Wednesday, February 10, 2016

The border between Colombia and Venezuela has become a new focus of zika

Health officials say the virus is spreading rapidly zika through Colombia and Venezuela, noting that the porous border between the two countries could become after Brazil in the next focus of the epidemic of the mosquito-borne virus, publishes The Wall Street Journal. Infectious disease specialists say there are at least tens of thousands of cases in both countries, which together have a population of 80 million. The border of 2,300 kilometers long has been of special concern to health officials, who say the virus has an acute presence in the border city of Cucuta, Colombia, and is expanding northward through a series of villages and cities deployed in hot, swampy pastoral areas to Maracaibo, Venezuela's second city, close to the Caribbean coast.

The border between Colombia and Venezuela has become a new focus of zika
A woman bathes with water stored in containers outside her home in San Josecito, which can serve as an incubator for the mosquitoes that transmit zika. PHOTO: SARA SCHAEFER MUĂ‘OZ / THE WALL STREET JOURNAL
On arrival the virus at this city, which usually produces mild symptoms but may be related to a rare neurological disorder in babies born with smaller heads than normal, is scaring people the same way as in Brazil, where up 1.5 million people could be infected. Last Friday, sitting in the waiting room of a clinic in San Josecito on the Venezuelan side of the border, Dairy Varela, 19, described her symptoms as chills and aches. She said doctors did not know they had, because they lack supplies for clinical trials, but their symptoms are hallmarks of zika.

"Now my skin feels terrible, is itching, and an outbreak is coming in my arms and my face, see?" She said, pointing to a pink spot on her face. "I am very worried [seeing] how it goes on TV babies with small brains."

Colombian health authorities have confirmed more than 20,000 cases of Zika, but estimate that amount to 100,000 cases because they believe many people infected with the virus have not been diagnosed. Extrapolating current rates, they estimate the number of people infected will grow to at least 700,000 by the end of the year. By then, authorities estimate, Colombia will have 500 cases of microcephaly, a condition in which babies are born with skulls and brains undersized, and 700 with Guillain-Barre syndrome, which can cause paralysis and death. Colombia reported three deaths caused by Guillain-Barre syndrome associated with zika last week. Compounding the anxiety is the collapse of the health system in Venezuela, beset by a lack of drugs and supplies in the midst of economic crisis. Venezuela stopped publishing weekly statistics on infectious diseases in 2014, so the health authorities of Colombia can only speculate on how severe the epidemic a few kilometers across the border.

"Mosquitoes do not respect the international borders," said Fernando Ruiz last week, Deputy Minister of Health of Colombia, during his visit to the worst affected areas along the border. "We are concerned about what is happening in Venezuela, because Venezuela has not made any epidemiological report".

Last month, the health minister of this country said authorities had identified 4,700 cases of Zika, a figure that has been criticized by associations of doctors and infectious disease specialists both in Venezuela and abroad. They say the real figure could be tens of thousands.

"What we are seeing now is the tip of the iceberg," said Barbossa Nellis, chief epidemiologist of Zulia, Venezuela border state, whose capital is Maracaibo. "We have an epidemic now." Calls seeking comment the Health Ministry were not returned.

Visits a slum and Maracaibo hospital and poor along the northwestern border with Colombia Venezuela communities left an impression that the zika is spreading uncontrollably. Venezuela lacks even aspirin and insect repellents, which doctors say they are among the first lines of defense against viruses such as zika.

Zulia has registered 463 cases of Zika, Barbossa said, but the specialist estimated that probably one in five of the 3.5 million inhabitants of the state could become infected. Mosquitoes are breeding in the trash in the streets and in home water tanks not only in overcrowded neighborhoods but also in the University Hospital of the state, where there was no water service, forcing workers to collect water buckets. The story of a man who died of Guillain-Barre syndrome possibly related to Zika, highlights the obstacles facing physicians in Venezuela.

Jorge La Cruz, 51, developed rashes in December. When his tongue and his arms went numb, he was diagnosed at the University Hospital with Guillain-Barre syndrome, according to documents seen The Wall Street Journal. Doctors told the family he needed immunoglobulin, but the hospital did not have any blisters and the family could not afford the $ 150 it cost on the black market. "I offered my house in exchange for medicine, but only wanted cash," said Bercelys Pelufo, wife of the deceased. As the paralysis-the horrible effect of Guillain-Barre-xpanded her body, De La Cruz needed to be on a ventilator. But the machine did not work, and the man died.

Nearby, the people of San Francisco, the working class district of Maracaibo, are concerned about how they or their children may be affected. Duana Rodriguez, a pregnant woman was recently with her four children standing beside a stream that smelled of sewage. Mosquitoes swarmed through human waste.

"I am very worried about the baby," She said. "The government has done nothing about the zika."

In Colombia, the Aedes mosquito carrying the Zika the multiplies rapidly. Residents of the town of El Zulia say they are constantly surrounded by swarms of what they call "vampire mosquitoes."

"Almost everyone has had zika here," said Piedad Uribe, manager at a small hospital in El Zulia.

Aleyda Zabaleta, a doctor of the hospital, duly recorded every possible case of Zika, dispenses paracetamol and ibuprofen for pain and stinging rashes antihistamines for the virus. Pregnant women are sent to a larger hospital in Cucuta.

Each morning the doctor Zabaleta manages a team that is headed in the only hospital ambulance to small nearby communities to treat people possibly infected with viruses and advise zika get rid of standing water where mosquitoes breed. "They have to know that the point of origin is often found in mosquitoes that breed in their homes," She said.