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Diseases in Costa RicaOne of the many struggles that accompany poverty in developing countries is the risk of disease. A greater understanding of the types of threats that face individual countries enables nonprofit and governmental organizations to better cater to their aid towards the needs of a community.

Costa Rica is best known for its beautiful beaches and mountains, which make it a tourist hot spot for much of the year. However, poverty impacts 21.7% of the population and this poverty brings a heightened risk of disease.

As a tropical country, tourists and locals alike are at risk of contracting illnesses related to insect and mosquito bites. Diseases in Costa Rica like dengue fever and chikungunya are especially of note considering their prevalence. Both are transmitted through mosquito bites and have similar symptoms including fever, headaches and joint pain.

Dengue fever, which is now present in 73 of Costa Rica’s 81 cantons, is usually an unpleasant but not fatal illness so long as it does not develop into severe dengue, which has more severe effects. Chikungunya is also typically not fatal, although the symptoms can be debilitating.

The Zika virus has recently been the subject of much study and media attention. Zika is another disease in Costa Rica that threatens the population. Like chikungunya and dengue, it is spread through mosquito bites. A June 15 report confirmed 107 cases of Zika in the country.

Costa Rica’s year is divided into two seasons, the rainy and the dry, and during the rainy season, mosquito populations increase due to the increase in still water. Costa Rica is taking the risk of disease seriously and has begun several important steps in the prevention of these illnesses.

Their efforts include fumigation campaigns across the country as well as attempts to rid communities of objects that collect still water and create additional breeding grounds for disease-carrying mosquitos. Another disease-fighting strategy rests in Spinosad, a product of bacterial fermentation.

This chemical is non-toxic to humans and yet has a deadly effect on insect larvae making it a perfect solution to the problem of mosquito breeding grounds. The Spinosad pills can be used in swimming pools, ponds and fountains.

While mosquitos are a significant cause of diseases in Costa Rica, there are many ways to prevent these types of illness. Costa Rica shows impressive self-sufficiency in their fight to end Zika, dengue and chikungunya.

Jordan Little
Photo: Flickr

global_health
Global health—what does that mean exactly? It isn’t the word “health” that gives us pause. It isn’t the word “global” either. But put the two words together, and people are not sure if it means health in developed countries as well as health in developing countries. Yet we know that “global” means the entire world. Anyway, why does it matter?

Commonly, we tend to think that health issues in developing countries refers to infectious diseases, while health issues in developed countries refers to chronic medical conditions. News of health issues in developing countries focuses on tropical diseases such as Ebola or diseases that have been eradicated in the developed nations such as polio and smallpox. In developed countries, news or feature stories on how to take care of our health focus on diabetes, heart attacks or strokes.

When diseases such as Ebola emerge in a developed country such as the U. S., we are jolted by the knowledge—knowledge we already have—that infectious diseases know no geographic boundaries. Ebola is not the only tropical disease to reach the U. S.

The chikungunya virus has reached a cumulative total of 2,500 cases since 2013 in the U. S. Erik Iverson, President of Business and Operations at the Infectious Disease Research Institute in Seattle, expects a “dramatic and well-reported increase in the number of chikungunya cases suffered in the U.S. over the next couple years—particularly from Florida up through the Eastern Seaboard.”

Chikungunya is a viral disease transmitted from human to human by the bites of infected female mosquitoes. Fever and debilitating joint pain are the outstanding symptoms. It has no cure but is usually not permanent or fatal. It can occasionally cause other health problems, however, such as eye, neurological, heart and gastrointestinal complications. It is a disease associated with Africa, Asia, and the Indian subcontinent. In recent decades it has spread to Europe and the Americas.

Leprosy, another tropical disease, also exists in the U. S. One hundred cases are reported every year, mostly in the south. No one knows exactly where it is coming from. Researchers and health officials have named armadillos as the source in the U. S., but some U. S. victims have had no access to armadillos.

