Amid blackouts, food shortages, Cubans face a dengue outbreak that has killed two children

Burdened by constant blackouts and food shortages, Cubans are now facing a new dengue outbreak in the middle of the hot summer that threatens again to overwhelm the island’s public health system, already reeling from the COVID-19 pandemic.

Dengue is a viral disease transmitted by the Aedes aegypti mosquito, and the government said the levels of mosquito infestation on the island are the worst in the past 15 years. In a meeting Tuesday, Cuban health authorities said they had confirmed 3,036 cases of dengue so far this year. But most people with symptoms, such as fever, vomiting or a rash, do not get tested, as the health system also lacks testing supplies.

Health Ministry officials acknowledged that just in the first week of July, they had identified 14,256 people with “unspecified fever.” The ministry said that figure represented a 42% increase in suspected dengue cases compared to the previous week.

Official figures, however, might not reveal the true extent of the epidemic, for which government officials are giving differing statistics. According to the Communist Party newspaper Granma, there were 27.91 detected cases per 100,000 inhabitants last week. Speaking of the same week, a health official quoted by state media outlet Cubadebate said the rate was lower, 19.7.

In a government meeting Tuesday, Cuba’s Minister of Health, José Angel Portal Miranda, said there was dengue transmission last week in eight provinces: Pinar del Río, Havana, Matanzas, Villa Clara, Camagüey, Las Tunas, Holguín and Guantánamo.

But videos shared on social media suggest the disease is also present and straining the public health system in other provinces.

Videos circulating during the weekend show the overcrowded emergency room at the children’s hospital in Cienfuegos, a province not mentioned by the minister. In one of the videos, a mother confronts a doctor asking loudly, “When will my daughter be seen?”

“Stop saying there’s nothing [to treat her]; I need you to see my daughter,” she shouted. “My daughter had convulsions, and you keep referring her from one place to another. What else do I need to do? I have a mother’s heart!”

There is no specific treatment for dengue, but early detection and access to proper medical care lower fatality rates, the World Health Organization says.

While dengue has been endemic in some areas in Latin America and the Caribbean for many years, it can hit Cuba especially hard because of the lack of air conditioning or window screens in homes, the frequent blackouts and improperly stored water in the many households with limited access to running water.

Cubans cannot rely on other mitigation measures such as repellents or mosquito netting because they are not readily available.

What you need to know about dengue, who’s at risk and does it matter where you got bitten?

Years of under-funding and the COVID-19 pandemic have left Cuban hospitals and local clinics poorly prepared to handle a new outbreak. Patients have to provide their own bed sheets; many hospitals lack running water, and healthcare workers lack basic supplies like gloves and catheters to treat patients.

This year, more than 140 medicines have been in short supply, almost 40 percent of the most common medications that should be available in pharmacies, said Tania Urquiza, the vice president of Bio-Cuba Pharma, a state pharmaceutical company. Urquiza blamed the U.S. embargo, but acknowledged that the government prioritized funding for developing the domestic COVID vaccines.

With daily electricity cuts lasting several hours, it is harder for Cubans to keep the mosquitoes at bay. Cuban officials recently said the situation does not have a short-term solution because the country has a power-generation deficit, since several plants are out of commission for maintenance or in need of repair.

In the children’s hospital in Cienfuegos, energy-saving measures in place mean the hospital is shutting down air conditioning for several hours a day, a mother of a child patient said on Facebook.

Shortages of fuel have also affected ambulance services and fumigation against the mosquitoes.

Last week, 26-year-old Andy Agüero Barrios died after waiting hours for an ambulance to take him to a hospital. He needed a transfusion.

Madelaine Rivera Sánchez, a public health official in charge of prevention efforts against mosquito-borne illnesses, said the country has been in short supply of Abate, a larvicide, and diesel for fumigation.

“That’s something we can’t deny, and that’s why we won’t be carrying out intense fumigation,” she said.

Authorities have said little about cases of severe dengue, which can cause bleeding and even death. Cuban independent media have reported at least three deaths caused by the severe version of the disease, also known as hemorrhagic dengue.

A primary school in Contramaestre, a town in Santiago de Cuba, confirmed the death of one of its students, second-grader Arlín Sailet Acuña Espinosa. Another 7-year-old died at the children’s hospital in Cienfuegos. And a pregnant doctor died in Camagüey, according to media reports.

In the government meeting Tuesday, health minister Portal Miranda said there were 32 patients in intensive care units, three of them in critical condition.