Puerto Rico goes back to basics in war against Zika mosquitoes

SAN JUAN: The United States faces its first real challenge with the Zika virus on the island territory of Puerto Rico, a part of the nation that is perhaps least prepared to cope with what is expected to be its worst outbreak. Zika is spreading rapidly in Puerto Rico and is expected to peak in late summer and early fall. By year’s end, public health officials estimate, hundreds of thousands of people will have been infected.
It is the only part of the country that is experiencing a major local outbreak, but the virus is expected to reach southern US states within weeks with warmer temperatures and rising mosquito populations.
Health officials from across the United States are gathering today at the headquarters of the Centers for Disease Control and Prevention in Atlanta to outline a national strategy for combating Zika. In a measure of the concern surrounding the outbreak in Puerto Rico, CDC director Tom Frieden toured the island, meeting with top health officials and local experts last month to assess the situation first-hand.
Puerto Rico is beset with problems already hampering the response: abundant mosquitoes, high levels of insecticide resistance and economic woes that have left vector control in shambles.
“We don’t have good surveillance” here, Frieden said in an interview at the Puerto Rican health department in San Juan during his tour. “We don’t have good control measures.”
First detected in Brazil last year, the Zika outbreak is spreading through the Americas. The World Health Organization declared a global health emergency last month because of growing evidence that Zika can cause microcephaly, a rare birth defect defined by an unusually small head. In adults, the virus has been linked to the typically rare autoimmune disorder, Guillain-Barre syndrome.
Fighting Zika in Puerto Rico is complicated by the toll of a decade-long recession. Nearly half of its 3.5 million residents live in poverty, and mosquitoes are an accepted nuisance. Puerto Rico has seen repeated outbreaks of dengue and more recently, chikungunya. Both viruses are carried by Aedes aegypti, the same species of mosquito that carries Zika.