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Posted September 13, 2006 by publisher in Cuban Healthcare

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Dalia Acosta | IPS

The start of the week-long 14th summit of the Non-Aligned Movement (NAM) forced the Cuban government to suspend its spraying with military planes, but it has not cut short the intense offensive against the Aedes aegypti mosquito, which carries the potentially deadly dengue virus.

Although the government has kept mum on the spread of dengue fever in this Caribbean island nation, sources close to the Public Health Ministry told IPS that several thousand cases have been reported in Havana alone, where special hospital wards have been created to care for the sick.

The authorities say everything is under control, while emphasising the need to keep up the health and awareness-raising campaign. “Let’s prevent the proliferation of the mosquitoes. Everyone must be aware of the problem,” said the host of a show on the CH TV state-run channel.

According to Dr. José San Martín Martínez, director of the Public Health Ministry’s National Surveillance and Anti-Vector Unit, “there is no danger of a dengue epidemic” inCuba.

“We have three provinces infested by the mosquito: Havana city, Santiago and Guantánamo. The other provinces are able to control the situation any time Aedes aegypti mosquitoes are detected,” the official told the state-run press.

More than 15,000 people are involved in the campaign against the mosquitoes. But according to local government spokespersons, in some Havana neighbourhoods there are not enough human resources.

Many saw the growing intensity of the prevention campaign in the last few weeks as a response to the NAM summit, which has drawn representatives of the governments of its member countries, that total 118 since Haiti and St. Kitts and Nevis joined on Monday.

Dengue outbreaks have not only been reported this year in Cuba, but also in Brazil, Colombia, the Dominican Republic, El Salvador, Honduras and Paraguay.

“People just don’t understand. You see a company that has been fined because it has 20 potential breeding sites, and the situation remains the same or worse. The only thing they are worried about is not appearing in the press,” one reporter with a government publication that follows health conditions inCuba told IPS.

TV ads, pamphlets and posters raising awareness of how to prevent the spread of dengue now form part of day-to-day life in Havana, as does the almost daily house-to-house spraying and the fumigation carried out by trucks, especially in the wee hours of the morning, with a product that is not harmful to people or animals except in cases of allergies or asthma, as authorities have warned.

“Today I haven’t seen the fumigation truck, but last night it drove by several times,” a clerk at a shop on Obispo street, in Old Havana, remarked to IPS.

Two book stores and a few shops lining Obispo street closed early on Monday for spraying. And in the central Havana neighbourhood of Vedado, a dental clinic and public offices closed their doors for the same reason.

The recommendations for interrupting the breeding cycle of the Aedes aegypti mosquito include covering all water containers, scrubbing the water dishes of pets and livestock, crushing empty cans and egg shells that are thrown into the garbage, keeping a close check on areas where water could accumulate, and changing the water in the glasses that are set out in many Cuban homes as a traditional offering to deities and to ward off evil spirits, as part of Afro-Cuban religions.

The Aedes aegypti mosquito prefers to lay its eggs in clean water that has accumulated in artificial containers like discarded tires, flower pots or old oil drums in shady areas close to human dwellings, although there is talk that the vector is adapting to other moist areas.

Only the female bites for blood which she needs to mature her eggs. The mosquitoes hatch in about 10 days and survive for a month. The mosquito transmits the disease by biting an infected person and then biting someone else.

Dengue fever usually starts with a high fever, rash, severe headache, pain behind the eyes, muscle and joint pain, loss of appetite, nausea and vomiting. Most infections result in relatively mild illness, but some cases progress to dengue hemorrhagic fever, which can be fatal.

Although there is neither a cure nor vaccine for the disease, the symptoms generally abate if the patient follows a regime of complete rest, continued hydration—intravenous in severe cases—and treatment with acetaminophen. Complete recovery can take up to a month.

“If you need to store water in containers, it is important to protect them from rainwater,” Dr. María del Carmen Marquetti, a specialist at the Pedro Kourí Institute of Tropical Medicine, recommended on TV.

The first major epidemic of dengue hemorrhagic fever in the western hemisphere occurred in Cuba in 1981, when 10,312 cases of the more serious form of the disease were reported among the total 344,203 cases of dengue. The outbreak caused the death of 158 people, including 101 children under 15.

The first reported epidemics of dengue fever in the world occurred nearly simultaneously, in 1779 and 1780, in Africa, Asia and North America.

Experts say climate change and the resultant increase in global temperatures could shorten the incubation period of dengue in the mosquito, which is currently between 10 and 15 days after the mosquito bites an infected person.

Pan American Health Organisation (PAHO) statistics from 2004 do not report figures from Cuba for that year, when 269,234 cases were documented in Latin America and the Caribbean.

“In many other Latin American countries, dengue is a major public health problem. For us it isn’t at this point, because the necessary control methods have been taken to keep it from becoming one,” a health professional who preferred to remain anonymous told IPS.

The suspension of aerial fumigation coincided with the publication and implementation of the NAM summit security measures, which include restrictions on traffic around the Havana conventions centre, where the meeting is taking place.

Restrictions have also been imposed on cultural, sports, recreational and other social activities that would involve the concentration and movement of groups of people, the use of radios, and the transfer or handling of toxic substances, explosives or inflammable materials.

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