Health: Yellow Fever in Paraguay

Conquerors of Yellow Fever, from the Congressional Gold Medal site

Auntie Beeb is reporting a recent outbreak of yellow fever in Paraguay &mdash the first in 34 years. Seven people have died so far.

The World Health Organization is sending two million doses of vaccine. Paraguay's own stocks have apparently been used up, as have those sent by neighbouring countries in the region. Paraguay has declared a state of national emergency.

Meanwhile, desperate Paraguayans are anxious and upset, and riot police have been called in to protect buildings from which vaccine is being distributed. Brazil, which is also experiencing an epidemic of yellow fever, in which 16 people have died so far, is one of the countries providing assistance to Paraguay.

Yellow fever, like malaria and dengue fever, is spread through mosquito bites, and out of 200,000 cases worldwide every year, an estimated 30,000 people die. Unlike malaria, yellow fever is a viral disease. It is spread by Aedes mosquitoes &mdash Aedes simpsaloni, A. africanus, and A. aegypti in Africa, the Haemagogus genus in South America, and the Sasbethes genera in France.

The disease gets its name from the outbreak of jaundice in affected patients. Because initial symptoms are so similar to those of other diseases, such as malaria and dengue, and even some forms of poisoning, yellow fever may be difficult to diagnose.

There is no cure for yellow fever, and the medical approach is to treat the symptoms. The only existing vaccine has been known to cause severe reactions in people over the age of 60, up to and including massive organ failure. The vaccine provides an approximately ten-year immunity to the disease, and thus must be re-administered periodically.

Robert Shope of the Yale Arbovirus Research Unit, Yale University School of Medicine, writes in Environmental Health Perspectives at length on the effects of a rise in temperature and rainfall patterns on the epidemiology of pathogenic infections. We do not have permission to reproduce his article, originally published in 1991; suffice it to say that he named yellow fever and dengue fever as the vector-borne diseases that pose the greatest threat in North America as the world warms.

Aedes mosquitoes are rapidly killed at freezing temperatures, according to the article. However, Shope goes on to say:

The northernmost winter survival of Aedes aegypti is now about 35deg. N latitude, or the latitude of Memphis, Tennessee. This distribution is predicted with global warming to move northward and encompass additional large population centers, the numbers depending on how much warming occurs. In addition, the development of mosquito larvae is faster in warm climates than cold ones, and thus with global warming, the mosquito will become a transmitting adult earlier in the season.

As early as January of this year, researchers were warning of a resurgence of dengue fever in the U.S., and the Los Angeles Times carried an article that cited Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, who helped lead the government's efforts against AIDS.

In an article this month in the Journal of the American Medical Association (JAMA), Fauci and his science adviser, Dr. David Morens, said more than 760,000 cases were reported in the Americas last year, of which some 20,000 involved the virulent form, known as dengue hemorrhagic fever. The disease [...] beginning to make its presence felt in the U.S., with cases popping up in Texas, Hawaii and Puerto Rico. Last week, top health officials warned that a "widespread appearance" in the continental U.S. is "a real possibility."

Thus far, cases of dengue fever in North America — where disease scientists thought they had conquered it 30 years ago — have tended to be scattered and affect relatively few people. But increased travel to and from South America, where a resurgence has made dengue widespread, is thought to be boosting the disease's spread northward. And some experts suspect climate change is aggravating the problem.

So, to those who scoff at the need for the U.N., or universal health care, here's your answer. Dengue fever, like yellow fever, has no cure. It too can kill. These diseases, and other like them, can be controlled with the help of vaccines and global cooperation. However, there are costs to such diseases.

Massive organ failure is not a great way to die. If you value your life, and the lives of your friends, neighbours, children, et cetera, you should support truly universal health care. Because the world is a small, round globe, and ultimately we are all interconnected through the very web of life that makes our lives possible.

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