Battling the Buzz

Dengue wars in Latin America.

In 2023, the relentless spread of mosquito-borne dengue cast a dark shadow over Latin America, affecting over four million individuals, with Latin America harbouring 80% of the world’s dengue cases. Brazil bore the brunt of the epidemic, with over three million cases reported, equating to approximately 1,145 infections per 100,000 inhabitants. Bolivia, too, faced alarming infection rates, with 1,306 dengue carriers per 100,000 residents. While Mexico and Peru recorded comparatively lower incidences, approximately 277,000 and 274,000 cases respectively, the threat loomed large across the region.

Attributed in part to global warming, particularly El Niño, the World Health Organisation sounded the alarm, warning of an impending dengue surge in Southern Europe, the Southern US and new parts of Africa by the decade’s end. “The increase in temperature accelerates the extrinsic incubation process, which is the time in which the mosquito becomes infected with the virus and transmits it,” cited an expert with more than 20 years of experience in the Colombian private and public health sector.

“In Brazil, the numbers are alarming, also reaching record highs with millions of dengue cases and hundreds of deaths,” exclaimed an adviser to the Secretary of Health of the federal district in Brasília. Responding to the crisis, Brazil launched a vaccination campaign in January 2024, aiming to immunise 2.5 million children in 512 municipalities, alongside conventional preventive measures like wearing protective clothing and repellents. “Brazil is good at vaccination campaigns, but the current situation is so alarming that risk groups and isolated regions need to be prioritised,” reported the adviser.

“In Brazil, the numbers are alarming, also reaching record highs with millions of dengue cases and hundreds of deaths.”

Adviser to the Secretary of Health of the federal district, Brasília  

“More than six states, seven including Brasília, declared a state of emergency as the authorities tried to avoid the stress on the health system.” The local pharmacist continued, “the government has opted for two pillars in the combatting the disease, which are eradicating mosquitoes and increasing population awareness.”

Innovative approaches to disease control offer a glimmer of hope amidst the gloom. Integrating the Wolbachia method into broader strategies presents a novel solution to curb dengue, Zika, and chikungunya outbreaks. “There are several initiatives at the regional level that have focused on releasing mosquitoes infected with Wolbachia, a bacterium that does not affect humans,” the health expert remarked. By releasing “the Wolbachia-infected mosquitoes, they mate with wild mosquitoes and the new mosquitoes acquire the bacteria, which reduces the incidence of dengue” and countries like Brazil, Colombia, Honduras and Mexico’s Yucatán region are witnessing promising results in disease reduction. The expert remarked, “I think it will end up being one of the most viable alternatives to combat this virus.”

Pharmaceutical companies play a crucial role in the fight against dengue. While antiviral treatments remain elusive, “vaccination is a very important step that more and more countries are promoting, for which it is essential that governments guarantee access to the vaccine,” only two vaccines have gained approval. Takeda Pharmaceutical’s Qdenga and Sanofi’s Dengvaxia offer some hope, although multiple doses are needed and there are significant safety concerns such as “warnings about its effects in increasing the risk of severe dengue in HIV-negative people” as well as limited deployment.

“vaccination is a very important step that more and more countries are promoting, for which it is essential that governments guarantee access to the vaccine.”

Expert in health issues with more than 20 years of experience, Colombia

“I believe that the big bet and a growing need is the creation of single-dose vaccines, which will protect more people in short periods of time, while reducing the high costs.” The health sector expert expanded, “Pharmaceutical companies can respond to the growing demand for vaccines or consider options that allow agreements to be reached to manufacture vaccines in the region.”

Local governments, too, play a pivotal role in prevention and management efforts. Drawing from Peru’s experience, effective community engagement, resource allocation and environmental risk management are imperative. The Colombian private and public health sector expert continued, “in countries such as Argentina, which are in the midst of an exponential increase in cases, problems have been reported in accessing the dengue vaccine, which is also quite expensive, due to the government’s refusal to include it in the national vaccination schedule, unlike Brazil, which, due to the crisis, decided to include the vaccine in its public health system.”

As Latin America grapples with the relentless onslaught of dengue, a multifaceted approach involving collaboration, innovation and community empowerment emerges as the beacon of hope in the fight against this debilitating disease. Through collective action and steadfast determination, the region can overcome the dengue emergency and pave the way for a healthier future although, the health expert warned, “all indications are that the picture is far from improving and urgent action must be taken to avoid a much larger public health crisis.”

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