(iht) - The shantytowns clinging to Rio's lush jungle hillsides are fertile breeding ground for a tiny black mosquito whose bites are causing an increasingly deadly dengue fever epidemic.
Crevices in dilapidated hovels, old tires and trash piles collect standing water where the insect breeds, while kids toting automatic weapons scare away the few public health agents who might teach slum dwellers how to protect themselves.
Successfully fighting dengue requires tedious, labor-intensive and well-organized efforts to persuade people to remove trash and standing water and accept the spraying of insecticides. Add government neglect and political infighting to the mix, and the result can be devastating.
Since January, dengue has killed at least 79 people and sickened over 75,000 in the surrounding Rio state, home to 40 percent of all of Brazil's cases of the disease. Another 80 deaths have been reported but are awaiting blood tests, the state health secretariat said Thursday. If confirmed as dengue, Rio's death toll this year would be higher than all of Brazil last year.
Dengue infects millions around the world, mostly in tropical regions where mosquitoes thrive in the heat and abundant water, and epidemiologists say Rio's shantytowns are at the leading edge of a dangerous global trend: while most dengue cases aren't fatal, the percentage of cases involving the more virulent, deadly form of the disease is growing - particularly among children, according to the Pan American Health Organization.
Nearly half of this year's dengue fatalities in Rio have been children under age 14, an especially disturbing statistic due the unexpectedly high mortality rate and because public officials failed to take measures beforehand to prevent it, said Jarbas Barbosa da Silva, the organization's area manager for health surveillance and disease management.
"They can't just fight the disease in the streets of Copacabana and Leblon," said 48-year-old Gloria Mendonca, referring to two fashionable beach neighborhoods. "They have to come to the poor communities. They have to see the children dying."
Mendonca and her 5-year-old son, who live in the Salgueiro Hill shantytown, are still recovering from the disease, which causes high fever, severe headaches and flu-like symptoms, nausea, rashes and joint pains for more than a week.%emph_on(type:italic;%) %emph_off(%)
A neighbor's son died only days after contracting the more virulent, hemorrhagic dengue that causes internal and external bleeding.
"Imagine the pain of a mother raising a child and losing it to tiny mosquito," said Mendonca, who took pains to eliminate puddles of standing water at home - but still came up short.
There is no vaccine for dengue, which is also known as "bonebreak fever" and is spread only by mosquito bites. Treatment includes pain relievers, rest and fluids.%emph_on(type:italic;%) %emph_off(%)In Rio, the army is feeding patients intravenous saline solution to avoid severe dehydration.
The more mosquitoes go unchecked, the deadlier the disease becomes. Mosquitoes carry four different strains of dengue, and there is good evidence that people who survive one or two infections will more likely contract the more deadly form if infected with another strain, according the U.S. Centers for Disease Control and Prevention.
Mendonca's one-room shack abuts thick rain forest where puddles are all but impossible to root out. Just up the hill, hundreds of black larvae of the Aedes aegypti mosquito seethe inside an abandoned cistern. Residents in these shantytowns behind Rio's famous Christ the Redeemer statue also store drinking water in piles of capless plastic soda bottles.
"It's a perfect breeding ground for mosquitoes. They like clean water and don't need very much of it to breed," said Josh Ruxin, founder of the Neglected Tropical Disease Control Project.
The job of helping 5,000 Salgueiro Hill families eradicate mosquitoes falls to two environmental agents employed by the mayor's office who haven't been paid since January. They also have to keep the hovels from expanding into the adjacent Tijuca National Forest, limit the local rat population and keep tabs on free-roaming pigs.
"The pump breaks for 10 days, two weeks at a time," said Denise Silva da Sousa, 32. "People have to go down and carry the water up the hill on their heads. If they find a larvae in the water, they're not going to throw the water out."
The agents try to persuade residents not to let garbage pile up, but that's difficult in slums lacking trash bins, Sousa says.
Jorge Darze, president of the Rio de Janeiro doctors' union, has accused the government of criminal negligence. While the virus infected 900,782 people across the Americas last year, killing 317, more than half of the cases were in Brazil.
"The threat of an epidemic was already apparent since last year and the city did nothing. And neither the state or federal government pressured them to do anything," Darze said. "The mayor can't run for re-election, so he left it all to luck and the Lord."
Political rivalries prompted the mayor to turn down a federal offer of 3,200 health agents, alleges Sandro Cezar, president of the Rio de Janeiro state health workers' union.
"That's a lie," responded Rio de Janeiro Mayor Cesar Maia in an e-mail to The Associated Press, blaming political agitators "who don't want to work" for spreading false accusations.
Federal officials declined to comment, but in March, Health Minister Jose Gomes Temporao noted that while dengue cases were down 40 percent across Brazil, the number of cases in Rio had exploded.
The military finally set up field hospitals, pleaded for pediatricians to help treat the victims and deployed 500 soldiers this week to help spray insecticide.
"I don't have the slightest doubt that we could have a new epidemic," State Health Secretary Sergio Cortes said. "We will have to change a lot of things and mobilize society."