Debt-ridden Puerto Rico's Zika outbreak escalating

There are 117 confirmed cases of Zika virus in Puerto Rico, four times the number at the end of January; with a population of 3.5m people, it makes it by far the most affected area in the US says Tom Frieden of the Centers of Disease Control and Prevention. Puerto Rico is one of America's poorest and most vulnerable states; it is debt-ridden and lacks a functioning healthcare system, window screens or sprays to work against mosquitoes spreading the virus. The number infected is expected to rise sharply in the coming weeks, increasing the likelihood of the virus spreading to the US. This outbreak lays bare how deeply Puerto Rico''s debt crisis has cut public programmes including the basic healthcare needed to fight the virus.

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This article was published 05/03/2016 (2655 days ago), so information in it may no longer be current.

SAN JUAN, Puerto Rico — Zika has landed forcefully in America, in one of its poorest and most vulnerable corners, a debt-ridden territory lacking a functioning health-care system, window screens and even a spray that works against the mosquitoes spreading the virus in homes, workplaces, schools and parks.

There are 117 confirmed cases of the virus in Puerto Rico, four times the number at the end of January. The island territory, which has a population of 3.5 million people, is “by far the most affected area” in the United States, Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), said last week.

The number will almost certainly rise sharply in coming weeks, making it ever more likely the virus will spread to the continental United States.

The growing outbreak has laid bare how deeply Puerto Rico’s debt crisis has cut public programs, including basic health and environmental control services needed to fight the virus.

Experts say urgent action is needed before mosquitos reach their peak with the start of the rainy season in April. Experts from the CDC estimate that 70,000 people — about 20 per cent of the population — could be infected across the island by the end of the year, based on previous outbreaks of dengue and chikungunya, related viral diseases.

In response, the CDC has sent 30 experts to Puerto Rico, adding to the 70 CDC staff members based here who usually work on dengue fever but now are focusing on Zika.

U.S. President Barack Obama’s US$1.9-billion emergency Zika request to Congress includes $250 million for Puerto Rico.

“I don’t think we’re going to be able to stop the Zika outbreak,” said Steve Waterman, chief of the CDC’s dengue branch, located on the city’s west side. “There will be a substantial Zika outbreak that will peak in the summer and fall. It’s likely that thousands of pregnant women will be exposed and infected, so that’s why our efforts are focused on protecting as many pregnant women as possible.”

Five of the 117 confirmed cases involve pregnant women. Almost all the cases in Puerto Rico involve people bitten here by infected Aedes aegypti mosquitoes, which also spreads dengue fever and chikungunya.

Mosquitoes have ample breeding grounds here.

In the Villa Palmeras cemetery in barrio Obrero, a low-income neighbourhood in northeastern San Juan, virtually all of the thousands of graves have built-in flower stands where water, and mosquito larvae, collect. There are 109 cemeteries across Puerto Rico and thousands of flower holders.

Mosquito larvae also flourish underground, in water meters and vent pipes of septic tanks, which contain more water than elsewhere in the United States, said Roberto Barrera, a CDC entomologist.

And then there are the mountains of used tires, which mosquitoes flock to, said Johnny Rullan, a former health secretary who is helping the government eliminate breeding sites. Puerto Rico has accumulated more used tires than anywhere else in the United States, experts said.

Women in Puerto Rico give birth to about 33,000 babies a year. The island has one of the highest teenage birth rates in the United States, and many public high schools have no window screens. The government is estimating how much it would cost to add screens, said Grace Santana, chief of staff to Gov. Alejandro Javier García Padilla.

Nearly half of Puerto Rico lives below the poverty line. The thousands of pastel-hued public housing projects that dot the island don’t have air conditioning. Residents don’t have window screens, in part because they can’t afford them, but also because they don’t want to block the breeze. Adding screens to those homes would cost about $70 million, said Grace Santana, chief of staff to García Padilla.

At dusk on a recent day, a maroon pickup truck drove through the streets in the middle-class neighbourhood of Riveras de Cupey, in San Juan’s south, spraying permethrin, a commonly used insecticide, from a machine mounted on the back.

But Aedes aegypti mosquitoes already have developed resistance to permethrin in some parts of Puerto Rico, said Audrey Lenhart, a CDC research entomologist. She is testing which insecticides are most effective, something that was never done before.

— The Washington Post