EXETER, United Kingdom — Peru has been under an epidemiological emergency over the past few months due to a historical surge in recorded dengue cases. Dengue is a viral disease, transmitted mainly by Aedes aegypti, a mosquito species that carries the dengue virus. An infected individual will experience symptoms such as fever, headache, pain behind the eyes and muscle and joint pain, the Centers for Disease Control and Prevention says. The Borgen Project spoke with Dr. Ivonne Ascencio, National Health Specialist at Save the Children for more insight into Peru’s dengue emergency. Moreover, Dr. Alberto Mendoza, director of Socios en Salud’s Medical Center Oscar Romero also sheds light on the situation.
Peru’s Situation in Numbers
Peru’s Ministry of Health recorded 130,826 dengue infections during the 22nd week of 2023. These numbers surpass those recorded in 2022, which peaked at 63,168 and are almost double the number of cases documented in 2020 and 2021. In the 22nd week of 2023, the ministry recorded 201 dengue-related deaths. Dr. Ascencio expresses her concern about children contributing to a concerning portion of the deaths. For instance, during a particular period, out of 60 dengue-related deaths recorded, children accounted for 24 deaths.
Moreover, Dr. Ascencio states that dengue in Peru is currently most dangerous in Piura and Lambayeque. Yet, other regions such as Tumbes, Trujillo, Loreto, Ucayali, La Libertad, Lima and others are no strangers to the disease. In fact, on May 13, 2023, the Health Ministry extended its public health emergency declaration to cover 20 regions out of 26.
Dengue: What to Know
The Aedes aegypti mosquitoes are dengue carriers but are unaffected by it. The Aedes aegypti catch the disease after biting an already infected person and infect other humans through biting. Mosquitoes thrive in humid, tropical weather, ideal for their reproduction and the spread of diseases. Ideal reproduction conditions lead to more mosquitos hatching and infecting people with dengue. Moreover, female Aedes aegypti lay their eggs in stagnant bodies of water, such as buckets filled with water, pots, vases and animal bowls.
Explaining the Surge in Dengue Cases in Peru
According to TDR, “Vector-borne diseases (VBDs) such as malaria and dengue are major contributors to the global disease burden. Populations of low-income countries are the most affected, notably in sub-Saharan Africa, South Asia and South America, where the favorable environmental conditions for vectors of diseases meet unfavorable socioeconomic and health system challenges.”
Peru is no stranger to dengue as the country records outbreaks yearly. The virus spreads mainly during the Amazon’s rain period and during the summer in coastal regions (December to March). In addition, research shows that the climate phenomenon El Niño and La Niña may have a magnifying influence on the spread of dengue infections.
However, the current sudden rise in infections is due to Cyclone Yaku. Cyclone Yaku began in March 2023 and brought with it high temperatures, heavy rains and flooding through overflowing rivers. The government of Peru declared 400 districts to be in a state of emergency and more than 85,000 houses have been affected. Moreover, 118 health centers suffered damage, hindering health service efficiency during the rise of dengue cases.
Access to clean water or a working drainage system is limited in the aftermath of the rains and floods, Dr. Ascencio explains. This inconvenience forces the affected populations to store water in containers and increases the risk of the Aedes aegypti occupying the stagnant water. In addition, most health centers’ infrastructure is also unfit for rainy weather, leading to the deterioration of facilities’ infrastructure and creating a risk of impending collapse in times of crisis.
Dengue’s Impact on Mental Health
The concurrent impacts of the dengue outbreak and Cyclone Yaku have resulted in dengue-infected individuals showcasing symptoms of anxiety, feelings of fear and longing for normalcy, Dr. Ascencio explains. She notes that these mental challenges develop because people experiencing the impacts of both Cyclone Yaku and dengue have suffered material losses and are now facing an uncertain future. Besides, these negative changes in mental health can often lead to an increase in acts of violence as a stress outlet, she adds. Within the family unit, both children and caretakers are prone to suffering from mental health issues.
There are simple ways to prevent dengue infections. Because the mosquito bite is the primary concern, it is critical for individuals to use insect repellent along with long sleeves and body-covering clothes. The CDC also recommends sealing stagnant bodies of water inside and near homes so that female mosquitoes will not infiltrate the water and lay their eggs. Installing mosquito traps also helps.
Save the Children advocates for these measures and insists on proper prevention campaigns in diverse formats that reach everyone, adults and children. Through these campaigns, Save the Children staff explain to people how prevention measures work and the importance of such measures.
Government Strategies and Shortcomings
The citizens of Peru are criticizing the government’s approach to this public health emergency for falling short, especially in terms of protecting those residing in high-risk regions. For instance, on June 4, 2023, the Ministry of Health started a fumigation campaign based in Piura, aiming to fumigate more than 150,000 households.
Dr. Ascencio expressed doubt about the campaign’s effectiveness because fumigation practices only target grown mosquitoes, not their eggs. Mosquito eggs can live for up to a year in favorable conditions. Besides, Dr. Mendoza highlights the unsustainability of this measure, given insecticides’ negative environmental impact and global warming’s link with climate phenomena such as El Niño.
On a wider scale, however, Peru’s health system is still unfit to handle a dengue outbreak. For instance, Piura does not have a pediatric intensive care unit, Dr. Mendoza states, despite having a population of more than 1.8 million people and standing as one of the hardest-hit regions in terms of the dengue outbreak. This puts dengue-infected children at risk and requires children in need of pediatric treatment to travel out of the region to access health care.
Both Dr. Ascencio and Dr. Mendoza note a lack of leadership over these past few months and a perceived overall lack of government interest to work on a long-term prevention strategy in collaboration with health organizations to minimize the damages of the annual dengue outbreaks.
Save the Children’s Efforts
Save the Children is an international organization with 40 years of experience working to defend and promote children’s rights in Peru. In the face of the dengue crisis in Peru, the organization has initiated a humanitarian response to help people affected by the floods and the risk of dengue in Tumbes, Piura, Lambayeque, La Libertad and Lima.
Save the Children has provided 16,530 people with clean water kits, food, dengue prevention tools and socioemotional support. Moreover, 14,784 minors have received the organization’s services. One of the organization’s aims, Dr. Ascencio says, is to help 30,000 families by June 2023. Save the Children accepts donations to keep financing its humanitarian response to help those affected by the rains and floods in Peru’s northern coast, including Piura and Lambayeque.
In conclusion, dengue in Peru has surpassed its previous reach, placing the country in a critical public health emergency affecting mainly the northern coastal regions. United efforts are underway to reduce the infections but an effective response on the part of the government is also essential. Health care professionals and organizations like Save the Children are working to support the affected individuals, raise awareness and implement preventive measures.
– Luciana Mena
Photo: Courtesy of Save the Children Peru