to combat dengue in Rio de Janeiro, claiming that it was the greatest health threat faced by Brazil in a decade and at least 35 people died. for evil in its most serious version, with hemorrhages and excruciating muscle and headaches, with redness of the skin and high temperatures. On this occasion, dengue also spread to other states, such as Sao Paulo, Brasilia; Goias and Mato Grosso. The Pan American Health Organization (PAHO) ensures that dengue epidemics occur due to problems of ecological imbalance and lack of infrastructure.

In 2002, Brazilian hospitals were filled with consultations from people who presented feverish ailments and body aches, some of the symptoms of dengue. Those responsible for health had to prioritize emergencies and care for children and pregnant women. The Aedes Aegypti mosquito reproduced in stagnant waters after heavy rains that fell in Brazil after a prolonged drought. More than a million people were found to have been infected. The scale of the epidemic was of such magnitude that the Globo television network, which was broadcasting at that time, the one that turned out to be one of its most successful telenovelas, El Clon, introduced the theme of dengue in its script, so that a of the characters was infected with this disease and the fiction served to warn millions of Brazilians of the problem that was being experienced. This 2002 epidemic in Brazil brought as a novelty the appearance of type 3 dengue, the previous ones only spread with types 1 and 2. This is particularly serious, for two reasons, the first, that the types of dengue are migrating to the south and the second that every time a new type enters, the possibility that a person who has had one of the other types increases, if he is infected again, will contract hemorrhagic dengue. Summer facilitates the procreation of the mosquito and the rains that fell in Argentina, of almost tropical characteristics, with volumes higher than the historical ones, in December and so far in January, increase the possibility of an outbreak.

The transmitting insect, which needs clean and stagnant water to reproduce, is present in the least suspect places, such as a small abandoned plastic cup, even a sewer, this makes the risk closer than imaginable. 90 percent of people are infected inside their homes, pet waterers and saucers that are usually placed under plant pots, are the ideal place for more than half of the larval hatcheries of this mosquito Dengue transmitter. But mosquitoes can also breed in abandoned areas or around industrial areas where waste such as plastic bags accumulate. The folds of the bags where rainwater is stored, small containers and disposable bottles are an ideal cradle for the larvae. Swimming pools, if they are properly filtered and have an adequate chemical treatment, are not a risk

The most important thing is to understand that dengue, even if it looks like it, is not a passing flu. The patient who has suffered from common dengue, unlike other diseases, is not immunized, on the contrary, is exposed in the future to suffer a more serious episode, that of hemorrhagic dengue, which, as we say, can be fatal.

Fortunately, Argentina has an opportunity to anticipate and prevent the epidemic from occurring, but this is not only the responsibility of the authorities. Citizen participation in the elimination of water reservoirs in the vicinity of their homes is decisive. To confirm this statement, it is enough to remember that the radius of influence of this dangerous mosquito, throughout its life, is only 100 meters from the place of birth. This is the reason that makes citizen participation essential to eradicate it

Dengue, a long and ancient history.

According to the Pan American Health Organization, for approximately 200 years, there has already been news of diseases such as dengue in America (also yellow fever and malaria, but these have a preventive vaccine). The first documented epidemic of dengue affected to the Caribbean Basin and Venezuela in 1963-1964, at the beginning and in the middle of the 70's, Colombia was affected. Dengue was beginning to become endemic in the Caribbean. In 1977, it was detected in Jamaica, from where it spread to most of the Caribbean islands causing explosive outbreaks. Similar outbreaks were observed in northern South America, Colombia, Venezuela, Guyana, Suriname, and French Guiana. Also in Central America, Belize, Honduras, El Salvador, Guatemala and Mexico. During the second half of 1980, it was documented in the state of Texas USA. In 1981, the outbreak of dengue hemorrhagic fever that affected Cuba was the most important event. There were more than 150 deaths, 100 were children. In three months, more than 100,000 patients were hospitalized. It is probable, however, that in America, millions of people were infected by the virus, since only in Cuba 42% of its 10 million inhabitants were infected. In '82 a dengue epidemic began in the north of Brazil, four years later, an outbreak in Rio de Janeiro spread to other Brazilian states. Bolivia in 1987, Paraguay and Ecuador in 1988, and Peru in 1990, suffered extensive epidemics. Studies suggested that several million people had been affected. During those same years, there was also a notable increase in the occurrence of dengue hemorrhagic fever. Reported cases of severe hemorrhagic disease include Aruba, Brazil, Colombia, El Salvador, Honduras, the United States Virgin Islands, Mexico, Nicaragua, Puerto Rico, the Dominican Republic, Saint Lucia, and Suriname, as well as Cuba and Venezuela. The second outbreak of hemorrhagic dengue began in October 1989 in Venezuela with 70 deaths, two-thirds in children under 14 years of age. It appears that dengue hemorrhagic fever is gradually becoming endemic in several American countries, following the trend observed in previous years. In September 2000, PAHO said, "Argentina is a country at risk of dengue. Aedes Aegypti mosquitoes were detected in almost the entire territory. For a country to be at risk of suffering a dengue epidemic, concurrence is needed of three conditions: that there is a vector that transmits it, the Aedes Aegypti mosquito, that there is a circulating virus, that is, infected people, and that there is a population susceptible to becoming ill. Unfortunately, our country meets all three conditions. " At that time, the provinces of Salta and Misiones suffered declared epidemics with several hundred autochthonous cases.

Sources: PAHO, Ministry of Health of the Nation.

Osvaldo Nicolás Pimpignano
Investigative Journalist
Member of the Argentine Association of Environmental Journalists
Director of Radial Initiative - Member of RENACE

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