Paraguay's Ministry of Health head nurse died last Friday of hemorrhagic dengue an epidemics caused by a mosquito which is rapidly extending in the landlocked South American country and has 15.000 cases officially confirmed.
Maria Catalina Roa became the tenth victim of hemorrhagic dengue or related diseases. She had been involved in fighting the disease since the first cases were reported in Paraguay and for the last two weeks had been in Paraguay's School of Medicine hospital as a patient. The dengue epidemic in its two basic forms, the classical which is not fatal and hemorrhagic which is lethal has rapidly extended to the whole country and although official reports mention 15.376 cases, doctors and nurses in the field believe the number is closer to 150.000, which the government considers "exaggerated". Paraguayan president Nicanor Duarte declared a 60 days state of "national emergency" and has destined five million US dollars contingency funds to fight the epidemic. However doctors and nurse last week marched in the capital Asunción demanding the resignation of the Minister of Public Health because of his "negligent" handling of the sanitary crisis. Paraguay has requested aid from United States and Argentine and this weekend the French government sent a humanitarian and scientific cooperation mission which includes experts from the Pasteur Institute branch in Cayenne (French Guyana) which specializes in tropical diseases. Paraguayan authorities want foreign scientific aid to help determine the different strains of the epidemics to ensure an appropriate treatment. Public health authorities revealed that this is the first time death cases because of dengue have been registered in the country and "with the help of epidemiologists and entomologists we expect to find the appropriate treatment for the virulent disease". Dengue (DF) and dengue hemorrhagic fever (DHF) are caused by one of four closely related, but antigenically distinct, virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4), of the genus Flavivirus. Infection with one of these serotypes provides immunity to only that serotype for life, so persons living in a dengue-endemic area can have more than one dengue infection during their lifetime. DF and DHF are primarily diseases of tropical and sub tropical areas, and the four different dengue serotypes are maintained in a cycle that involves humans and the Aedes mosquito. However, Aedes aegypti, a domestic, day-biting mosquito that prefers to feed on humans, is the most common Aedes species. Infections produce a spectrum of clinical illness ranging from a nonspecific viral syndrome to severe and fatal hemorrhagic disease. Important risk factors for DHF include the strain of the infecting virus, as well as the age, and especially the prior dengue infection history of the patient. Paraguay with a population of approximately 6.5 million and a tropical climate has launched a massive national campaign to eliminate stagnant water and deposits of untreated organic matter. Meantime in the northern provinces of Argentina thousands of people had to be evacuated because of intense rains and flooding and local authorities fear the dengue epidemic in Paraguay could make its appearance. Authorities are particularly concerned with stagnant waters where the mosquito larvae prosper and could easily begin spreading the disease. In the northern provinces of Argentine so far 30 cases of mild dengue have been reported.