By Dr. Medardo Avila Vazquez
1-The Dengue epidemic in Brazil is endemically (permanently) sustained in the marginality and misery of millions of people, especially in the Brazilian Northeast. Now the circulation of the Zika virus is added, a similar disease, although more benign.
2. An increase in congenital malformations is detected in a very striking way, especially microcephaly in newborns. The Brazilian Ministry of Health quickly links him to the Zika virus. Although it is unaware that in the area where the patients have been living for 18 months they have applied a chemical larvicide that produces malformations in mosquitoes, and that this poison (pyriproxyphene) is applied by the state in the drinking water of the affected population.
3. The previous epidemics of Zika did not generate malformations in newborns, despite infecting 75% of the population of the countries, neither countries such as Colombia register cases of microcephaly and if a lot of Zika.
4. The pyriproxyfen used (as recommended by WHO) is produced by Sumimoto Chemical, a Japanese subsidiary of Monsanto.
5. Brazilian doctors (Abrasco) denounce that the chemical control strategy contaminates the environment and people and fails to reduce the number of mosquitoes, and that this strategy involves a commercial maneuver by the chemical poisons industry with deep involvement in the ministries Latin American health and in WHO and PAHO.
6. Mass spraying with airplanes as it is being evaluated by the Mercosur governments is criminal, useless and a political maneuver so that measures are taken. The basis of the disease's progression is found in inequity and poverty, and the best defense is through community-based actions.
7. The last strategy deployed in Brazil and that intends to be replicated in all our countries is the use of transgenic mosquitoes; a total failure, except for the company that supplies the mosquitoes.
The chronic epidemic of Dengue in Brazil (practically endemic in the Brazilian Northeast along with the poverty and marginalization of millions of people) has been joined by an outbreak of Zika for 9 months, a virus also transmitted by the Aedes mosquito.
In Pernambuco about 4,000 newborn children in 2015 presented congenital malformations, mainly MICROCEPHALIA (head smaller than normal). The Brazilian Ministry of Health quickly stated that it was a consequence of the Zika virus infection (1)
Discovered in 1947 in the Zika forest in Uganda, the ZIKA virus is an arbovirus of the genus Flavivirus, similar to dengue virus, yellow fever, Japanese encephalitis, West Nile fever, and San encephalitis viruses. Luis. The first human cases of Zika infection were described in the 1960s in Africa, then outbreaks appeared in Southeast Asia and Oceania (2).
Until 2007 when a major epidemic broke out on Yap, an island in the Pacific Ocean (Micronesia), Zika infections had remained limited to sporadic cases or small-scale epidemics. During the epidemic in Yap, it was estimated that three-quarters of the local population had been infected. (2)
The expanding area of distribution of ZIKA made Zika fever an emerging disease, confirmed by the current epidemic affecting French Polynesia since October 2013 and New Caledonia with reported cases since late 2013. These Pacific islands are characterized by the large number of mosquitoes that proliferate, especially in villages with native populations. (2)
In May 2015, the World Health Organization reported autochthonous cases identified in Brazil. In December, the Ministry of Health of that country estimated that 440,000 to 1,300,000 suspected cases of the Zika virus disease had occurred in Brazil in 2015. (2)
The true incidence of Zika fever is unknown, due to the clinical manifestations that mimic dengue virus infection, and the lack of simple reliable laboratory diagnostic tests. In endemic areas, epidemiological studies showed a high prevalence of antibodies against ZIKA. For example, the Yap epidemic in 2007 resulted in an attack rate of 14.6 per 1,000 inhabitants and a seroprevalence of 750 per 1,000 inhabitants after the epidemic (ie 750/1000 had the infection without developing disease). The infection appears to be symptomatic in only 18% of cases. (2-3)
It usually presents as a flu-like syndrome, often confused with other arbovirus infections such as Dengue or Chikungunya viruses. The typical form of the disease is associated with a low-grade fever (between 37.8 ° C and 38.5 ° C), arthralgia, particularly of the small joints of the hands and feet, myalgia, headache, retroocular pain, conjunctivitis and maculopapular skin rash. Digestive problems (abdominal pain, diarrhea, constipation), ulcerations of the mucous membranes (canker sores) and itching may be more rarely observed. Asthenia after infection appears to be common. (2)
In December 2013, during the Zika epidemic in French Polynesia, an increase in cases of Guillain Barré Syndrome was reported, a neurological paralysis that is linked to immunological disruption generated by viruses, vaccines or / and environmental toxins. (4)
Zika in Brazil
In January 2016, the Brazilian Association of Collective Health (ABRASCO) published a Technical Note and Open Letter to the Brazilian People (1) questioning the linear analysis of the Brazilian Ministry of Health that links emerging congenital malformations to Zika, neglects other factors that They may be influencing the problem and minimizes that the extensive epidemics in the Pacific and the current one in Colombia do not refer cases of malformations and even less microcephaly. It mainly ignores the role of the chemical model for vector control. This model involves the massive use of chemical poisons to try to reduce or eradicate the presence of the mosquito and has been carried out for 40 years in the most vulnerable areas of the Brazilian Northeast while epidemics, poverty, social marginalization, land clearing multiply and climate change.
