Nonspecific febrile syndrome and fumigation.

Fumigation is necessary, but not enough. Arboviruses must be tackled with a system of coherent measures, social discipline, and honest communication.

Many believe that fumigation is the main solution to the rise in arbovirus cases in several provinces, including Matanzas. However, that measure alone is insufficient: the problem requires a comprehensive approach.

In Cuba, mosquitoes are as old as the island’s earliest inhabitants, and the essential thing has always been to prevent rather than regret. The lack of consistency in fumigation, visits from vector control workers, and larvicidal efforts—combined with intermittent solid waste collection, increased garbage, and, let’s be honest, poor hygiene in communities and homes—have created fertile ground for the spread of these diseases.

Added to this are water supply issues, which force people to store water in unsafe conditions, and a climate that favors mosquito proliferation. All of this has worsened a situation that could have been better managed with foresight and social discipline.

The above, dear reader, you know, you endure, and you suffer. Although I am not a specialist on the subject, I would like to share some considerations that, if handled comprehensively, could help improve control.

First, there is the issue of the infected population. A considerable percentage of people carry viruses like dengue or chikungunya in their bodies for several days. Although these diseases are not transmitted from person to person, the mosquito acts as an intermediary, making each patient a potential source of contagion. That’s why it is recommended to keep them, as much as possible, isolated under a mosquito net. It’s not an exaggeration—it’s a basic public health measure.

Second, fumigation. Cycles every 22 days are crucial to impact the adult mosquito population. But here’s a pause: a fogging machine requires four liters of diesel, one of gasoline, and the insecticide. If the health system lacks fuel, it’s time for all institutions to align. Even self-employed workers who offer this service could be included. The solution cannot fall solely on the state sector.

Third, it’s important to understand that the adult mosquito is not everything. Even if fumigation is stabilized today, heavily focused on dengue cases and the most affected areas, that measure only impacts adult mosquitoes. The most important thing remains eliminating larvae: breaking the cycle.

Fourth, eliminating breeding grounds. To control larvae, it is essential to eliminate the environment in which they develop. The State must stabilize solid waste collection and seek alternatives, such as using carts when motorized transport fails. Setting schedules for taking out the trash and strictly enforcing them can make a difference. Imposing fines, if necessary, is also valid. Sometimes discipline is achieved only when there are consequences.

Fifth, the role of the family. Even with a clean environment, responsibility within the home is unavoidable. Self-monitoring is fundamental: keeping water tanks and containers tightly closed, applying larvicide, and adopting simple measures that stop the vector’s reproduction. No amount of fumigation can compensate for a yard full of uncovered containers.

Sixth, the role of vector control workers. Their larvicidal work is vital and must be reinforced with more resources, organization, and oversight. They are the first line of defense, but often work with material limitations that reduce their effectiveness.

Finally, communication. It remains a weak link in the chain. Clear and transparent information helps build trust and encourage citizen participation. It would be especially timely, for instance, to explain what progress has been made with the dengue vaccine, whose development began in 2023, or whether Cuba could feasibly apply the sterile insect technique, which has shown promising results in other countries. People need to know what is being done and why.

In conclusion, fumigation is necessary but not sufficient. Arboviral diseases must be tackled with a coherent system of measures, social discipline, and honest communication.

Written by Yunielys Moliner Isasi.