The West Nile virus originates from Central Africa and was first detected in the jungle of Uganda in 1937 in a young woman suffering terribly on the floor of her mud-walled house with grass thatch roof. If this reminds you of the opening scenes of blockbuster movie 'Outbreak' with Dustin Hoffman you get the picture.
The virus escaped from the African continent, and it may have been an infected mosquito on board of an airliner that brought the virus to the USA. If it strikes, it causes flu-like symptoms but also encephalitis and can be fatal. It hit New York in August 1999 after the stowaway mosquito fled the cargo compartment at JFK airport. Not long afterwards, some sixty New York citizens became seriously ill. Nobody knew what they suffered from. Six died. By that time birds had been infected and started spreading the virus. Today the disease is present in the entire USA, causing thousands of cases, and killing tens to hundreds of US citizens, each year. It is spreading into Mexico and further south into Central America as I write this story. There is no vaccine, there are no drugs. The African virus has a firm grip on the USA and is there to stay.
To many this may sound like fiction. It’s not. Once it became publicly known that it was an African virus that hit the metropole, police forces were needed to calm the public that feared a terrorist attack with a biological weapon. A big concert in Central Park was cancelled by mayor Juliani when it became known that mosquitoes were the culprit.
Globalisation is leading to the spread of tropical diseases. Diseases of the developing world are conquering the developed world.
It’s the way we respond to these threats that is striking in the following two videos. First we see the response to the West Nile virus threat in California, then the response to malaria in Tanzania’s capital, Dar es Salaam…
San Joaquim, California, USA
Some comments directly copied from the video:
“An air attack will stop the spread of the West Nile virus…”
“Spraying by air and ground to fight these mosquitoes here […] after a recent explosion of the mosquito population…”
“The San Joaquim County calls their efforts very aggressive to reduce the mosquito population here…”
“Officials say the fine mist is harmless to humans…”
“We have a lot of mosquitoes infected with West Nile Virus…”
“We want to knock down these populations to reduce the risk to the public…”
Malaria in Dar es Salaam, Tanzania
The city of Dar es Salaam was once malaria-free. During the colonial days it was prohibited to practice agriculture near or within the city. For fear of breeding sites that would bring mosquitoes and malaria. The massive growth of the capital and uncontrolled expansion has changed this situation. Malaria is now back in urban Dar es Salaam. Unlike West Nile in California, where it has only been present for five years, malaria is of course an ancient scourge in East Africa.
Some comments from the video:
[voice-over] “Larvicides could be back on the malaria control agenda…”
“So the industrial area was completely not included in the map…”
“The coverage is not complete. Even we can not go larviciding properly…”
In San Joaquim resides a well funded and well equipped vector control force, that is capable of flying and spraying large areas. And blanket all breeding sites with larvicides that kill the immature mosquitoes. Postal codes are available, making the organization of the campaign meticulous. Streets have names, houses have numbers.
In Dar es Salaam, the Urban Malaria Control Project treats breeding sites on foot, and a recent report showed that many are missed. The programme relies on volunteers from the community (community-owned resource persons, COPRs) rather than well payed professional staff as in San Joaquim. This brings its own challenges.
So spotting the differences is not difficult and it won’t take much guessing in which of these two settings mosquito control is most effective in curbing disease transmission.
But the big question becomes: If we know how to do it in our own backyard, why isn’t it done in the same way over there? Development in this case would be to take the big man from San Joaquim and put him in Dar es Salaam for a few months. Reciprocally, the Tanzanians should get the experience in California... right? Both parties would have a lot to learn from each other, with the aim to build sufficient capacity and capability in both settings to ward off deadly disease.
How would you tackle malaria in Africa?