Since the second semester of 2014, the Brazilian Ministry of Health (5) stops using temephos (organophosphate agro-toxic to which Aedes larvae became resistant) as a larvicide and massively incorporates the poison Pyriproxyphene whose trade name is Sumilarv manufactured by Sumimoto Chemical , Japanese company associated or subsidiary of Monsanto in Latin America (1.5).
The spatial distribution by place of residence of the mothers of newborns with microcephaly shows a higher concentration in the poorest areas, with precarious urbanization and inadequate environmental sanitation, in the Brazilian Northeast. Extensive areas of Recife and other cities in the Northeast with intermittent supply of drinking water led these populations to store water in their homes in an insecure manner, very favorable conditions for the reproduction of the Aedes aegypti mosquito by establishing "breeding grounds" that should not exist and are subject to mechanical disposal, due to insufficient protection of the deposits intended for human consumption. (1)
Pyriproxyfen is applied by the Brazilian Ministry of Health directly in the drinking water reservoirs used by the Pernambuco population; here the proliferation of Aedes mosquitoes is very high (similar to the situation in the Pacific islands). (6) This poison, recommended by the WHO, is an inhibitor of the growth of mosquito larvae, altering their larval-pupal development processes. - adult, thus generating malformations in developing mosquitoes that cause their death or disability. It is an analog of the juvenile or juvenoid hormone of the insect, with the effect of inhibiting the development of characteristics of adult insects (for example, the wings, the maturation of the external genital organs) and reproductive, keeping it with an "immature" aspect (nymph or larva), it means that it acts by endocrine disruption and is teratogenic.
The malformations detected in thousands of children of pregnant women who live in areas where the Brazilian state placed pyriproxyphene in drinking water does not seem like a coincidence, even though the Ministry of Health blames the Zika virus directly for this damage , try to ignore your responsibility and discard the hypothesis of direct and accumulated chemical damage by years of endocrine and immune disruption in the affected population. Doctors from the Brazilian Association of Collective Health (ABRASCO) demand urgent epidemiological studies that consider this causal option, especially when among the 3,893 cases of confirmed malformations as of January 20, 2016, 49 of these children had died and in only five, Zika infection had been confirmed. (1)
Easily many managers of public policies, including PAHO and WHO, medical epidemiologists, sanitarians, chemists and politicians in general forget that humans, each of us, have deployed embryonic development processes where we go through very different stages. The evolution from egg or zygote to embryo, from embryo to fetus and from fetus to newborn, is not very far from the development process of the mosquito affected by pyriproxyphene. They also very easily try to ignore that in the human species 60% of our active genes are identical to those of insects such as the Aedes mosquito itself. And everything is much more confusing when they are “advised” by experts from Foundations and chemical insecticide companies (for example: Fundación Mundo Sano y Chemotecnica) or the decision-makers of the health ministries are former employees of the world poison companies “to sanitary use ”.
Brazil fumigates against adult Aedes using malathion, a WHO carcinogenic organophosphate compound. Paraguay acquired thousands of tons of chlorpyrifos to "kill" mosquitoes, although we do know that chlorpyrifos affects the developing brain of fetuses and newborns. In Argentina, the "control" of vectors is done with pyrethroids, a little less toxic but prohibited in Europe due to their effects on people.