Tuberculosis, is another disease that knows no boundaries as World TB Day reminds us with the past theme “tuberculosis anywhere is tuberculosis everywhere.” London is now considered to be the TB center of Europe, and cities in the U. S.—Los Angeles, Seattle, and Indianapolis—have each had a significant number of cases.

Swine flu and avian flu are not diseases of the past either. The swine flu is still part of the seasonal flu vaccine in the U. S. While avian flu poses a very low threat to infecting humans, it does cause a huge risk to our food supply which in turn creates economic havoc for our farmers. May 2015, saw the worst outbreak of avian flu in our nation.

Iowa, our largest producer of eggs, and Minnesota, our largest producer of turkeys, were hit the hardest. Iowa declared a state of emergency as egg prices as well as fear of buying anything related to poultry rose. Minnesota turkey farmers spent $7 million trying to prevent the spread of the disease. Approximately 41 million chickens and turkeys were destroyed in Iowa and Minnesota combined due to the avian flu. Minnesota has just been cleared by the Minnesota Board of Animal Health to restock their farms.

Recently, I hesitated to buy my favorite eggs due to the exaggerated price. I buy them because they are pasteurized, and I have a fear of salmonella having bought a dozen that was infected not long ago. Luckily, I had hard boiled the one egg I ate from the package before I knew it was recalled. They are usually significantly more expensive than even the eggs that are cage free. But when I saw the price had gone up even more, I wondered about our economy—and with good reason it turns out. But salmonella wasn’t the culprit, avian flu was.

If the avian flu affects our Thanksgiving this year, as a nation, we may take more notice. This may cause more awareness that illnesses anywhere can be illnesses everywhere. But awareness isn’t enough. According to Iverson, we are regrettably not concentrating our time, attention and research on these potential domestic health care problems. “[T]oo often, we assume that diseases like TB, chikungunya or leprosy are ‘global’ dangers, only affecting poor people in developing countries, rather than threats to the U.S.”

Ebola, avian flu and swine flu are profound examples of diseases that all too quickly affect the world. The Global Health Technologies Coalition’s 2015 Policy Report reminds us that if we are not prepared with the essential tools and systems to fight infectious diseases worldwide, they “can have devastating regional and international impact.”

The meaning of global health matters because as the GHTC analysis reiterates, “No matter how geographically distant a threat may seem, a threat to some is a threat to all.”

Janet Quinn

Sources: KARE-TV, SiouxLandMatters.com, World Health Organization 1, World Health Organization 2, Xconomy
Photo: Stroke Smart

mosquito_borne_virus
Chikungunya is not a term commonly recognized by the average American. The mosquito-borne virus was originally found in Tanzania in 1952, though it is suspected to have been circulating in the region for many centuries. Chikungunya is transmitted to humans by mosquitoes, and has been predominately concentrated in countries in Africa, Asia and the Indian subcontinent until quite recently.

Within the past week, the virus has been diagnosed in patients from several states in the U.S., including Indiana, Florida and North Carolina. These cases appeared after a major outbreak in the Caribbean that has affected thousands in the past few months.

While chikungunya is rarely a fatal disease, it can cause intense pain, which sometimes lasts for months. The main symptoms are fever and joint pain, though it can be accompanied by nausea, headache and fatigue as well. The World Health Organization states, “the disease shares some clinical signs with dengue (fever), and can be misdiagnosed in areas where dengue is common.”

The mosquito-borne virus is most common in areas close to mosquito breeding sites. The New York Daily News says that cases of the virus will continue to rise in Haiti due to large amounts of standing water left in open containers, which are “used in many Haitian homes that lack running water.” The WHO says that the virus spreads by bites from infected female mosquitoes. Symptoms usually begin to show four to eight days after the bite.

