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Zika Isn’t The Biggest Mosquito-Transmitted Disease Plaguing Brazil

Protected by a mosquito net, Nadia Gonzalez recovers from a bout of dengue fever at a hospital in Luque, Paraguay Friday, Feb. 5, 2016. CREDIT: AP PHOTO/JORGE SAENZ, THINKPROGRESS
Protected by a mosquito net, Nadia Gonzalez recovers from a bout of dengue fever at a hospital in Luque, Paraguay Friday, Feb. 5, 2016. CREDIT: AP PHOTO/JORGE SAENZ, THINKPROGRESS

This is a part of ThinkProgress’s #Rio2016 coverage. To read other articles about the 2016 Games, click here.

Ask anyone in the United States what the biggest health risk is at the Summer Olympic Games in Rio de Janeiro, and they’ll tell you it’s Zika. The mosquito-borne virus has hit Brazil the hardest, leaving more than 1,500 newborns with serious brain defects in its wake. Zika’s spread ignited a fiery funding battle in Congress, pushed cities to blindly craft local public health responses, and even convinced some Olympic athletes to skip this summer’s event.

For the majority of the population in Brazil, dengue is more of a problem than Zika

While the fear of the currently incurable virus is serious, especially to women trying to get pregnant, global disease experts believe the attention on Zika has overshadowed another fast-growing disease that’s infected thousands more in Brazil: Dengue fever.

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“For the majority of the population in Brazil, dengue is more of a problem than Zika,” said Anna Durbin, a professor and vaccine researcher at Johns Hopkins University’s Department of International Health. “That’s what people coming for the Olympics should be concerned about. It’s burning through South America. And I don’t think it’s going anywhere.”

This year in Brazil, there have been 4,771 reported cases of Zika — compared to 1,244,583 cases of dengue. Rio de Janeiro alone has seen 8,133 cases of dengue, six times higher than the reported number at this time last year. Durbin said it’s the most widespread dengue outbreak she’s seen in her 17 years studying the disease.

Over the past few years, mosquito-borne diseases in general have grown at an “explosive” rate, and epidemiologists haven’t been able to pinpoint the source of this growth, according to Peter Hotez, the dean of Baylor College of Medicine’s National School of Tropical Medicine.

Like Zika, dengue is transmitted through mosquito bites and it has no vaccine or cure. But unlike Zika, which shows its mild flu-like symptoms in only 80 percent of its victims, dengue wreaks havoc on most people it comes into contact with. Symptoms can include continuous joint pain, vomiting, severe rashes, and a high fever. Infants and children are the most susceptible to dengue’s life-threatening symptoms. In total, the disease has killed 288 people in Brazil this year.

So why haven’t lawmakers and health officials demanded the same kind of aggressive response to dengue as they have for Zika?

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Durbin said it comes down to two delicate topics. First, not as many people die from dengue as they do from other tropical diseases, like malaria or yellow fever — which makes it hard to get research grants. If dengue had a higher mortality rate, Durbin said, more people would be paying attention. Secondly, the optics of a thousand babies with shrunken heads, the result of Zika-induced microcephaly, has a serious emotional impact on people.

Dengue affects many, many more people. But it doesn’t really make news like Zika

“I think if it were’t for microcephaly, people wouldn’t be caring as much,” Durbin said. “Certainly, microcephaly is real and it’s tragic, but it impacts a limited population. Dengue affects many, many more people. But it doesn’t really make news like Zika.”

She said the media’s reaction to Zika has been “a little alarmist.”

This resonates with those on the ground in Brazil, who, according to Rodrigo Cesar da Silva Magalhães, a researcher with Brazil’s Ministry of Health, are much more concerned about the risk of contracting dengue than Zika.

And although there’s currently an effort to stem the spread of Zika in Rio de Janeiro in preparation for the Games, da Silva Magalhães said there have been few past investments to eradicate disease-carrying mosquitoes. “[Dengue’s impact] worsens year after year, due to the lack of investment in setting up a health infrastructure — especially in the poorest regions of the country,” he said.

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That doesn’t seem to be changing anytime soon. The country’s recent budget crisis has shuttered public hospitals, greatly limited public health programs, and left what few medical facilities remain with insufficient medical supplies. http://thinkprogress.org/sports/2016/07/05/3795386/rio-olympics-many-problems/But there is one bright spot. The global focus on Zika — especially amplified as athletes and attendees pack their bags for Rio — may actually help the researchers who’ve spent years trying to get any significant attention on overlooked illnesses.

For instance, Durbin and other dengue experts are hoping to use Zika-fighting funds to create a new 2-in-1 vaccine that combats both Zika and dengue.

“We’re trying to leverage the national attention to protect people from both of these diseases,” she said. “Dengue is not going anywhere, but Zika may burn itself out in a couple years. We can make a much more commercially viable vaccine when we pair them together.”

Hopefully this will be the opportunity we need to focus on all neglected tropical diseases

And it’s not just about dengue. Many of Brazil’s poorest populations have been devastated by little-known, clinically-ignored diseases like hookworm infections, schistosomiasis, Chagas disease, and leishmaniasis. Baylor College’s Hotez calls Brazil “ground zero for all neglected tropical diseases,” a term he coined himself after decades of study in this field.

Hotez has watched waves of national attention focus on global epidemics — and then recede — many times. “A disease will only gain attention in the media if it threatens people living on the East Coast of the United States or Western Europe,” he said. “That’s what’s happened with Zika.”

Now, he’s hoping the dire headlines about Zika will translate to increased awareness about the other health issues affecting people in Brazil and around the world.

“Hopefully this will be the opportunity we need to focus on all neglected tropical diseases.”