The Winter of Dengue Fever » Counterpunch: Tells the Facts, Names the NamesPosted: February 9, 2012
Cuban researchers have played a key role in developing the widely accepted model that DHF is determined by “the interaction between the host, the virus and the vector in an epidemiological and ecosystem setting”  In Cuba, this translates to a the most important risk factor for getting DHF is having a second infection of DF which is a different strain; b being infected a second time in a specific order of DF strains places children at a higher risk for DHF than adults; c white Cubans are at a higher risk for DHF than Afro-Cubans; but, d those who already have sickle cell anemia, bronchial asthma or diabetes are at higher risk.Cuban researchers openly discuss weaknesses in their health care system. One study indicated that there could be a “marked undercounting” of dengue due to missing a large number of cases. This finding occurred even though the study examined data during a time of “maximum alert,” suggesting that undercounting could be very widespread. A typical finding is that the community must feel that the dengue control program belongs to them if it is to be successful and sustainable.  Some of the best work I’ve seen on the role of public health takes an honest look at effects of “the absence of active involvement of the community” in dengue control. The authors felt that Cuba’s outdoor spraying of adult mosquitoes “is of questionable efficacy.” Instead, they focused on “the bad conditions or absence of covers on water storage containers” in the city of Guantánamo.