Saturday, March 10, 2012

Mérida, Yucatán is the Dengue capital of Mexico

*See 2014 updates below*
Mérida, Yucatán -
The state of Yucatán and its capital city of Mérida are virtual Ground Zero for Dengue Fever in Mexico, accounting for far more cases of the potentially deadly illness than any other location in the country. Diario de Yucatán, the city's most widely read paper, made the claim in its yesterday's edition (Mar. 9). It quoted both federal and state government sources.

Diario said one-third of all reported cases of Dengue Fever in Mexcio originate in Mérida, and one-half in Yucatán state. The federal government recently has sent brigades of workers to help clean up areas where disease outbreaks are most likely to occur, according to the paper.

A primer on Dengue Fever, drawn from Wikipedia:
"Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains and a characteristic skin rash that is similar to measles. In a small proportion of cases the disease develops into the life-threatening dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.

"Dengue is transmitted by several species of mosquito, principally Aedes aegypti. The virus has four different types. Infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. As there is no vaccine, prevention is sought by reducing the habitat and the number of mosquitoes and limiting exposure to bites.

"Treatment of acute dengue is supportive, using either oral or intravenous rehydration for mild or moderate disease, and intravenous fluids and blood transfusion for more severe cases. The incidence of dengue fever has increased dramatically since the 1960s, with around 50–100 million people infected yearly. Early descriptions of the condition date from 1779, and its viral cause and the transmission were elucidated in the early 20th century. Dengue has become a global problem since the Second World War and is endemic in more than 110 countries."

Those are the basics, and there are huge amounts of material available on the internet for anyone wanting to research Dengue in greater detail. I don't know how many people died in Yucatán in 2011 from the illness, but I'm guessing multiple dozens. During the prime disease season here (the rainy season, which runs from June through September), Diario frequently carries articles about local fatalities. Deaths are particularly common in outlying towns and economically marginal communities, where people are more likely to suffer from other illnesses or are already in a compromised state of health when they get infected. Those same people are less likely to seek prompt medical care due to lack of resources (48% of Yucatán lives in poverty, says the government). Moreover, the infrastructure in such areas is often in poor condition, providing an ideal breeding ground for mosquito transmitters. The government work brigades will do little more than clean up trash and debris, remove standing water and counsel local residents about household sanitation.

Dengue Fever is not without political repercussions. The municipal and state governments here are both PRI controlled -- that's the Institutional Revolutionary Party. The PAN (National Action Party) dominated Diario (many Mexican newspapers are intensely political, some of them bought and paid for by party "contributions") loves to beat up on the governor and the former mayor for allegedly failing to spray insecticide early enough in 2011 to prevent a particularly severe Dengue outbreak which took many lives last year.

Such is life in Mérida, Mexico, a World City of Peace, in this election year 2012. It promises to be a long, hot, muggy one. Perhaps the mosquitoes, recognizing that the politicians are showing us no mercy, will extend a little of their own.

Feb. 24, 2014 - Dengue Fever ranking has Jalisco authorities concerned
Jan. 4, 2014 - Dengue Fever still claims lives in Mérida, but far fewer

2013
Feb. 13 - Mérida is no longer Dengue capital of Mexico, after falling to fourth place. In the first five weeks of the year health authorities reported 1,061 confirmed cases nationwide - 706 with classic symptoms and 355 of the more serious hemorrhagic type. Of those 17.6% were on the Yucatán peninsula. The top five states with number of cases: Guerrero (209), Veracruz (118), Michoacán (106), Yucatán (92) and Quintana Roo (89). In Yucatán 51 cases were classic and 41 hemorrhagic.

