By Helém Peña in Asunción and Sadia Kaenzig in Geneva
At least 25 people have died and 200 are severely ill as a result of a dengue fever outbreak, according to the Paraguayan Ministry of Health (MINSA). Esperanza Martínez, the Minister of Health, stated on Monday that “…this is the worst dengue outbreak in the history of our country”. She added that “…doctors and nurses are seeing dozens of patients every day in emergency rooms in public and private hospitals and clinics in the country”. Official sources have informed that hospital services, as well as the capacity of the local health system, have collapsed country-wide as a result of the demand.
Most of the cases have been reported in the regions of Itapúa, Alto Paraná and Central, located in the south, east and centre of the country. The State has informed that 26,732 possible cases have been reported to date, of which 9,652 have already been confirmed through epidemiological criteria and/or laboratory tests.
"We are very concerned because of the rapid spread of the disease”, said Cynthia Margarita León González, health coordinator at the Paraguayan Red Cross (PRC). “The number of deaths is high, as the virus that is causing the majority of the cases is new to Paraguay. This means that people who have already had the disease are nonetheless exposed to becoming infected again; they have no immunity”.
The first dengue epidemic in Paraguay was registered between 1988 and 1989. At that time, 41,990 cases were registered due to the DEN1 strain. No cases were reported between 1989 and November 1998. The most recent outbreak was seen in 2007, when thousands of people became ill and 17 deaths occurred.
Red Cross action
MINSA and the National Emergency Secretariat (SEN) have invited PRC to become part of the inter-institutional coordination team, considering that PRC is part of the Secretariat’s Executive Council and a leader in Risk Reduction. In this context, PRC has committed to working in a joint and coordinated manner with relevant State organizations, and in the municipalities that register the highest rate of infestation.
PRC’s contribution to this national effort consists mainly of working with municipal authorities where Red Cross Branches are located, and implementing advocacy activities with an aim to facilitate implementation of MINSA’s contingency plan. PRC will also focus its actions on working with communities in volunteer mobilization through the communities’ environmental mingas (community fairs where everyone participates and helps for a purpose), carrying out advocacy and awareness raising and disseminating relevant information through mass media.
PRC also sits in the Situation Room that has been set up as part of the Contingency Plan. Its responsibilities are related to data collection, daily activity reports, data base management for daily visits statistics, inventory control of mobilized resources, coverage areas and projections. All this is carried out through the National Disaster Response Unit (UNRD).
“Paraguayan Red Cross has started to use the Spanish version of Epidemic Control for Volunteers – Manual and Toolbox. During the pilot test that took place in 2009, PRC volunteer networks received training on how to limit the number of victims of an outbreak, how to act quickly and efficiently and how to define their own role in a community before, during and after an epidemic. As a result, PRC is well prepared to respond to outbreaks and to contribute toward the achievement of healthier and more resilient communities”, said Dr. Carlos Vera Urdapilleta, Secretary General of the Paraguayan Red Cross.
According to Dr. Marta Trayner, IFRC Emergency Health Coordinator in the Americas Zone, “…the high rate of dengue cases has led PRC and the State to activate a contingency plan aimed at preventing the worsening of the situation, while assisting those affected.” The International Federation is providing technical support to the operation, and working with the Paraguayan Red Cross in assisting neighborhood committees in cleaning breeding grounds.
According to Pan American Health Organization (PAHO) data, only 43 percent of Paraguay’s population of 6.3 million has access to drinking water, and there are only 4.9 doctors available for every 10,000 people.
Dengue is transmitted by the Aedes aegypti mosquito. Patients can become incapacitated for over one week, and present severe headaches and joint pain. There is no antiviral treatment or vaccine to treat the illness, but patients do need to be kept well hydrated. Less than 5 percent of cases registered correspond to a hemorrhagic variant of the illness that causes internal and external hemorrhaging and is lethal. Although these cases do not yet represent a very high percentage of the total, there are signs of an increase. This variety often affects people that have recovered from a mild or not very severe case of dengue.
The spread of dengue has gained strength in the continent since 1980. The only way to control it is through prevention, an area where the Red Cross network in the Americas carries out important efforts.