CNN reports that 25 to 28 American travelers bring the virus back to the U.S. after traveling to high-risk areas abroad. The New York Daily News affirms that the latest cases in the U.S. were not from local mosquitoes, but were “carried by recent travelers to the Caribbean where the virus is raging.”

The outbreak in the Caribbean has been troubling internationally, as tourist destinations like St. Martin could act as a hub for this epidemic, says The New York Times.

The Oxford Journals recognize that though the disease does not typically have a high death toll, in developing nations, “the epidemics resulted in significant morbidity and taxed the health care and public health infrastructure.”

Reducing the outbreak of chikungunya presents a challenge to the global community. Rural villages in African and Caribbean countries do not have access to running water, which creates the need for standing water sources. The risk of attracting mosquitoes increases under these conditions, and therefore the risk of disease goes up as well.

There is currently no vaccine or cure for chikungunya. According to the WHO, treatment aims to alleviate symptoms, usually using anti-pyretics (fever reducers), optimal analgesics (painkillers) and fluids. Travelers to high-risk areas are told to be cautious and protect exposed skin with clothing and bug spray. However, very few recommendations have been made for those who live in the afflicted areas. Unfortunately, reducing the number of cases in such areas would require major overhaul of health care systems and vast improvement of living conditions. Hopefully, the future will bring a vaccine and the social change needed to reduce the spread of this epidemic.

— Bridget Tobin

Sources: CNN, NY Daily News, NY Times, Oxford Journals, WHO
Photo: USA Today

Chikungunya_WHO_aedes_aegypti_mosquito
Picture the beautiful Réunion, a French island in the Indian Ocean off the east coast of Madagascar. Then picture the repulsive Aedes albopictus, a pesty little vermin that’s biting its way to the top of the World’s 100 Worst Invasive Alien Species list.

Put them together and you get an island devastated by the chikungunya epidemic, which has since infected one-third of the island’s population, a total of 250,000 people. $60 million of emergency aid has been sent from France, to hopefully pick up the pieces of the island’s once thriving tourist economy.

Derived from a word in the Kimakonde language of southern Tanzania, chikungunya translates to “to become contorted,” describing the stooped appearance of sufferers experiencing joint pain. The disease was first described during an outbreak in southern Tanzania in 1952 and has recently been rearing its ugly head once again.

Described as similar to malaria and dengue fever, this mosquito-borne viral disease is characterized by severe muscle pains, high fevers, lymph node swellings, rashes, and red eyes. It is transmitted by the bites of infected female mosquitoes, most commonly the Aedes aegypti and Aedes albopictusspecies, both of which tend to be found in highly populated, urban areas. After the bite of an infected mosquito the onset of illness occurs anywhere between 3 – 12 days.

Most patients recover fully but there have been reported cases of joint pain persisting for years following the illness, as well as eye, neurological and heart complications.

The World Health Organization (WHO) has already raised concerns, especially to travellers, regarding the growing numbers of chikungunya infection. The virus is easily spread, especially through international travel, and although not life-threatening there is still no vaccine for its treatment.

As chikungunya is similar to other mosquito-borne viruses, similar safety precautions have been recommended to prevent subsequent infections. Repellant, indoor spraying of insecticides, and mosquito nets are but a few of the preventive measures that can be taken.

Most recently, outbreaks of the disease have been reported in Asia, the south Pacific, the Caribbean islands, and Australia. The WHO reports that since 2005, India, Indonesia, Thailand, Maldives and Myanmar have reported over 1.9 million cases. In 2007, the virus was reported for the first time in Europe, in a localized outbreak in northern Italy. In 2013, there were a reported 127 cases of the disease in Australia, an increase of 568% within twelve months.

These statistics show that, although originating in Africa, the virus seems to have made its way across the globe with no signs of slowing down. We can only hope that a more effective treatment will soon be found, lest there be hundreds more Réunion’s devastated by the smallest of foes.

Mollie O’Brien

Sources: New Vision, Herald Sun, WHO, The Australian
Photo: CDC