As a result of I’ve private expertise with this illness and with the struggle in opposition to the dengue epidemic, which is in any other case often called bone-breaking fever, I’ve just lately observed the media stories and knowledge on tv and different media about its incidence in Europe and its course, which could be very tough and unsafe. It’s manifested by a sudden improve in excessive temperature accompanied by a extreme headache, weak point, muscle and joint ache, nausea and vomiting. The course of the illness itself normally doesn’t exceed ten days, however restoration can take as much as a number of weeks or months. The incidence of dengue has already been recorded in 13 European nations, particularly within the space of southern Europe. Nonetheless, it has already appeared in France or Germany, writes the web site Journey Tomorrow. I even observed someplace that it might have appeared in Austria and Slovakia.
In June 1981, a dengue epidemic broke out whereas I used to be working on the Ministry of Building of Cuba in Havana as a senior marketing consultant for engineering geology and geotechnics. The federal government ordered the institution of brigades of well being staff who searched home by home and condo by condo to be able to use particular sprays to remove attainable mosquito breeding grounds. They did not even keep away from the residences of international consultants within the Sierra Maestra lodge complicated, the place I stayed in an condo with my household.
As soon as after coming house from work I felt very exhausted and drained. Out of nowhere, my entire physique began to ache and I felt feverish. This case arose instantly, utterly out of the blue. It was night and the thermometer within the condo, as common, didn’t wish to drop under 31 °C with excessive humidity. Subsequently, I attributed the shortly arising fatigue to the sweltering warmth. Nonetheless, after I acquired away from bed within the morning, I felt so weak that I may barely stand. I had a temperature of 39.5°C. Colleagues advised me that I apparently had “dengue” which that they had already skilled and that I’d be high quality in a number of days. I used to be prescribed aspirin, lemon and plenty of fluids. Certainly, on the second day the temperatures dropped, and on the third day I felt roughly effectively. In fact, this was a manifestation of dengue in its easiest type, in any other case it’s accompanied by excessive temperatures, with some sorts the affected person even breaks out in rashes. Such a type of the illness can not be left to put remedy. You must see a health care provider shortly.
Nonetheless, the idea of “dengue” continued to be a thriller to me on the time, so I started to seek for all out there details about it. I came upon that dengue is likely one of the yellow fever viruses. Yellow fever is a febrile contagious illness that occurred primarily within the Antilles and the Gulf of Mexico, but in addition in Central and South America, West Africa and even within the Mississippi area, the place an epidemic occurred in 1878 that value the lives of 13,000 individuals. Much more than 100 years in the past, this illness was the scourge of humanity within the talked about areas. Medical science on the time knew that yellow fever was attributable to a pathogenic virus, nevertheless it remained unclear why it was transmitted in a short time over lengthy distances.
Within the eighties of the nineteenth century, the Cuban scientist Carlos J. Finlay, born on December 3, 1833 within the central Cuban province of Camagüey, started to check the causes of yellow fever. His father was Scottish and his mom French. His analysis in 1879-1880 revealed that the pathogenic virus enters the physique via the blood. Dr. Finlay was well-educated and studied scholarly articles in all kinds of fields. In a single professional report, he found {that a} parasitic fungus that happens in grain is transmitted by one other plant. From this, he concluded that even yellow fever in people might be transmitted by a service that may “inoculate” the blood of wholesome individuals with a pathogenic germ from the blood of sick individuals. By additional statement, he found that in tropical areas, pathogenic viruses are transmitted by the damaging virus of the mosquito “Aedes Aegypti”. He reported this information for the primary time on the earth in 1881. The “Aedes Aegypti” mosquito might be distinguished from odd mosquitoes by being barely bigger than different mosquitoes and by having grey and white stripes on its legs. The virus is transmitted solely by the feminine, who wants candy blood for her eggs. She lays her eggs in moist, shady locations, most frequently instantly in water. If the water through which the mosquito larvae are at a sure stage of growth dries up and the larvae come into contact with water after a sure time frame – maybe half a yr – the mosquito hatches. This makes Aedes Aegypti much more harmful.
Dr. Finlay proposed in 1898 to destroy mosquito larvae in all water tanks through the use of chemical compounds. By 1900, he experimentally inoculated about 100 individuals with contaminated blood, and typically the transmission idea was confirmed. Regardless of these profitable makes an attempt, he didn’t discover many adherents to his idea. They even referred to as him the mosquito physician. In 1900, a navy medical fee from the USA arrived in Havana (at the moment, Cuba was militarily occupied by the USA after the Spanish-American Warfare). The fee was headed by Walter Reed. Her activity was to research the causes of yellow fever. It targeted extra on the identification of pathogenic microorganisms than on the detection of the peculiarity of virus transmission. Solely after very robust insistence of Dr. Finlay’s fee studied the conclusions of his work. It’s a curious coincidence that the one member of the fee who supported Finley’s idea, the younger physician Dr. Jesse Lazear, died throughout the conclusive experiments, which have been carried out exactly on his personal initiative.
Within the North American navy mission (in Cuba and different Caribbean nations, in addition to all through South and Central America, the designation “North American” is used for every little thing associated to the US), the navy commander of Cuba was dr. Leonard Wooden, who later understood the significance of Finley’s idea and used his suggestions to remove the larvae of the Aedes Aegypti mosquito. He ordered a really costly operation through which all muddy puddles and cesspools have been doused with oil. Newly skilled staff visited households, suggested tips on how to forestall the damaging mosquito from hatching and carried out spraying. This service in opposition to dangerous bugs, which incorporates the American cockroach (cucaracha in Cuba), was and is free and continues to today.
