Dengue

The Bolivians say "watch out for the
ones with striped legs", or Aedes
(this battle of mine was a lose-lose situation)

In the large room where most of the internal medicine male patients lay, a few nets dangle from the high ceilings (remnants of old European style hospital wards which utilized sunlight and air to treat tuberculosis). That's right, it's dengue season.

Dengue is carried by Aedes aegypti, the primary vector, seen here and recognizable by the stripes on its legs (which are surprisingly apparent while it's flying too). Fun fact, only female mosquitos bite as males don't need as much nutrition for reproduction. As well, Dr. Seuss started his career doing cartoon mosquitoes warning soldiers about malaria.  Back on track...

Anyways the Aedes mosquito often breeds in wet containers, and thus is associated with living in areas of poor trash disposal. It was found in Puerto Rico that broken septic containers can breed immature forms in rates of hundreds per day. The mosquitos live mainly in subtropical areas, and outbreaks have recently been seen in the Florida Keys.

Don't worry, even if I get dengue, I will likely survive. Most people get a mild illness including fever. The biggest risk comes from getting infected with the same serotype (of 4) twice, i.e. something to do with the immune reaction. There is no current vaccine. The risk is hemorraghic dengue, which for pimping you can use the tourniquet test as people can drop their platelets rapidly and fatally. As long as people are in the hospital monitored, they do fine. The main risk is letting people who live in the countryside go, as they may not have access to quick healthcare if their blood counts unexpectedly drop.

When an intern (our friend actually) fell sick with a fever (UTI), the head of medicine became concerned about dengue and the vector control in the hospital. So the next day, they announced the exterminators were coming. In the U.S. this would take about a week of entire staff cooperation, moving patients carefully from one ward to another in a well-orchestrated plan. Here? Just wheel the patients into the fresh air outside the ward, sit the interns next to them, and have everyone wait outside for a few hours enjoying the fresh air. It was quite nice : )