Ready, Set, Spray! Brazil Battles Dengue Ahead Of The World Cup

May 29, 2014
Originally published on May 29, 2014 2:11 pm

In Sao Paulo's poor north zone, in the neighborhood of Tucuruvi, teams of city workers knock on doors, warning people to take pets and small children out of the area.

Quickly after, men in hazmat suits with metal cylinders strapped to their backs start spraying the street, and some of the interiors of the homes, with powerful pesticides. This is the front line of the war on dengue fever in Brazil's largest city.

"This year, dengue transmission has been much more significant in Sao Paulo than in other years," says Nancy Marcal Bastos de Souza, a biologist who works with the city authorities. "We spray neighborhoods where we have a confirmed case of someone contracting dengue so we know there are dengue-carrying mosquitoes there," she says.

Only two weeks shy of the World Cup soccer tournament in Brazil, which begins June 12, there's concern that international visitors could get infected and then bring the disease back to their home nations.

Already, it seems like everything that can go wrong is going wrong. There have been protests and strikes, and now government officials, like those in Paraguay, are warning their citizens about the dengue epidemic sweeping Brazil.

Dengue fever has long been a problem in Brazil. The country has more recorded cases than any other in the world — some 1 million on average each year.

The infection is carried by female mosquitoes, who bite during the day and who pass on the dengue virus to their female offspring. Symptoms include fever, aching joints and headaches. There is no treatment or vaccine, and a rarer form of the disease — dengue hemorrhagic fever — can be fatal.

The disease is caused by four different types of the dengue virus, all of which are active in Brazil. But the one that has everyone most worried is called Type 4, which has only recently arrived in the region.

So why does Brazil have such a big problem with dengue?

Biologists say one of the reasons is poor water infrastructure.

"People have to put water in a space close to their homes, and there, the mosquitoes come and breed," says Celso Granato, head of infectious diseases at the Federal University of Sao Paulo.

Mosquito eggs can survive up to a year as well, so he says the key to combating dengue is persistence. That means using a combination of controls, such as spraying even when there aren't that many cases, as the infection comes in waves.

But the local governments in Brazil don't do that, says Granato. "What does the public administrator here think?" he asks. "This year we didn't have dengue so don't worry about next year."

Politicians, he adds, are usually short-sighted.

A new project in the Brazilian state of Bahia with genetically modified mosquitoes has shown early promise but is still in the test phase.

So there's been little to stop the sudden spike in Sao Paulo, Brazil's biggest city with a population of 20 million. With more than 6,000 cases so far in the city alone — and almost 60,000 in the surrounding state — hospitals are overrun.

Granato says once dengue arrives somewhere, it's there to stay.

Antonio Rios Sobrinho, a lawyer in his 70s, says he began to feel sick on a Friday. He went home early from work and quickly got worse. He was rushed to the hospital where, after a lengthy period, he was diagnosed with dengue hemorrhagic fever.

Sobrinho says he's been living in his neighborhood for 60 years and there had never been a single case of dengue. In fact, dengue was generally rare in Sao Paulo. But this year, just on his street, 15 people came down with the infection.

He says he was lucky to survive. This year was bad, but he fears next year will be worse.

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Transcript

MELISSA BLOCK, HOST:

The World Cup begins two weeks from today. Protests and strikes have been plaguing Brazil in the run up to soccer's largest tournament. The host country is also trying to contain another problem, an epidemic of dengue fever. NPR's Lourdes Garcia-Navarro reports from Sao Paulo.

UNIDENTIFIED SPEAKER: (Foreign language spoken).

LOURDES GARCIA-NAVARRO, BYLINE: In Sao Paulo's poor north zone, in the neighborhood of Tucuruvi, teams of city workers knock on doors, warning people to take pets and small children out of the area. Quickly after, men in hazmat suits with metal cylinders strapped to their backs looking like something out of "ET" start spraying the street and some of the interiors of homes with powerful pesticides. This is the front line of the war on dengue in São Paulo. Nancy Marcal Bastos de Souza is a biologist who works with the city authorities.

NANCY MARCAL BASTOS DE SOUZA: (Foreign language spoken).

GARCIA-NAVARRO: This year dengue transmission has been much more significant in São Paulo she says than in any other year. We spray the neighborhoods where we have a confirmed case of someone contracting dengue, so we know there are dengue carrying mosquitoes there. Dengue has long been a problem in Brazil.

In fact Brazil has more recorded cases of dengue fever than any other country in the world. Some 1 million on average a year. The infection is carried by female mosquitoes that bite during the day and is passed on through their female offspring. Its symptoms include fever, aching joints and headaches. There is no treatment or vaccine and a rarer form of the disease hemorrhagic dengue can be fatal. There is a concern that international visitors could get infected during the World Cup. They could spread the disease back in their home countries.

CELSO GRANATO: My name is Celso Granato. I am the chief of clinical Virology laboratory. I am the chief of the of infectious diseases.

GARCIA-NAVARRO: There are four different kinds of strains of dengue, all active in Brazil. Granato says one of the reasons dengue is so prevalent here is because of poor water infrastructure.

GRANATO: And, so people have to put water in a space close to their homes. There, the mosquito comes, breeds, this mosquito is very well adapted to the surroundings of your house.

GARCIA-NAVARRO: Mosquito eggs can survive up to a year. So he says the key to combating dengue is persistence. You have to use a combination of controls like spraying, even when there aren't that many cases as the infection comes in waves. But he says the local governments here don't do that.

GRANATO: So what public administrator usually things. well this year we didn't have dengue. Don't worry about next. You know how politicians are. They are usually short viewed.

GARCIA-NAVARRO: A new project in the Brazilian state of Bahia with genetically modified mosquitoes has shown early promise but it's still in the test phase. So there's been little to stop the spike in Sao Paulo, Brazil's biggest city has a population of 20 million. There have been over 6,000 cases here so far. Almost 60,000 in the state as a whole. Hospitals have been overrun. Granato says once dengue arrives somewhere it's there to say.

ANTONIO RIOS SOBRINHO: (Foreign language spoken).

GARCIA-NAVARRO: Antonio Rios Sobrinho is a lawyer in his seventies and he began to feel sick on a Friday he tells me. He went home early from work and he quickly got worse. He was rushed to the hospital where after a lengthy period he was diagnosed with hemorrhagic dengue. He says he's been living in his neighborhood for 60 years.

And there'd never been a single case of dengue. In fact dengue was rare in São Paulo generally. But this year just on his street 15 people came down with the infection. He says he was lucky to survive. He says this year was bad, and He fears next year could be worse. Lourdes Garcia-Navarro NPR News São Paulo. Transcript provided by NPR, Copyright NPR.