Friday, September 02, 2016

Cuba reports remarkable success in containing Zika virus

Cuba reports remarkable success in containing Zika virus
By Michael Weissenstein | AP September 2 at 12:25 AM

HAVANA — Six months after President Raul Castro declared war on the Zika
virus in Cuba, a militarized nationwide campaign of intensive mosquito
spraying, monitoring and quarantine appears to be working.

Cuba is among the few countries in the Western Hemisphere that have so
far prevented significant spread of the disease blamed for birth defects
in thousands of children. Only three people have caught Zika in Cuba.
Thirty have been diagnosed with cases of the virus they got outside the
island, according to Cuban officials.

Many are now watching to see whether Cuba is able to maintain control
of Zika or will drop its guard and see widening infection like so many
of its neighbors. The battle against Zika is testing what Cuba calls a
signal accomplishment of its single-party socialist revolution — a free
health-care system that assigns a family doctor to every neighborhood,
with a focus on preventive care and maternal and pediatric health. That
system has come under strain in recent years as thousands of specialists
emigrate to the U.S., Europe and South America for higher pay and the
allied government of Venezuela reduces the flow of subsidized oil that
has been keeping Cuba solvent.

U.S. government scientists fly to Havana in November for a two-day
meeting on animal-borne viruses such as Zika, the first conference of
its kind since the re-establishment of diplomatic relations a year ago.
American researchers say they are eager to learn more and help
incorporate Cuba into U.S.-backed international health programs after a
half-century without significant professional interaction.

"Probably in the last decade we've had two people that have gone down
there for anything," said F. Gray Handley, associate director for
international research affairs at the U.S. National Institute of Allergy
and Infectious Diseases. "It has been pretty much of a black box."

So far, there have been about 40 cases of Zika caused by mosquito bites
in Florida. Health officials don't expect widespread outbreaks in the
mainland U.S. but there are thousands of cases in Puerto Rico and
countries such as Brazil and Venezuela are struggling with large-scale

International medical experts familiar with Cuba say other countries can
learn from Cuba's intense focus on preventing disease, which led the
government to decimate the mosquito population by spraying virtually
every neighborhood in Cuba this spring.

"Cuba's response has been strong and effective," said Dr. Cristian
Morales, the World Health Organization's representative in Cuba. "It has
to do with the capacity to organize the population. Applying it to other
countries, other contexts, would be extremely difficult."

Other elements of Cuba's success so far against Zika may simply not
apply to other nations because they are inextricably tied to a form of
government unique in the Western hemisphere.

Most aspects of life in Cuba are controlled by a single-party state that
rigorously monitors citizens' activities. From neighborhood doctors to
reporters to block watch captains, most people in Cuba work for a
massive government apparatus whose components all ultimately answer to a
single unelected leader, Raul Castro, who heads the military, the state
and the Communist Party.

In February, as Zika spread through South America, Castro announced that
he would be deploying the army to spray homes and workplaces because of
the failings of civilian government fumigators, whom Cubans frequently
brushed off to avoid the smelly, noisy filling of their homes with
insecticidal fog.

"Our people will be able to demonstrate their ability to organize to
maintain the levels of health achieved by the revolution and avoid our
families suffering," he wrote. "As never before in similar efforts, we
must be ever-more disciplined and demanding."

In the following weeks, Cubans cities, towns and villages filled with
olive-clad soldiers moving door-to-door with handheld foggers, and using
sprayer trucks to blanket entire streets with clouds of insecticide.

Cuba's approach compares favorably to the effort in Florida, where
officials are spraying areas where Zika cases have already started
cropping up, said Carlos Espinal, director of the Global Health
Consortium at Florida International University in Miami.

"They started very early in advance of the Zika virus," he said. "Once
you start going behind the cases then it's complicated, you're just
detecting once the transmission is already in place."

The Cuban state has officials from immigration agents to neighborhood
doctors watching for Zika, especially in the thousands of doctors,
nurses and support staff who work overseas in programs that earn the
Cuban government billions of dollars a year in badly needed hard currency.

"The neighborhood family doctor is told, 'In your community there are 10
people who've gone to Jamaica. Two are doctors, three are nurses and the
other six or five are business people, tourists, whatever.' And he has
to keep an eye on them, go to their homes, call them," said Professor
Jorge Perez, director of the Pedro Kouri Tropical Medicine Institute in

Perez said 1,700 people with fever or other symptoms had been
quarantined for 24-48 hours while being tested for Zika. All pregnant
women are tested for Zika in their first trimester, he said. Every
worker sent overseas on a government "mission" is quarantined and tested
before returning to the island.

"We're surrounded by Zika, everywhere," he said. "We've learned that
it's better to prevent than to treat."

The Cuban government holds regular video conferences among top health
officials, military officers, Communist Party officials and sanitation
and water experts in the capital and in Cuba's 14 provinces. Even
elementary- and middle-school students had been drawn into the campaign,
with teams of children as young as 10 sent door-to-door to check for
standing water where mosquitoes breed and distribute information about
Zika. Those who defy orders to eliminate standing water or trash or
allow inspections or fumigation are fined.

"In our neighborhood people watch out for surges of mosquitoes, keep
things clean and work with the neighborhood to raise their awareness,"
said Gerardo Olvera, 51, a self-employed vendor of phone cards in
Havana. "Meanwhile the authorities are visiting, fumigating. It's all
designed to get everyone involved."

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Source: Cuba reports remarkable success in containing Zika virus - The
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