2024-03-14 09:21:00
The head of the International Health Service at the Hospital Clínic and researcher at the Barcelona Institute of Global Health, Dr. José Muoz, has pointed out “more or less it is considered that 40% of the world’s population is at risk of dengue”, and that “There are an estimated 400 million cases,” although “many of the cases are asymptomatic,” specifically 80%.
“Clearly, year by year it grows. Now the figures we have in countries that have serious problems, like Brazil, for example, Mexico, are growths of 189-200% compared to last year in incidence,” he stated during the One Health meeting: the expansion of dengue, organized by the National Association of Health Informants (ANIS) and Takeda this Tuesday.
Dengue is a disease that is transmitted by tiger mosquito bite which, due to factors such as globalization and climate change, is increasingly widespread throughout the world. In 20 years, dengue cases have multiplied by 10, That is, it has gone from registering 500,000 cases to five million in the world. There were seven countries where dengue was endemic and now there are up to 129 according to the latest count by the World Health Organization.
“Aedes aegypti mosquitoes, vectors of dengue, are tropical species that also breed in natural environments, in holes in tree trunks, but They have adapted to living within cities. So they have become our companions and we are responsible for that expansion. The expansion it has had throughout the world is precisely because it has been able to adapt to cities,” said entomatologist and professor of Animal Health at the University of Zaragoza, Dr. Javier Lucientes.
Thus, Dr. Lucientes explained that this species “is an eminently urban mosquito, which mainly bites people.” In addition, it has two peculiarities that make it “very dangerous”: “one is that it is diurnal and its activity coincides with the activity of the others”, and the other that “It is very aggressive” and the females are “excessively aggressive.”
“When they decide that they are going to bite you, they bite you. They say that it also hurts a lot, I have escaped until now. It depends on the people, but in principle they don’t hurt me that much, the black fly hurts me more. So when you have some protective measure, remembering that you not only have to give it to the hand and face, but to the entire body,” he explained.
Among the reasons why almost half of the world’s population is la globalizacin“that ability to move people and goods in a few hours, especially goods related to tires from continent to continent, but especially with plant issues.”
Likewise, the winters are getting warmer and this is beneficial for the spread of the disease since “very cold winters kill mosquito eggs and adult mosquitoes, but what these warmer winters do is that the strains adapt and are able to withstand the winter.
“The key is in good surveillance of people and in having good prophylaxis of infected people. Let’s not hide behind the fact that we are going to wait until it is summer when there are more mosquitoes, which at this time on the coastline there may be sufficient vector densities to be able to transmit,” warned Dr. Lucientes.
In this sense, the head of infectious diseases at the La Fe Hospital in Valencia, Dr. Miguel Calavert, has pointed out “wars, hunger, deforestation, climate change and global warming in general” as causes of the expansion of the mosquito. tiger, and not only of this but of “ticks and other types of vectors.”
For this reason, Dr. Calavert has pointed out the need to “raise awareness and educate” citizens about vectors in general and preventive measures in particular. “In Spain there is a lot of love for hunting, fishing, all of this, they are leisure activities that favor contagion,” he added.
Surveillance, control and prevention
During the colloquium, the experts have opted for three key aspects to address the global dengue situation: surveillance, control and prevention.
With respect to the first two, the deputy director general of surveillance of the Public Health Agency of Catalonia, Jacobo Mendioroz, surveillance is key because “most cases are asymptomatic and we only end up seeing the tip of the iceberg.” Among the forms of surveillance, the expert has especially highlighted the Mosquito Alert application, which helps detect tiger mosquito bites and know how to act in each case.
On the other hand, prevention focuses on the measures taken when traveling abroad and returning to Spain, such as vaccination. In this regard, the training member of the Spanish Vaccine Association, Dr. Natividad Tolosa, has pointed out that “you have to protect yourself from mosquitoes in the ranch but also when they return.”
“We do not take into account that we have to protect ourselves from the mosquito in the ranch, but when we return here we already have the vector, but many cases are asymptomatic. We have a possibility of “protection with a vaccine that we can offer travelers for dengue”he pointed out.
However, Dr. Tolosa has pointed out that “the vaccine is not one hundred percent effective except for some wonderful cases.” “The novelty and advantage is that it is a vaccine that can be administered both to people who have had contact with dengue and to people who have not had contact with dengue, which is why it is useful for travelers,” she explained.
Thus, he has detailed that it is a vaccine with a two-dose schedule for which three months are needed but it has been seen that the protection begins 14 days after the first dose and, therefore, “with a first dose you can endure up to almost a year with 80% effectiveness.”
“It makes no sense to put it in the state vaccination schedule, but financing it in cases of travelers, etc. I don’t see it as crazy at all. They should do it before it becomes endemic here,” concluded Dr. Tolosa.
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