PCMOs on Oropouche Fever
BAYAGUANA, Dominican Republic — If the WhatsApp groups are to be believed, a new mosquito borne virus just dropped. Oropouche is actually not new, but has records dating back to the 1950s and 60s. So why is the teachers group chat telling me there is a new Dengue going around? This is because WhatsApp is a bad place to get epidemiology information. But also because in May 2024, cases were detected in our sister island of Cuba. This article aims to share PCMO information about Oropouche, provide help identifying mosquitoes and biting flies, and arm the reader with knowledge to engage in the arena of infectious disease disinformation. Below you will find interview questions answered by our very own PCMO team.
Your Daily Vívere: What is Oropouche?
PCMO: Oropouche fever is a tropical viral infection like dengue which is transmitted by biting midges (jején) and mosquitoes (culex) from the blood of sloths to humans. The symptoms usually start after the incubation period of 5 to 7 days, which is characterized by fever, headaches, muscle, and joint pain, sometimes vomiting and diarrhea are also reported. There is no specific treatment, only general measures to relieve symptoms. The disease was first described in 1961 in Vega de Oropouche, Trinidad and they have appeared predominantly in rural and forested areas of Brazil, Peru, Ecuador, Argentina, Bolivia, Panama, Colombia and Venezuela.
YDV: What is happening with cases in Latin America? In the DR are we at higher risk of Oropouche?
PCMO: There has been an increase in cases in countries like Bolivia, Peru, Brazil and Colombia compared to the previous year, on May 27th the ministry of health in Cuba confirmed they had cases of Oropouche fever but with no critical cases. As of now there are no confirmed cases of Oropouche in the Dominican Republic, the ministry confirms they are on the lookout but no cases so far.
YDV: Are there possible complication that result from Oropouche?
PCMO: Oropouche fever is usually self-limiting, and complications are very rare but in those very rare cases it can lead to neuroinvasive disease such as meningitis.
YDV: Are there additional precautions we should take related to Oropouche?
PCMO: We recommend applying the same measures that you use for other mosquito borne diseases like: use of insect repellent, mosquito net, protective clothing, making sure your surroundings are clean with no standing water.
YDV: Is there anything else you would like us to know?
PCMO: The disease has symptoms very similar to dengue and other mosquito borne illnesses so remember to take same precautions, there is no specific treatment just managing your symptoms as the other diseases, the risk of getting sick by it are low right now but if you do experience fever like symptoms contact the medical unit and remember that your first line of treatment for fever with muscle/joint pain is always acetaminophen (Tylenol) and hydration.
This interview was conducted over email on June 11th, 2024 and June 12th, 2024. Your Daily Vívere would like to extend warm abrazos to the PCMO team for their thoughtful and prompt response to our questions.
The above graphics were taken from a Brazilian source but are available in English. They present a map of how Oropouche made its way from animals to mosquitoes to people, and also a timeline of global developments in the disease. The below graphic provides a map updated for where Oropouche has spread over time, although additional dots should be added over Cuba for the year 2024, one for Santiago de Cuba and another for Cienfuegos. To date no cases have been detected in the Dominican Republic. Even though it has never been detected here, it is worth noting that this year cases are up 513% as compared to the year of 2023. I believe this large increase is what has sparked interest in the group chats despite the low level of risk we currently run in the Dominican Republic.
Know your enemy: mosquito edition. Maybe this should be its own article, and maybe we will expand on it in the future. But for now here is some information about different mosquitoes and biting flies. Que ustedes sepan. I have been fortunate enough to know personally 2/3 mosquito subfamilies listed in the below graphic — Aedes and Anopheles. Anopheles mosquitoes are vectors of plasmodium, which is how Malaria spreads in sub-Saharan Africa. They also have spread West Nile Virus, Zika, and Yellow Fever. I was bitten by them when I lived in Malawi. On the other hand we have Aedes mosquitoes in the Dominican Republic, where they spread Dengue, Zika, and Chikungunya. I should note that these diseases aren’t the only ones spread by these mosquitoes, they can actually spread quite a lot more, and some diseases are spread by both or all mosquito types (Hernandez-Valencia et al). Further complicating the mosquito question is that they may be found outside of their defined zones or overlapping with other subfamilies. By studying Oropouche I have finally been introduced to the Culex, although I’m not sure that I’ve been bitten by them before. Maybe soon I will be able to add them to my collection of bug bites? ¡Ahh pero me pica mucho!
What is a jején? They have a lot of names, but in my campo they are called maje. Some of the other names they are called include Culicoides paraensis, gnats, sandflies, biting midges, punkies, and no-see-ums. They are not found in all parts of the Dominican Republic, but as any Monte Plata PCV will tell you, they are without a doubt found here. They are tiny black flies that you can barely see when they land on you (I think this is where the name maje comes from, like magic!), and leave a little bit of blood dripping after feeding. Later the site of the bite swells differently than a mosquito bite with a dark red dot in the middle from where you were bleeding. They itch more and for longer duration than mosquito bites. Normally they feed on nectar but the females need blood for the incubation of their eggs. My feet and ankles are currently covered in both Aedes and maje bites. Ayyy madreeee.
What do I do to avoid the bites? As soon as school is over I tuck myself into the mosquitero and do not move for about 12 hours. If I have to go outside you know I’ve got vela de mosquito burning. Pican mucho ahi en el patio. Y si me toca lavar la ropa, ya tu sabes que estoy cubierto de repelente. Y luego, de una vez estoy baña’o y de vuelta en mi mosquitero. ¡Pero estos pajaritos no me dejan vivir!
Claudia F., Carmeli C.. 31 May 2024. Autoridades de Salud Afirman Riesgo en el país para brote de oropouche es bajo, Diario Libre. link. (Accessed: 12 June 2024).
Files, M.A., Hansen, C.A., Herrera, V.C. et al. 2022. Baseline mapping of Oropouche virology, epidemiology, therapeutics, and vaccine research and development. npj Vaccines 7, 38. link. (Accessed: 12 June 2024)
Hernandez-Valencia, Juan C., Paola Muñoz-Laiton, Giovan F. Gómez, and Margarita M. Correa. 2023. “A Systematic Review on the Viruses of Anopheles Mosquitoes: The Potential Importance for Public Health” Tropical Medicine and Infectious Disease 8, no. 10: 459. link (Accessed: 12 June 2024)
Nunes, Marcio & Vasconcelos, H.B. & Medeiros, D.B.A.. 2017. A Febre do Oropouche: Uma revisão dos aspectos epidemiológicos e moleculares na Amazônia Brasileira. Cad Saúde Colet. 15. 303–318. link. (Accessed: 12 June 2024)
Syeed, Mahbubul & Hossain, Md.. 2022. Aedes Larva Detection Using Ensemble Learning to Prevent Dengue Endemic. BioMedInformatics. 2. 405–423. link. (Accessed: 12 June 2024)
