One morning in late May, after returning from his farm (cultivating land) in Villa La Legua in the Piura department of Peru, Carlos Arturo Zapata, 93, felt unwell. He was a strong and vital man, but suddenly fever, headache and a strange feeling like burning in his eyes began to attack him. He didn’t want to go to the doctor. His relatives gave him acetaminophen and hydration to ease his symptoms and things began to improve. Until four days later it unexpectedly got worse again. The pain returned, he didn’t want to eat anymore and his fever didn’t go down. They rushed him in a car to the Jorge Reátegui Hospital in the capital of that department on the north coast of Peru, but he died on the way.
Fumigation of houses in Comas district. Sebastian Castañeda
He died of dengue fever, a disease that has been widespread in this region for years, but which today has spread almost uncontrollably. Ralph Zapata, his still-injured grandson, says that for the past few weeks, 30 cases a day have been reported in La Legua, a population of about 5,000 people, affected by this pathogen of the flavivirus family. The disease, which usually causes sudden fever, muscle pains in the joints, and spots all over the body, cannot be treated and can be fatal in its most severe forms, such as dengue hemorrhagic fever.
There was nothing like this there, nor in the entire Catacaos district, to which La Legua belongs, where, according to the Ministry of Health (Minsa), 2,086 cases were recorded in a population of 75,000 by mid-June. Across the department of Piura, the worst-hit department in the country, there are 46,650 confirmed to probable cases and the death toll stands at 96. Nationally, the number is more than 161,000 and the death toll is at least 287. Given the Given the deadly effects of the Covid pandemic, which claimed almost 200,000 lives in this country, that doesn’t seem like much. But the growth has been exponential: 43,899 cases of dengue were registered last year, and in 2021 there will be 24,642.
Water distribution by tanker at the Nadine Heredia human settlement in the San Juan de Miraflores district of Lima. Sebastian Castañeda
The spike in cases also comes after Cyclone Yaku, an unusual tropical low-pressure system at this latitude, caused severe flooding and devastation in various regions of Peru’s coast in March. for dr Rául Urquizo, Dean of the Medical School of Peru, in this regard, it was expected that the epidemic would occur due to the accumulation of stagnant water combined with the heat, leading to rapid reproduction of the vector insect Aedes aegypti. according to dr César Cabezas of the National Institute of Health, the time it takes for the mosquito to go from egg to adult insect under normal conditions is about nine days. But as the heat increases, this cycle gets shorter.
climate change
dr Cabezas also points to another alarm factor: the presence of the virus has been detected “in the insect’s reproductive system,” which is believed to nullify a phase in the normal contagion process. To do this, it is necessary for the female Aedes aegypti to bite an already infected person, since she needs blood for her reproduction, and then a third person. But this finding accelerates everything from the development of the mosquito in the egg-larva-pupa-insect cycle to contagion and the increase in cases.
A woman is treated at the Clinical Surveillance Unit, Uviclin in the Puente Piedra district. Sebastian Castañeda
Adding to all these factors is the lack of a concerted government response and poverty. In communities with fewer resources, such as settlements where they have no access to potable water, it is common to store water in open containers that serve as breeding grounds for mosquitoes. for dr Nancy Serpa, former Deputy Minister of Health, “it’s not just a health problem, it’s also a social problem.” And today it’s basically a climatic one.
According to the World Health Organization (WHO), dengue fever is spreading in countries where it was previously almost unknown, such as Croatia. A document released by the organization earlier this year shows that 390 million infections are reported each year. It is also estimated that 3.9 billion people are at risk of contracting the disease.
For Raman Velayudhan, coordinator of the WHO’s dengue and arbovirus initiative, “climate change plays a key role in facilitating the spread of the mosquito.” The warning is not new. Peruvian researcher Paul Maquet recalled that as early as 2007, the Intergovernmental Panel on Climate Change claimed that the phenomenon would cause “a change in the vectors of infectious diseases in certain areas”.
call the mosquito
The Ministry of Environment (Minam) itself indicated in its Climate Change Adaptation Plan presented in July 2021 that one of the dangers related to global warming is the increase in metaxenic diseases (those whose vectors are sensitive to changes in the environment) . Dengue fever. Especially for those who lack drinking water and sewage.
Dengue Research Laboratory at the INS National Institute of Health. Sebastian Castañeda
In Puente Piedra, on the outskirts of the Lima metropolitan area, you can see that something has changed. It is already winter and the temperature exceeds 25 degrees, it is hot and wearing a coat is not necessary. This is not common in Lima, which is mostly cloudy at this time of year and temperatures hover around 20 degrees or less. But this year the heat won’t go away.
Milagros Sanchez is 33 years old. She is being hospitalized for an acute case of dengue in a bed of the Clinical Surveillance Unit (Uviclin) established in this area by the Ministry of Health (Minsa). “One day, around 3 a.m., I woke up with chills, muscle aches, and a fever, and I didn’t want to eat. I thought it was the flu,” he recalls.
Since the paracetamol had no effect, he took a test at a private diagnostic center and confirmed that he had dengue fever. He believes he got infected at his grandmother’s house, who has several pots in her garden, some with just water, an ideal place to house the transmitting mosquito.
For example, in the northern part of Lima, the Ministry of Health (Minsa) has been able to establish that Aedes aegypti is usually found in this type of containers, particularly in vessels of water containing the plant bamboo (Bambusoideae), which is believed to have the power to attract good luck, but in this case it can lead to tragedy.
fumigate to live
On a recent afternoon, a Minsa team conducted a fumigation day in Carabayllo, another district where dengue fever is rampant. On a street where there is hardly any asphalt, dozens of modest houses are piled up in low and high parts. Managers knock on doors, people come out and shoot a cloud of an insecticide called malathion. It kills the mosquito but not its larvae.
Fumigation of houses against dengue fever. Sebastian Castañeda
But in some areas mistrust works against prevention. “It’s a red zone. It’s likely that they believe it’s an attack and that’s why they’re not opening,” a health officer from the ministry team said after no one in a house opened for them. Eventually someone opens the door and the woman sprays pyriproxyfen, a substance that actually kills the larvae, into a bowl of water and a wilted rose.
It’s already night outside. In the background, in the upper parts of a hill, you can see even poorer houses, which are difficult to cover with fumigation. In such areas, the mosquito responsible for the epidemic roams freely while poverty and climate change feed it. And soon the El Niño phenomenon will cause even more heat.