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Dengue Prevention Needs Some Attention

Dengue preventionHaving heard of the dengue infestations and deaths in other Caribbean countries, the authorities in Antigua & Barbuda have started to bring dengue awareness to the fore.

But while I commend the efforts of those involved in the campaign, I have no doubt that our approach to this, and many other public health issues, is seriously flawed.

There has to be a more co-ordinated effort to tackle this problem and prevent  potential dengue outbreaks. In the first place, public health care has to be recognised as an integral process that is intimately dependent on how every other social and national service is delivered.

As a result, it is impossible to tackle any health care issue without addressing matters such as electricity and water delivery, education, transport, mass communication systems, and the state of public infrastructure, including roads.

What does all this  have to do with dengue fever? The Aedes aegypti mosquito which causes dengue fever is very domesticated. Unlike most other mosquitoes, which can live in forested areas a long way from humans, the Aedes relies on man. She (the female is the one that does the biting) will only bite other animals if there is a total absence of humans. This mosquito is not only tough, but also very intelligent, and knows how to adapt so it is better able to attack us.


Other mosquitoes are noisy, but the Aedes reduces the humming sound she makes with her wings, so she does not awake you from sleeping. She further reduces your lines of defense by attacking you from behind and below, around your feet and ankles from underneath desk and chairs. Unlike other mosquitoes that will fly directly to your face, in your line of sight, Aedes is a stealth killer that attacks usually after dusk and before dawn.

She never lives more than 90 metres from dwellings, guaranteeing her food, and  does well even in chlorinated water. She is smaller that most other mosquitoes, and knows how to hide effectively around the house.

So what do pot holes have to do with dengue fever? The road I live on is a victim of the classic lack of co-ordination between Public Works and APUA; the same problem the minister of Public Works spoke about recently.  As a result, there is a huge hole in the road directly in front of my gate. This hole, that stretches almost the length of the road on one side, is a perfect breeding ground for Aedes.

Although myself  and others try to fill it with rocks and other material, as the rainy season intensifies, our efforts have been in vain. The problem is, even though the families in the community keep their yards clean, and take steps to prevent mosquito breeding within their homes, that breeding ground so close by still exist. As a result, we are left with a constant battle against these angry female mosquitoes seeking blood to mature their eggs.

Even when the hole is dry, the problem is not solved. This is because the dengue virus can be passed from the adult to eggs, and these eggs can survive for more than a year in the dry state. They will then emerge the next rainy season as fully infective adults with the virus intact.

In Antigua & Barbuda we have been lucky over the years, in that we have had relatively few serious dengue cases. And I make no apologies for saying we are lucky, because in reality we do have a serious problem with mosquito infestation. So that tells me we do have a problem in controlling mosquito breeding around our homes.

Therefore, the mistakes we are making might someday turn around to bite us. If we keep paving the way for the Aedes to attack, someday it may do it in full force. Be cognisant of the fact that this mosquito arrived largely in the Caribbean and Latin American on slave trading ships. Hence, if it can survive an Atlantic crossing, it more than likely will survive the favourable conditions that we are providing.

It is not enough to come around with fogging machines and insecticides. Though they have their place, some of these chemicals do as much harm to us as they do to mosquitoes. We have to take a holistic approach to the problem, and at all levels make it difficult for the Aedes to coexist with us.


It starts with education, giving people the knowledge they need to protect themselves, their families and communities. However, the education cannot just be in the form of public service messages on television, radio, news websites and in newspapers. It has to be taken to the level of the community where public health officials have to interact and work directly with people in places such as  their homes, schools, churches and shops.

Once again, I call on the authorities to get the Cuban-trained Antiguan & Barbudan physicians involved in this and other public health campaigns. Many of them participated in the very efficiently organised dengue eradication campaigns in Cuba. Some even got special commendation from Cuban government officials.

At the scientific level, we have several people in this country skilled in natural medicine and biological methods that can be used to help control mosquito proliferation. Do not ignore those persons either. And please, for the people's sake, I am calling on the authorities to fix the pot holes in the roads. Some of them not only damage our cars, but they may breed the dengue carrying-mosquitoes that can kill our children.

Dr Jerry Simon (NSA Medical Surgical Rehab Centre, 462 0631, This email address is being protected from spambots. You need JavaScript enabled to view it. ).

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3 Comments In This Article   

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#3 King roy » 2010-08-16 09:26

It is good to see a young man with some insight. Why is he not an advicer to the Minister of health. By the way, nice pair of shades.
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King roy

Time to get it right

#2 Ras B » 2010-08-15 09:56

It is about time the different ministries and bodies involved co-ordiante their efforts for the public good.
Lots of things in this country get duplicated and are still not done properly. This waste resources and hurts the population. I have read a number of dr. Simon's articles before, and he keeps calling for more co-ordinated effort to the way public health is managed.
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Ras B

Showing keen judgement

#1 andro » 2010-08-14 16:23

Another reason to fix the roads, but good luck getting that done before elections. Hopefully elections will be called early.
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andro

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Dr. Jerry Simon

Dr.Jerry Simon,a general physician, is a graduate of the University of the West Indies and Villa Clara (Cuba) Medical School. He has previously worked in Internal Medicine and Psychiatry. Presently he is Medical Director of the NSA Medical Surgical Rehab Centre and is a certified member of the American Society of Addiction Medicine.

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