Dengue en Colombia

En los últimos días se han dado a conocer noticias sobre el incremento de casos de Dengue en Colombia, una enfermedad que es muy común en regiones tropicales y es transmitida por el mosquito Aedes aegypti, que de hecho, se cría en ambientes con agua estancada. Pero, ahora hay un brote de esta enfermedad y en InformalMENTES les contamos sobre el manejo, sus consecuencias, los métodos de contagio, síntomas de alarma y prevención. Nuestro invitado, el profesor Juan David Ramírez, de la Facultad de Ciencias Naturales de la Universidad del Rosario, también nos cuenta sobre los avances en la investigación y la posibilidad de una nueva variante del virus del Dengue en Colombia que podría explicar el aumento de casos en el país. ¡No te pierdas este episodio!

Episode Transcript

(00:04):
Science inform them, patchy and welldone. This is informally. In recent
days news has been released about theincrease in cases of denga in the country,
a disease that is very common intropical regions and that, in fact,
is transmitted by the edes mosquito toEgypti, since it is raised in
environments with stagnant water. Now thereis an outbreak of this disease and we

(00:28):
are not all understanding perfection, itsmanagement, consequences, methods of contagion,
warning symptoms and prevention. But,to understand more about this disease, we
have a guest expert on the subject, Professor Juan David Ramírez, Professor of
the Faculty of Natural Sciences of theUniversity of Rosario, who has been studying
infectious diseases such as Denk for years. Welcome, Professor Hello, thank you

(00:54):
so much for the pleasure invitation tobe with you. Well, let'
s start by solving some doubts aboutthis disease and understanding from the beginning why
it' s important to pay attention. For this. We have this section
called Bara Gemela slower. Prepereper BaraGemela slow down. Okay. The first
question is what is Colombia' sproblem with dengue fever and what does the

(01:18):
research contribute to its management? Itis not important to mention that dengue is
considered a tropical Colombia disease. Itis endemic to Denk, which means endemic
that it is a disease typical ofthe country. It is not like what
happened with covid nineteen, which wasa disease that came into the country and
became endemic Then, Colombia, sincethe seventies, has been suffering from dengue

(01:40):
fever. Why for the introduction ofthe mosquito to Colombia, which already happened
more than fifty years ago. Thenwe' ve always had the problem with
denque. Colombia has always had thatproblem. However, we have seen a
significant increase in the number of casesover the past three years. This is
what it' s about. Youcan see many reasons. One of the
main phenomena is the phenomenon of thechild. Then strong periods of drought.

(02:00):
What they do is they help spreadmosquitoes, and with more mosquitoes, people
are more likely to get the virustransmitted to them. Another important factor is
the fact that, during the pandemic, because 19 were covid, since all
the financial resources of the Colombian healthsystem were invested in preventing the pandemic because

(02:22):
nineteen covid and, obviously, theystopped financing disease control programs such as denque.
So, that could come, too? That could also favor this increase
in the number of cases we areseeing today. Dengue is also called a
vector- borne disease. Who isthe vector, the mosquito to that Gipti

(02:44):
then by the bite is that thisvirus is transmitted and this virus will generate
different types of symptoms, usually headache, muscle pain, general weakness. And
dengue is divided into two, classicdengue and hemorrhagic deng. The classic dengue
that as I mentioned, headache,fever, general malaise. It can happen

(03:06):
at home with painkillers, but itcan evolve to severe forms, such as
dengue hemorrhagic. And that is thehemorrhagic denga, because the virus begins to
cause internal bleeding and people can sufferinternal bleeding and die. That is what
we know today as a serious dengue, dengue, as well as in covid
nineteen that spoke to us of thevariants that omicron, that alpha, that

(03:30):
sees taque delta, since the denguevirus is also going to have some variants,
and these variants we know as serotypes. We currently know four serotypes of
the dengue virus. In Colombia wefind the four serotypes, but serotype one
and serotype two are the most important. Then the research center is Microbiology and
Biotechnology of the University. We arevery interested in knowing more about these serotypes

(03:55):
of serotype dengel one and zero typetwo, and in collaboration with many departmental
health secretariats, we have been investigatingmore about those serotypes of dengue and particularly,
we have found that there are variantswithin the variants that means that within
the serotype one you can find subdivisionsand within the serotype two you can find

(04:16):
subdivisions, which complements the disease situation. And let' s say that in
Colombia, these variants were being monitoredin recent years and there was always a
variant called the Asian American genotype withinserotype two. I know it may sound
like tongues, but there' sthe dengue virus, the serotype two,

(04:39):
and the Asian American variant within serotypetwo. Well, and we knew that
ninety- nine percent of denga caseswere caused by facts. But we started
to see some important peaks in thenumber of dengue cases by the end of
the two thousand twenty- three.And then we ask ourselves that it'
s normal, that that' sthe child' s phenomenon, that'

(05:01):
s reproducing the vector. That iswhat I mentioned to you and that the
programs for the prevention and control ofvector- borne diseases had been defunded.
And so in our research we finda new variant. What hadn' t
been reported in Colombia, my Godso we said OK, here it might
be that this could be explaining thenumber of cases and we saw that it

(05:25):
was defined as one cosmopolitan variant withinthe serotype two of denque i e another
part of Asian American. And whenwe saw that and started tracking across America
where it had been reported the most, it was known that in Peru and
Brazil they had already been reported forthe two thousand twenty- three. But
what' s the most curious thingabout this that this variant comes mainly from

