Puerto Rico Races To Stop Zika's Mosquitoes Before Rains Begin

Feb 29, 2016
Originally published on February 29, 2016 8:01 am

The Zika virus is a health threat not just to Latin America, but also to parts of the U.S. It's already a problem in Puerto Rico where there are nearly 120 cases so far, including five pregnant women. That's a concern, because Zika may be involved in causing birth defects.

The U.S. territory has declared a public health emergency and is working to protect residents from Zika and from the primary mosquito that carries the disease, Aedes aegypti. The species is largely responsible for the spread of Zika and many other tropical diseases, including yellow fever and dengue. It can breed anywhere it finds as little as a teaspoonful of standing water.

In Puerto Rico's 78 municipalities, emergency crews are looking for the places the mosquitoes breed. In Guaynabo, a suburb of Puerto Rico's capital San Juan, Luis Hernandez gets out of his truck to take a look at some old tires piled outside a home. Hernandez is an entomologist who advises local authorities on how to combat the A. aegypti.

He dips a cup into one of the tires and shows me what's inside. A dozen or more mosquito larvae wriggle in the water.

"That means this tire has been here for more than one week," Hernandez says. "Because of the size of the larvae, I know how long the tire's been here."

There are dumps of old tires from automobiles and trucks everywhere in Puerto Rico. That's because the recycling fees customers pay when they purchase tires don't cover the actual cost of disposal. Tires pile up and they become breeding grounds for mosquitoes.

Puerto Rico's legislature has passed an emergency measure to pay the cost of picking up and recycling tires. In Guaynabo, emergency response crews have already started collecting the tires, sending a grapple truck to clean up 15 sites in the municipality.

Crews are also working to remove standing water around schools, abandoned houses and even cemeteries, where flower vases can serve as mosquito breeding areas.

Unsealed septic tanks can also be a problem. Crews will inspect and install screens over vents where they're needed.

Puerto Rico's governor wants this work done in 45 days, before the start of the rainy season.

In Guaynabo, no cases of Zika have been reported yet. But long before most people had heard of Zika, Guaynabo was dealing with another tropical disease — dengue. It's sometimes called bonebreak fever, and can lead to death.

"We had many, many cases. Dengue was really hard here," says Dr. Silvia Medina, Guaynabo's former health director. Medina is helping Guaynabo now as a consultant, taking charts, pictures and information about Zika out to the community. She did something similar during the last dengue outbreak.

"We went into the communities, school, churches — everywhere," Medina says. "We had good results. When people are educated, they're healthy people."

As part of the public health emergency, Puerto Rico is asking all residents to check their homes and the homes of their neighbors for standing water and mosquitoes. A big problem in Puerto Rico is that most homes aren't air conditioned and many lack screens, so residents are exposed to more mosquitoes.

Hernandez says fumigation trucks respond quickly when crews get calls from areas where there are lots of mosquitoes. But A. aegypti mosquitoes spend much of their time indoors, Hernandez says, so aerial spraying is often not effective. And when the fumigation trucks begin spraying in a neighborhood, residents often close their windows, he says.

Hernandez throws up his hands in frustration. "If the mosquito is inside with you, and you close the window," he says, you and your family may still be bitten.

The Obama administration has asked Congress for more than $200 million to help Puerto Rico protect residents. Dr. Johnny Rullan is a former Puerto Rico secretary of health who is advising the government on its Zika response. After outbreaks of dengue, chikungunya and now Zika, Rullan says, it's clear Puerto Rico has to get serious about protecting residents from A. aegypti.

"We will have to do like we did for yellow fever," he says. "We declared war on yellow fever and Puerto Rico was successful. We have declared war now on the Aedes aegypti mosquito and we need to win it."

Puerto Rico is scrambling to adopt mosquito control measures in the next six weeks, before the rainy season begins. Rullan says these are measures that the island should already have put in place — over the last 30 years.

