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Mexico fights rise in dengue fever by rjh17349


									                        World Report

                                                   Mexico fights rise in dengue fever
                                                   With an outbreak of H1N1 scarcely behind it, the Mexican Government is also fighting the
                                                   spread of another viral illness: dengue fever. Mary Cuddehe reports from Mexico City.

                                                The incidence of dengue fever in                   in January this year. That was months      crumpled-up cigarette pack thrown on
                                                Mexico has been climbing steadily                  before the start of the summer             the ground, even on a roadside, with
                                                for a decade. In 2000, there were                  rains that traditionally kick off peak      rain will form enough of a little pool of
                                                1781 reported cases. Last year, the                breeding season, suggesting that           water to give mosquitoes a breeding
                                                number totalled 33 000, according to               A aegypti has begun to reproduce           spot”, said Epstein. “Education is more
                                                Mexico’s Public Health Department.                 year-round. “Normally we start the         important than spraying. Spraying is a
                                                And confirmed cases this year have                  year with zero cases”, said Juan Miguel    one-time thing.”
                                                already surpassed 2008 figures by 15%.              Torre, the head of epidemiology for          Mexico is applying these measures
                                                  In many ways Mexico is an ideal                  the Public Health Department in            aggressively. States like Colima have
                                                place for dengue fever. It is a heavily                                                       launched large-scale eradication
                                                populated country with 9300 km of                  “...the earliest cases of dengue           and public-education programmes.
                                                coastline, vast tropical regions, and               fever were reported in January...         A recent operation had 500 health
                                                an economy based largely on foreign                 suggesting that A aegypti has             workers in yellow vests sweep through
                                                trade and tourism. Dengue fever most                begun to reproduce year-                  a small town in a single day, knocking
                                                frequently occurs in urban and tropical             round.”                                   on the doors of nearly 9000 homes.
                                                areas, and the rise in global commerce                                                        They inspected, sprayed, and lectured
                                                and tourism is one of the main factors,            Colima, the central state on the Pacific    residents on techniques for keeping
                                                along with climate change, that                    Coast that leads Mexico in confirmed        their homes mosquito free. “The
                                                experts identify as a root cause of the            cases this year. “This year, we started    key to no dengue is no mosquitoes”,
                                                disease’s expansion.                               with 80 cases.”                            said Miguel Angel Lezana, the
                                                  Experts also point to the carrier                  Worldwide, tens of millions of cases     head of epidemiology for Mexico’s
                                                mosquito itself, Aedes aegypti, to                 occur every year, and the disease has      Public Health Department. “We put
                                                explain the growing incidence.                     spread consistently throughout the         insecticide around the house and
                                                Recently, A aegypti has appeared in                western hemisphere for a quarter           inside, and work with people to
                                                more Mexican states and at higher                  century, bursting on 3–5 year epidemic     eliminate standing water or at least
                                                altitudes than previously seen. It                 cycles. In 2002, a major outbreak swept    guard it properly.”
                                                has been detected in 21 of Mexico’s                the region, striking more than 1 million     This year Mexico has reported
                                                31 states this year, and while                     people, according to the Pan American      5052 cases. Classic dengue, or
                                                entomologists once believed that it                Health Organization. 5 years later, the    serotype 1, the least severe of the
                                                was not able to fly above 1500 m, they              second worst outbreak on record left       four dengue viruses, has made up the
                                                have discovered it buzzing around                  nearly another 1 million people ill in     majority of those, with haemorrhagic
                                                at 1700 m. What is more, the earliest              11 countries, including Mexico.            cases totalling 901. Experts remain
                                                cases of dengue fever were reported                  The disease’s widespread and             especially wary of an outbreak this
                                                                                                   increasing presence has incited world      year, though, because the recent H1N1
                                                                                                   health organisations to develop novel      epidemic devastated the country’s
                                                                                                   approaches to mosquito eradication.        US$13 billion tourism industry and
                                                                                                   In the 1950s, a programme to               the same beach towns that draw
                                                                                                   combat yellow fever, which A aegypti       tourists are also breeding grounds for
                       The printed journal                                                         also carries, all but vanquished the
                                                                                                   mosquito from the Americas. (It
                                                                                                                                              the disease vectors. But so far they
                                                                                                                                              say that this year’s numbers square
                       includes an image merely                                                    returned in the late 1970s.) In those
                                                                                                   days eradication was synonymous with
                                                                                                                                              with the Public Health Department’s
                                                                                                                                              predictions for 2009. “The serotype
                       for illustration                                                            insecticide spraying. Today it means
                                                                                                   getting individuals involved. Health
                                                                                                                                              that’s circulating is serotype 1”, said
                                                                                                                                              Torre. “That gives us, not cause for
                                                                                                   organisations reach out to community       calm exactly, but it tells us that the
AP/Israel Leal

                                                                                                   leaders who in turn mobilise citizens to   resources we have may be sufficient.”
                                                                                                   clear out havens for larvae by dumping
                 An anti-dengue brigade in Cancun, Mexico, checks the streets for standing water   waste and covering standing water. “A      Mary Cuddehe

                 602                                                                                                                  Vol 374 August 22, 2009

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