Thousand faces of drought: Dengue Fever and Distrust of Social Workers

A Brazilian biologist handles boxes with mosquitoes infected with the Wolbachia bacterium — which reduces mosquito-transmitted diseases such as dengue and chikungunya by shortening adult life span, affecting mosquito reproduction and interfering with pathogen replication — in Rio de Janeiro. Photographer: Christophe Simon/AFP via Getty Images via Bloomberg Business

“The hospital itself was full of mosquitoes; who’s to say those mosquitoes don’t have dengue? It’s getting out of hand.”

“Where I live you can’t trust people very much, so people will have more confidence if there’s a soldier there. Things will go better with this idea of sending the army."

How in heck could drought produce a dengue outbreak?  People storing up water in the drought without putting covers on the water containers. The mosquitoes bred like, well, mosquitoes.  Dengue fever has been sweeping drought-plagued Sao Paulo.  Then in February when torrential rains struck, the mosquitoes really went to town -- literally.  The Bloomberg Business article I link to above has the lowdown on the Great Mosquito Invasion of Sao Paulo including the above quote plus this juicy gossip, a bit dated but still interesting:

The government could have done more to stop leaks from the water system, Leo Heller, the United Nations special rapporteur for water and sanitation rights, said in a December interview. About 31 percent of treated water escapes from the Sao Paulo utility’s network — more than a third caused by illegal siphoning.

Be nice Mr Heller; the Summer Olympics are just around the corner.

The government finally had to call in the army to help fight the dengue plague. This was more of a social issue.  From the Wall Street Journal, April 17

:SÃO PAULO—Brazil’s biggest city has called in the army to help combat a deadly outbreak of dengue fever that has sickened hundreds of thousands of people nationwide.

Soldiers will next week begin going door-to-door in some of São Paulo’s hardest-hit neighborhoods to educate residents on fighting mosquitoes, Mayor Fernando Haddad said on Friday.

A severe drought in southeastern Brazil has spurred residents to hoard water, often in makeshift containers, providing breeding grounds for mosquitoes that spread the disease whose symptoms can include intense muscle pain, convulsions and high fever.

Dengue has killed 132 people in Brazil in just the first 12 weeks of the year, a nearly 30% jump from the same period in 2014. Three-quarters of those deaths have been in São Paulo state, which has registered more than half of the 460,502 cases reported in Brazil in the first quarter. The state had more cases in the first 12 weeks of this year than it did in all of 2014.

In São Paulo city, where confirmed cases have soared more than fourfold to nearly 32,000 over the period, Mr. Haddad said that 50 army soldiers are being trained to advise residents on how to store water and most effectively use repellents and insecticides.

Around 2,500 health workers are already going door to door in a mass education effort. But many residents visited, particularly in high crime areas, have refused to open their doors to these strangers, the mayor said.

Fabio Tobias, 37 years old, a musician who lives in Sao Paulo’s lower-middle class Freguesia do Ó neighborhood and was infected earlier this year with dengue, along with two of his four children, said the presence of the army should help.

“Where I live you can’t trust people very much, so people will have more confidence if there’s a soldier there,” he said. “Things will go better with this idea of sending the army.”

Mr. Haddad said the soldiers will be deployed in this outreach effort for a month until the end of the rainy season, when dengue cases are expected to decline.

The hope is that their presence in affected communities will result in more cooperation with health authorities, he said in a Friday news conference.

“In around 20% of residences across the city visited by our agents, people don’t open their doors,“ he said. “We hope the presence of soldiers in some regions will help solve this.”

Dengue is a historic problem in Brazil, particularly during the peak of the rainy season, which in the country’s populous southeast is in the first four or five months of the year. But this time, it’s not the abundance of rain but a lack of it that has led to the problem.

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The government has also taken a hi-tech approach to battling the winged critters, as the above pix and caption indicate.

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