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STEVE INSKEEP, HOST:

Health officials say it is unlikely that the Zika virus could spread widely in the United States. Note they said it's unlikely to spread widely, not that it won't spread at all. Puerto Rico has reported nearly 120 case. NPR's Greg Allen reports on how Puerto Rico is responding.

(DOG BARKING)

GREG ALLEN, BYLINE: Outside of a house in Guaynabo, a suburb of Puerto Rico's capital, San Juan, Luis Hernandez stops to take a look at some old truck tires. He's an entomologist who advises local authorities on how to combat the Aedas aeqypti mosquito, the species that carries Zika, dengue and other topical diseases. He dips a cup into one of the tires and shows me what's inside.

LUIS HERNANDEZ: OK. If you can see...

ALLEN: I can see at least one larvae at the top. There's probably more. Oh, there's a bunch, yeah.

HERNANDEZ: That means that this tire is here more than one week...

ALLEN: Right.

HERNANDEZ: ...Because for the size of the larvae, I know how long is the tire here.

ALLEN: There were dumps of old automobile and truck tires everywhere in Puerto Rico, and they become breeding grounds for mosquitoes. At Kenny's tire store in Guaynabo, a grapple truck is picking up more than 100 old tires that have accumulated there. When Puerto Rico's governor declared Zika a public health emergency, one of the first moves was to begin an emergency clean up of tire dumps around the island. Jose Acosta is Guaynabo's health director.

JOSE ACOSTA: Since we have the problem with Zika and dengue again after the rains, what we are doing right now it's, like, taking care of it.

ALLEN: Emergency response crews across Puerto Rico are working to remove standing water around schools, abandoned houses and cemeteries where flower vases serve as mosquito breeding areas. In Guaynabo, no cases of Zika have been reported yet. But long before most people had heard of Zika, Guaynabo was dealing with another tropical disease, dengue.

SYLVIA MEDINA: Oh, we had many, many, many, many cases - many cases. Dengue was really hard here.

ALLEN: Sylvia Medina is Guaynabo's former health director, now a consultant who takes charts, pictures and information about Zika out to the community. She did something similar during the last outbreak of dengue.

MEDINA: We went to the communities, to the schools, to the churches, everywhere. We had really good results because people, when they are educated, they're healthy people.

ALLEN: Puerto Rico's governor declared a public health emergency and is asking all residents to check their homes and the homes of their neighbors for standing water and mosquitoes. A big problem in Puerto Rico is that most homes aren't air-conditioned. And many lack screens, so residents are exposed more to mosquitoes. Entomologist Luis Hernandez says fumigation trucks respond quickly when crews get calls from areas where there are lots of mosquitoes. But Aedes aegypti mosquitoes, he says, spend much of their time indoors.

HERNANDEZ: And when - when the machine arrive, they close the window.

(LAUGHTER)

HERNANDEZ: They close the - immediately. When they hear, wah (ph), they close the window. And then say, OK, if the mosquito is inside with you and you close the window...

ALLEN: That's why fumigation doesn't really work so well.

(LAUGHTER)

HERNANDEZ: Exactly, I say, why?

ALLEN: The Obama administration has asked Congress for more than $200 million to help Puerto Rico protect residents. Johnny Rullan is a former Puerto Rico secretary of health who's advising the government on its Zika response. After outbreaks of dengue, chikungunya and now, Zika, Rullan says it's clear Puerto Rico has to get serious about protecting residents from the Aedes aegypti mosquito.

JOHNNY RULLAN: We will have to do like we did for yellow fever, that we declared war on yellow fever. And Puerto Rico was successful. We have declared war now on the Aedes aegypti mosquito, and we need to win it.

ALLEN: Over the next month and half before the rainy season begins, Puerto Rico is scrambling to adopt mosquito control measures, measures, Rullan says, that should have been put in place over the last 30 years. Greg Allen, NPR News, Guaynabo, Puerto Rico. Transcript provided by NPR, Copyright NPR.