For ABRASCO doctors, the problem is that behind these decisions is the World Health Organization and the Pan American Health Organization with their "Pesticides" committees that do not dialogue with the environmental, sanitation and health promotion committees. In these bodies, the committees that prescribe the use and regulate the purchase of vector control inputs for the world are imperial. These are the organizations that convince and endorse the bidding processes of national governments. (1)
How to deal with these diseases
The hegemonic strategies to confront these diseases transmitted by mosquitoes and multiplied by poverty, the lack of environmental sanitation, excreta, and safe water are vertical intervention programs, with chemical poisons (larvicides and adulticides) that demobilize the population by depending on all the success of the properties of the poison, which in turn makes them sick, kills the natural predators of mosquitoes and generates the need to repeat the applications for the benefit of chemical poison companies.
Numerous independent scientific information demonstrates how this strategy is flawed and only useful for photos of the current rulers. Community-based strategies, with participation and social mobilization, give better results in the face of the imminence of epidemics. (7,8,9) The measures that make it possible to defeat the disease are linked to social justice and equity. Clearly, the social sectors affected by dengue and Zika are the poorest and most deprived of services and rights.
At some very specific moments, massive spraying of inhabited areas may be recommended, but its effects are limited to reducing the number of adult mosquitoes for 2 or 3 days, which can be useful when the coldest days arrive, remember that with less than 23 ° C Aedes is immobilized and does not reproduce or feed.
Controlled applications around the residence of the first cases (focus control) are useful in reducing the advance of the epidemic, but mass spraying of entire cities requires a health cost analysis (damage to human health and the ecosystem) vs health benefit ( control and mitigation of the epidemic) that is not justified in any “sanitary” way, although it is used by governments and the hegemonic press to simulate that they take measures to defend people's health.
Our experience of the Dengue epidemic in Córdoba in 2009, where we participated directly, showed that the distribution of cases corresponded to the same distribution of infant mortality in 2007 and to the distribution of the population with greater unsatisfied basic needs, that is: lack of housing, work, education and health, which can be seen in the attached maps.
Mass spraying does not solve the problem, it is just generating a business within the problem.
New strategy: transgenic mosquitoes (new business)
Within this framework, a new health intervention strategy is inscribed in Brazil, which they will try to expand to the entire region: transgenic mosquitoes.
The Oxitec company of England sells male transgenic mosquitoes supposedly to reduce the Aedes population. These mosquitoes undergo the insertion of a lethal gene that is transmitted to the offspring causing the death of the larvae if it is not blocked by an antibiotic (tetracycline).
The goal is to release millions of male mosquitoes that mate with wild females and that the eggs of these females generate larvae that will die spontaneously. (10,11)
The business is to sell these laboratory mosquitoes to governments, then the populations have to "protect" the mosquitoes because supposedly it is not necessary or advisable to eliminate the pots with hatcheries.
In Brazil at the moment almost 15 million transgenic mosquitoes were released and the failure is total, where field trials were carried out, less than 15% of the larvae were transgenic, that is to say ... the wild females did not accept the English mosquito from Oxitec. The answer: increase releases in slums. (10)
Furthermore, it must be taken into account that the biology of the disease shows that the female "bites" only when she is pregnant, when she is generating eggs after having been fertilized by a male; in this state and only in it, because it needs blood components to develop its eggs. Then millions of male mosquitoes are released there would be many more fertilized females looking for mammalian blood to suck and thus the transmission of the disease from infected people to healthy people will increase !!!
Faced with the threat of Zika, massive spraying in Mercosur
Mercosur governments are alarming with the threat of Zika and its microcephaly and proposing more of the same. Agribusiness offers the services of the Soybean Air Force to spray cities and towns. (12) Monoculture, massive use of pesticides, land clearing, destruction of flora and fauna, ecological imbalance, climate change, inequality, they are not considered as the cause of the problem.