It was solely years later that Dr. Finlay’s satisfaction from the North American doctor Dr. William Gorges, who gave him credit score for the invention of the yellow fever virus service in a letter. On the similar time, he advised him that with out his data and help, the navy fee wouldn’t have fulfilled its mission. Dr. Finlay additionally defined why Cuban natives suffered much less from yellow fever than foreigners who spent a short while in Cuba. In his opinion, it’s because the mosquitoes acted as “vaccinators” for these completely dwelling in Cuba, thereby inducing a sure immunity in them. This conclusion was a vital aspect for the remedy of tropical illnesses. The vector idea has been used to fight different tropical illnesses, equivalent to malaria. That is why Dr. Finlay acquired quite a few worldwide recognitions: he was a full member of the French Academy of Drugs, the French Academy of Drugs awarded him the Breant Prize, the College of Liverpool awarded him the Mary Kingslay Medal, the French Authorities awarded him the Legion of Honor. The day of his delivery – December 3, was proposed in 1933 by the Pan American Medical Congress as American Drugs Day.
After the revolution, epidemics of yellow fever have been virtually eradicated in Cuba on account of very thorough hygiene and well being measures.
Nonetheless, Might 1981 got here. On the finish of the month, the primary dengue illness was registered within the Havana district of Rancho Boyeros, which additionally consists of José Martí Airport. The reason for the reappearance of the illness was the “dengue” virus. Attributable to the potential of transmission of the illness by the Aedes Aegypti mosquito, the epidemic started to unfold in an avalanche within the districts adjoining to Rancho Boyeros and from there to each Havana provinces (Havana-city and Havana). On June 16, 1981, the illness was already occurring in all Cuban provinces. The biggest variety of sick individuals was recorded within the week from June 30 to July 6, when a median of 9,829 individuals fell ailing per day, on July 6 even 11,721 individuals fell ailing. There was a really tough and really costly struggle in opposition to the epidemic, throughout which it was vital to deal with two issues: with the remedy of the sick and with the prevention of the unfold of the illness, in different phrases – with the elimination of the service of the illness. Neither of the 2 primary duties was straightforward. The sufferers have been bleeding very dangerously and have been going into shocks, which was a very uncommon manifestation of this illness. Roughly one third of the sufferers needed to bear hospital remedy. There weren’t sufficient beds, so makeshift hospitals have been constructed, particularly in colleges. Medicines and lots of different medical provides needed to be supplied, a lot of them from overseas. On the central celebration of the anniversary of the assault on the Moncada barracks on July 26, Fidel Castro in Las Tunas declared:
“All of the means to remedy the illness have been bought. Sera, blood, method can be found all over the place.”
The epidemic elimination program turned the topic of curiosity not just for well being staff, but in addition for civil protection items, Poder Well-liked (nationwide committees), CDR (Committees for the Safety of the Revolution), and its implementation was monitored by the very best representatives of the state. Fidel Castro himself visited quite a few hospitals, particularly kids’s hospitals in Havana, Granma and Santiago de Cuba. No much less effort was dedicated to the elimination of the service. All of the mass media continually identified the locations the place the mosquito may very well be discovered. 73,000 individuals have been chosen and skilled, who visited households and suggested what measures ought to be taken to forestall mosquito breeding, residences have been sprayed with particular sprays, cities have been sprayed from airplanes a number of occasions a day. On account of the struggle in opposition to mosquito breeding grounds, vases with flowers additionally disappeared from households, and water tanks have been closed. Staff from the Ministry of Well being visited households a number of occasions. After the recommendation on preventive measures, there have been each day checks. If the prescribed rules weren’t adopted, heavy fines have been imposed. Even our Havana condo didn’t escape the inspections. Even our vases turned orphans with out water, we additionally needed to cancel the hydroponic cultivation of tropical vegetation. 6,500 staff continued to hold out preventive measures lengthy after the tip of the epidemic.
The epidemic was efficiently eradicated. It lasted from June 9 to October 10. Her steadiness sheet was unimaginable. 344,203 individuals fell ailing, of which 116,143 needed to bear hospital remedy. A critical situation of the illness was marked in 9203 sufferers, a really critical situation in 1109 individuals. A complete of 158 individuals died, of which 101 have been beneath the age of 15. Through the liquidation of the epidemic, Cuba was visited by dr. RJ Tona, Regional Adviser on Medical Entomology of the Pan American Well being Group, who said:
“It’s in all probability the primary time in historical past that such an intensive struggle in opposition to the service of the epidemic has been carried out. Cuba has nice status in its well being achievements. Optimism, braveness, good group are all crucial stipulations for a profitable struggle in opposition to “Aedes Aegypti”. Your complete marketing campaign might be described as very profitable.”
Information concerning the incidence of dengue in Cuba and the struggle in opposition to this illness have been very extensively commented on within the information of ČTK and within the radio packages of the Czechoslovak radio reporter in South America, Dr. Ján Kravárík. The time period “dengue” was recognized in Czechoslovakia right now, and everybody requested us detailed questions on this type of malaria throughout our trip. We have been completely satisfied to move on the knowledge. In conclusion, I wish to say that giving this instance of the struggle in opposition to the dengue epidemic might be an instance in case the virus spreads to us from nations the place it already happens. And it is rather shut, even already in Austria and, in keeping with deník.cz, maybe already within the Czech Republic. Thank God, we won’t speak about an epidemic but. Thus far! However you must be ready for it.
Be aware: Official info on the variety of instances and deaths was routinely printed within the Cuban press in 1981. So was the picture of the mosquito, given because the introduction, which was scanned by me.