2012
July 25 - Dengue Fever roars on in Yucatán
July 14 - A teenage girl in Mérida died from Dengue this past week, the Diario de Yucatán reported today.
Mar. 15: To date in 2012 there have been 870 reported cases, including 408 cases of the so-called hemorrhagic type, which can be fatal. An interesting note in today's Diario was about Mérida's anti-mosquito spraying campaign. In my neighborhood trucks have passed through several times. One evening I got sprayed while walking home with some carry-out food from a local restaurant. But this morning's paper says that the insecticide used here is banned in the U.S. and some other countries. Death by the Aedes aegypti mosquito, or death by bug spray. Take your pick.
Oct. 6 - Mérida has mobilized against Dengue Fever, according to a local press source, to confront the "imminent danger on the streets." An army of 600 federal, state and city workers, together with boy scouts and other "conscripts," is focused on cleaning up abandoned tires, containers and other trash which may harbor mosquitoes. Yucatán has reported 3,800 diagnosed cases of both types in recent days, 2,280 of which were in the capital city.
Oct. 18 - Dengue has claimed an eight year old boy in Kanasín, part of metropolitan Mérida.

Rabies on the rise in Mérida: http://mexicogulfreporter.blogspot.com/2012/02/rabies-on-rise-in-merida-and-environs.html.
Crushed by poverty, Yucatán style: http://mexicogulfreporter.blogspot.com/2011/10/crushed-by-poverty-yucatan-style-crime.html.
Increasing poverty and rising state debt in Mexico: http://mexicogulfreporter.blogspot.com/2012/02/increase-in-state-indebtedness-poverty.html.
Gloves-off politics in Mexico: http://mexicogulfreporter-supplement.blogspot.com/2011/11/violence-over-underpass-underscores.html.

Here's a good illustration of why Dengue is such a problem in Mérida. I took this photo in Sept. 2010, about two blocks from the heart of town (or the main plaza, as it's called). We'd had a typical afternoon rain, which probably lasted an hour or so. But since there are no modern storm sewers in much of the city, this is the result. Water stands for hours, and as soon as the sun pops out the air becomes a torrid incubator for mosquitoes. By the way - there's no way of getting across many such street corners other than just wading through the water. You might have to walk multiple blocks in different directions to avoid wet feet altogether. Mérida has its own style of beauty, but the fact remains that it's an almost 500 year old city.

4 comments:

  1. I fail to see how a few hours of standing water can be considered a "torrid incubator of mosquitoes", when dengue requires a week's worth of incubation in water before mosquito eggs hatch. From Yucalandia: ■The Dengue carrying mosquitoes Aedes aegypti (A. ae) need only a teaspoon of water that doesn’t evaporate for one week to convert eggs to free-flying adults at Yucatecan temperatures.
    So the few hours it takes for the water to drain away in the city isn't a cause.It is more probable to be tinacos (water cisterns) that don't have a lid, bucketsleft standing around in gardens and unattended swimming pools...

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  2. If you fail to see how water standing in streets for hours or days is directly implicated in Dengue fever (on the rise again, according to yesterday's [Aug. 15] local paper), then I'll leave you to your own fantasies, reader. Wake up and smell the coffee . . . and start reading reliable sources to educate yourself.

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    1. While vacationing in Merida I was bitten and contracted Dengue Hemorrhagic fever . It is not "so-called" hemorrhagic ? Get your facts strait ! Interview someone that's been suffering for a month and gets 3 -4 blood transfusions a week . I was there at the end of August this year . I now have blood not only coming out of my eyes ,nose I cough it up as I can barely breath since it is in my lungs . To those that that believe this does not happen often open your eyes I am fighting for my life . This can be a painful deadly virus . So who ever wrote on March 15 your numbers are very low ... There are a lot more people sick and I can tell you this medical bill will be more then some people make in 4 years in the US . We do spray all the time for Mosquitos because of West Nile and that seems very small compared to what you are going through . Prayers to those that are suffering the way I am because this is hell .

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    2. I'm sorry to learn of your experience. MGRR has written several times on Dengue Fever You may have missed this more recent article in August:

      http://www.mexicogulfreporter.com/2012/07/dengue-fever-roars-on-in-yucatan.html

      The numbers cited in that piece and this one are accurate (if you can believe local press sources, anyway). But just yesterday another report was published in Mérida indicating that the illness has affected more people.

      The term "so-called" Hemorrhagic Dengue isn't/wasn't meant to imply that it's not real, or that it doesn't exist. On the contrary, it means that particular subspecies is referred to as "hemorrhagic" because a suffering patient indeed bleeds, and is most at risk for death.

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