These epidemics add to social inequality health inequality, governments with chemical aggression generate environmental inequality.-
1- TECHNICAL NOTE AND OPEN LETTER À POPULAÇÃO Microcephaly and vetoriais doenças related to Aedes aegypti: the perigos of approaches with larvicides and chemical nebulization - fumacê. Janeiro 2016. GT Health and Environment. Brazilian Association of Collective Health. ABRASCO. https://www.abrasco.org.br/site/2016/02/nota-tecnica-sobre-microcefalia-e-doencas-vetoriais-relacionadas-ao-aedes-aegypti-os-perigos-das-abordagens-com- larvicides-and-chemical-mist-smoke /
2. Hennessey M, Fischer M, Staples JE. Zika Virus Spreads to New Areas - Region of the Americas, May 2015 – January 2016. MMWR Morb Mortal Wkly Rep 2016; 65 (Early Release): 1–4. DOI: http://dx.doi.org/10.15585/mmwr.mm6503e1er
3. Duffy MR1, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, Pretrick M, Marfel M, Holzbauer S, Dubray C, Guillaumot L, Griggs A, Bel M, Lambert AJ, Laven J, Kosoy O, Panella A, Biggerstaff BJ, Fischer M, Hayes EB Zika virus outbreak on Yap Island, Federated States of Micronesia N Engl J Med. 2009 Jun 11; 360 (24): 2536-43. doi: 10.1056 / NEJMoa0805715.
4. Oehler E, Watrin L, Larre P, Leparc-Goffart I, Lastère S, Valour F, Baudouin L, Mallet HP, Musso D, Ghawche F. Zika virus infection complicated by Guillain-Barré syndrome - case report, French Polynesia, December 2013. Euro Surveill. 2014; 19 (9): pii = 20720. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId= 07202.
5. Sumitomo Chemical and Monsanto Expand Weed Control Collaboration to
Latin America. Sumimoto Chemical News Release December 09, 2014. http://www.sumitomo-chem.co.jp/english/newsreleases/docs/20141209e.pdf
6. Technical guidelines for the use of pyriproxyfen larvicide (0.5 G) do not control Aedes aegypti. Ministry of Health. http://u.saude.gov.br/images/pdf/2014/maio/30/Instrucoes-para-uso-de-pyriproxifen-maio-2014.pdf
7. Caprara, Andrea et al. "Entomological Impact and Social Participation in Dengue Control: A Cluster Randomized Trial in Fortaleza, Brazil." Transactions of the Royal Society of Tropical Medicine and Hygiene 109.2 (2015): 99–105. PMC. Web. 3 Feb. 2016.
8. Espinoza-Gomez, F, H Moises, and R Coll-Cardenas. "Educational Campaign versus Malathion Spraying for the Control of Aedes Aegypti in Colima, Mexico." Journal of Epidemiology and Community Health 56.2 (2002):
9. Andersson, Neil et al. "Evidence Based Community Mobilization for Dengue Prevention in Nicaragua and Mexico (Camino Verde, the Green Way): Cluster Randomized Controlled Trial." BMJ: British Medical Journal 351 (2015): h3267. 2016.
10. Helen Wallace. Genetically Modified Mosquitoes: Current Concerns. TWN Biotechnology & Biosafety Series No. 15. Rapal Uruguay. 3 Feb 2016. http://www.rapaluruguay.org/transgenicos/Mosquitos%20Gen%E9ticamente%20Modificados%20%20parte%20I%20y%20II.pdf
11. Genewatch UK. March 2015. Oxitec Genetically Modified Mosquitoes: A Credible Approach to Addressing the Dengue Problem ?. Web 03 Feb 2016. http://www.genewatch.org/uploads/f03c6d66a9b354535738483c1c3d49e4/Mosquitos_Gen_ticamente_Modificados_de_Oxitec.pdf
12. The Nation. Some 135 planes are ready to spray Mercosur. Web 3 Feb 2016. http://www.lanacion.com.py/2016/02/02/alistan-unos-135-aviones-para-fumigar-mercosur/
February 03, 2016, REDUAS production team, Coordinator Dr. Medardo Avila Vazquez.
Pediatrician and Neonatologist
Coordinator of the University Network of Environment and Health
Doctors of Fumigated Towns
+54 9 351 5915933