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    Cuba reports remarkable success in containing Zika virus
    By Michael Weissenstein?|?AP September 2 at 12:25 AM

    HAVANA — Six months after President Raul Castro declared war on the Zika
    virus in Cuba, a militarized nationwide campaign of intensive mosquito
    spraying, monitoring and quarantine appears to be working.

    Cuba is among the few countries in the Western Hemisphere that have so
    far prevented significant spread of the disease blamed for birth defects
    in thousands of children. Only three people have caught Zika in Cuba.
    Thirty have been diagnosed with cases of the virus they got outside the
    island, according to Cuban officials.

    Many are now watching to see whether Cuba is able to maintain control
    of Zika or will drop its guard and see widening infection like so many
    of its neighbors. The battle against Zika is testing what Cuba calls a
    signal accomplishment of its single-party socialist revolution — a free
    health-care system that assigns a family doctor to every neighborhood,
    with a focus on preventive care and maternal and pediatric health. That
    system has come under strain in recent years as thousands of specialists
    emigrate to the U.S., Europe and South America for higher pay and the
    allied government of Venezuela reduces the flow of subsidized oil that
    has been keeping Cuba solvent.

    U.S. government scientists fly to Havana in November for a two-day
    meeting on animal-borne viruses such as Zika, the first conference of
    its kind since the re-establishment of diplomatic relations a year ago.
    American researchers say they are eager to learn more and help
    incorporate Cuba into U.S.-backed international health programs after a
    half-century without significant professional interaction.

    “Probably in the last decade we’ve had two people that have gone down
    there for anything,” said F. Gray Handley, associate director for
    international research affairs at the U.S. National Institute of Allergy
    and Infectious Diseases. “It has been pretty much of a black box.”

    So far, there have been about 40 cases of Zika caused by mosquito bites
    in Florida. Health officials don’t expect widespread outbreaks in the
    mainland U.S. but there are thousands of cases in Puerto Rico and
    countries such as Brazil and Venezuela are struggling with large-scale
    infection.

    International medical experts familiar with Cuba say other countries can
    learn from Cuba’s intense focus on preventing disease, which led the
    government to decimate the mosquito population by spraying virtually
    every neighborhood in Cuba this spring.

    “Cuba’s response has been strong and effective,” said Dr. Cristian
    Morales, the World Health Organization’s representative in Cuba. “It has
    to do with the capacity to organize the population. Applying it to other
    countries, other contexts, would be extremely difficult.”

    Other elements of Cuba’s success so far against Zika may simply not
    apply to other nations because they are inextricably tied to a form of
    government unique in the Western hemisphere.

    Most aspects of life in Cuba are controlled by a single-party state that
    rigorously monitors citizens’ activities. From neighborhood doctors to
    reporters to block watch captains, most people in Cuba work for a
    massive government apparatus whose components all ultimately answer to a
    single unelected leader, Raul Castro, who heads the military, the state
    and the Communist Party.

    In February, as Zika spread through South America, Castro announced that
    he would be deploying the army to spray homes and workplaces because of
    the failings of civilian government fumigators, whom Cubans frequently
    brushed off to avoid the smelly, noisy filling of their homes with
    insecticidal fog.

    “Our people will be able to demonstrate their ability to organize to
    maintain the levels of health achieved by the revolution and avoid our
    families suffering,” he wrote. “As never before in similar efforts, we
    must be ever-more disciplined and demanding.”

    In the following weeks, Cubans cities, towns and villages filled with
    olive-clad soldiers moving door-to-door with handheld foggers, and using
    sprayer trucks to blanket entire streets with clouds of insecticide.

    Cuba’s approach compares favorably to the effort in Florida, where
    officials are spraying areas where Zika cases have already started
    cropping up, said Carlos Espinal, director of the Global Health
    Consortium at Florida International University in Miami.

    “They started very early in advance of the Zika virus,” he said. “Once
    you start going behind the cases then it’s complicated, you’re just
    detecting once the transmission is already in place.”

    The Cuban state has officials from immigration agents to neighborhood
    doctors watching for Zika, especially in the thousands of doctors,
    nurses and support staff who work overseas in programs that earn the
    Cuban government billions of dollars a year in badly needed hard currency.

    “The neighborhood family doctor is told, ‘In your community there are 10
    people who’ve gone to Jamaica. Two are doctors, three are nurses and the
    other six or five are business people, tourists, whatever.’ And he has
    to keep an eye on them, go to their homes, call them,” said Professor
    Jorge Perez, director of the Pedro Kouri Tropical Medicine Institute in
    Havana.

    Perez said 1,700 people with fever or other symptoms had been
    quarantined for 24-48 hours while being tested for Zika. All pregnant
    women are tested for Zika in their first trimester, he said. Every
    worker sent overseas on a government “mission” is quarantined and tested
    before returning to the island.

    “We’re surrounded by Zika, everywhere,” he said. “We’ve learned that
    it’s better to prevent than to treat.”

    The Cuban government holds regular video conferences among top health
    officials, military officers, Communist Party officials and sanitation
    and water experts in the capital and in Cuba’s 14 provinces. Even
    elementary- and middle-school students had been drawn into the campaign,
    with teams of children as young as 10 sent door-to-door to check for
    standing water where mosquitoes breed and distribute information about
    Zika. Those who defy orders to eliminate standing water or trash or
    allow inspections or fumigation are fined.

    “In our neighborhood people watch out for surges of mosquitoes, keep
    things clean and work with the neighborhood to raise their awareness,”
    said Gerardo Olvera, 51, a self-employed vendor of phone cards in
    Havana. “Meanwhile the authorities are visiting, fumigating. It’s all
    designed to get everyone involved.”
    _____

    Michael Weissenstein on Twitter: twitter.com/mweissenstein

    Source: Cuba reports remarkable success in containing Zika virus – The
    Washington Post –
    www.washingtonpost.com/world/the_americas/cuba-reports-remarkable-success-in-containing-zika-virus/2016/09/02/72d8a308-70c4-11e6-993f-73c693a89820_story.html

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