Central America Wearies under Dengue Onslaught
Por Néfer Muñoz
The tropical epidemic has been merciless in the region, and is revealing the vulnerability of the poorest sectors of the population.
SAN JOSE, (Tierramérica).-
More than 3,400 people have been infected and eight have died from dengue in El Salvador, and 6,500 cases and nine dead have been reported in Honduras, as the two countries' governments have been forced to declare a state of emergency.
There are hundreds of people infected in the rest of the Central American countries as well. Hospitals in many cities have been overrun in recent weeks with people complaining of high fever, dehydration and rashes, the classic symptoms of dengue, a disease that in its worst form can cause deathly internal hemorrhaging.
The true scope of the epidemic is likely to be much greater, as some experts calculate that for every case of dengue detected five more go unreported.
Dengue proliferates as a result of poverty, overcrowding, and the lack of hygiene, potable water and sanitation, as well as inadequate treatment of garbage and solid waste, experts told Tierramérica.
"Dengue is not exclusive to just one country. It is attacking all Central America and many other countries in Latin America," El Salvador's Health Minister José Francisco López said in a conversation with Tierramérica.
The Salvadoran authorities launched a house-by-house campaign in June to wipe out potential breeding sites of the Aedes aegypti mosquito, which transmits the dengue virus.
The insect reproduces in stagnant water, whether it is in open containers, puddles, or discarded tires. The epidemic has worsened with the onset of Central America's rainy season -- May to November -- as the precipitation benefits the reproduction of the mosquito.
"This is an urban disease because the mosquito that transmits it is concentrated in urban areas," Costa Rican microbiologist and expert in epidemics, Teresita Solano, told Tierramérica.
The vulnerability of the isthmus arises in part from the deficient distribution of potable water in many cities, where the lack of reliable services prompts thousands of families to store water in their homes.
And their storage methods are not always appropriate. In many cases, tanks of water are left open, allowing mosquitoes to lay their eggs and rubbish to collect in the water supply.
Other factors favoring the propagation of any epidemic outbreak are overcrowding and the high population density.
El Salvador, with six million inhabitants living in 21,000 square km, is the most densely populated country in Central America and one of the highest densities found in Latin America.
On average, El Salvador has more than 250 people per square km, but in some parts of the capital, there are 3,000 to 9,000 people per square km.
Another factors hampering dengue prevention efforts is the great number of indigenous dialects in the region, making it difficult to get information out about the disease, added Solano, head of the epidemic monitoring unit at Costa Rica's Ministry of Health.
According to a study by the José Simeón Cañas Central American University, in El Salvador, the epidemic is hitting "the poorest and the neglected" the hardest.
Although the vast majority of the respondents to a survey conducted by the Francisco Gavidia University in El Salvador stated that they are aware of the disease, 53 percent admitted that they do nothing to prevent contagion.
"Dengue is a very dangerous disease, but it can be overcome if it is detected on time and the patient is given adequate medical attention," Solano said.
There is still no vaccine or cure for dengue, but its effects can be combated if the infected person maintains complete rest, ongoing hydration and takes acetaminophen.
The virus manifest in Central America has been found to be of the four known varieties, or serotypes: dengue 1, 2, 3 and 4. In general, they cause the classic form of dengue, which includes fever, rashes, weakness, joint pain and headache.
The real danger arises when a person is infected by the different serotypes in succession. It is then that hemorrhagic dengue can appear, causing internal bleeding that can lead to death.
Central America is fertile ground for infections diseases because of the overall lack of adequate waste collection systems and the loose rules of hygiene.
"There is a clear link between poor health and poverty," says Delmin Cury, an expert from the Dominican Republic who serves as an adviser on contagious diseases to the Pan-American Health Organization in Honduras.
Cury told Tierramérica that the solution to dengue requires concerted action by numerous sectors of society to resolve problems related to sanitation, potable water supplies and garbage collection.
The abatement of the dengue epidemic will only be possible if the population participates in these efforts, he said.
* Néfer Muñoz is an IPS correspondent.