(05:46):
Asia. OK. The first reportoccurs in Asia, but then it appears
in Brazil and then it appears inEcuador, in Peru, sorry, and
but it is understandable, we gotcovid so why it will bring us a
variant of Denk and we found thatthey were the first cases of that cosmopolitan

(06:06):
variant and we reported it and publishedit towards the end of last year.
And now, because it caused usto doubt, it will be that this
emergency, that variant within the sretypetwo, may be causing this increase in
the number of cases and that iswhat we are currently investigating. Unfortunately,
when we heard from covid that wewere talking about all these variants, we

(06:30):
knew a lot about their biology andthey told us that this variant is not
more transmissible or this variant can evadethe vaccine system, but here we don
' t know that. So whatwe are doing now is to investigate those
biological properties of that cosmopolitan and cosmopolitanvariant forgiveness and its impact on the transmission
of dengue and so on the biologyof the disease. Of course, as

(06:55):
a matter of fact, it's not like the rocket that was seen
as more about how it was transmitted, what consequences it had. And as
far as it is concerned, itis as at this point, to discover
another variant, for yes, thestudies and even the same hypotheses that had
been formulated before complement much more.That, then, is very curious and

(07:17):
the truth worries me a little becausebecause aha that is, it is how
there are more diseases. Better said, that' s the big advantage of
doing research, so it' sfinding those, those new causes that may
be generating those biological effects on infectiousdiseases. Of course and I think there
is another question, because, asvery common, what is the difference with

(07:41):
the chicunguña and similar that also likethat the lenga the chicunmuya. And I
think another truth I don' tremember right now. And because there is
always confusion if it' s symptomsand it' s the same mosquitoes and
what the difference is. Well,that' s an excellent question, because
there' s a group of virusescalled arboviruses, which means the arboviruses virus
transmitted by OK insects and let's think that not only this mosquito can

(08:05):
transmit viruses, but there are otherinsects that can transmit viruses. And then
I' m not going to gointo names of scientific species here so I
don' t create entanglements. Butthat' s what arbovirus is known,
which means that there are other viruses, like dengue, which is an arbovirus,
there' s the chikungunya virus,which is also an arbovirus, there
' s the psycho virus. Andwe currently have an alarm for a new

(08:26):
virus called oropuche. I hadn't heard it. Then the National Health
Institute yesterday issued an alert because theoropuche virus was circulating in Colombia. So,
what about these arboviruses are transmitted bythe same mosquito, to say,
Gipti, and by another mosquito thatis colonizing Colombia, which is called safe
pictus Ok. And if we goto the symptoms, we can say that

(08:52):
the symptoms are very similar among themthe denga, the chicungunya and the sica.
The symptoms are similar. There aresome differences, such as ch and
kungunya. It generates many joint painsthat keep you from getting out of bed.
I' m telling you because I' m a half- boy numidia
of the office exactly what it feelslike and what that pain is. The

(09:13):
sica virus, which is also characterizedby skin rashes and generated an important public
health emergency around two thousand fifteen,two thousand sixteen, because in women who
are pregnant, it generates malformations totheir child, mainly the increase in the
size of the brain, which isknown as hydrocephalus, and are imminent risks

(09:35):
that a country such as Ours suffers, which is endemic to the arboviruses and
where the mosquitoes that can transmit themare. So it' s dengue,
it' s chicongn already, it' s psycho, this yellow fever is
oropuche and surely there are many others. So it' s true on a
clinical level, for a doctor it' s very difficult to be able to

(09:56):
tell which is which and the onlyway to know if I' m infected
by denge for if capuchicoon gonya bylaboratory tests OK. If that' s
going to ask you how you knowthe differences and the only way to do
a blood test to know exactly whatvirus is infecting both of you. Proceed
with treatment to keep abreast of scientificevents. Don' t forget to follow

(10:18):
us on our social networks as itwas research and look for our research hashtag
or rosary. This is informally asummer university program. The next section is
very interesting because it makes sense towhy we do this podcast and in this
case we hear the questions or opinionsthat students have in specific of this disease.

(10:43):
This is what the Patch says.In regions where dengue is endemic to
the Community' s commitment and powerare essential components of successful vector control initiatives.

(11:05):
You can share examples of Community-based approaches that have effectively mobilized recent
locals in dengue prevention efforts and howthese models can be replicated or expanded.
Well, that' s a very, very interesting question, and it'
s that, even though we're in two, twenty- four,

(11:26):
where one would think we have allthe technology to fight dengue dengue is considered,
as I said at the beginning,a vector- borne disease. Then
it is not ensida to attack thevirus directly the most effective way to prevent
it, but to avoid the biteby the mosquito. For we must work
hard to prevent this bite, andwe must do a very important social work

(11:48):
to raise awareness among people about preventingthe existence of mosquito breeding sites in their
homes, especially those created by thesemosquitoes. People keep water stagnant at home
and mosquitoes that can transmit the readyvirus can proliferate there. So strategies,

(12:11):
community strategies have proven to be themost effective and successful way to control denque
and exist and if something is calledcitizen science and that citizen science, therefore,
empower communities about what disease is,how disease is prevented and how to
avoid those mosquito farms. And wehave experiences in literature if you do a

(12:33):
search, we have very interesting experiencesin Asia, in Central America as well
and in certain places in Brazil wherethey have used citizen science. What is
an app, for example, thatdevelops where the person takes a picture of
the mosquito and automatically tells him yes, this is one of that Egypt and

(12:56):
that photograph goes directly where the researcherand the researcher already knows that there is
circulating the s Gipti WOW. So, strategies like this one of app development
to be able to identify mosquitoes oralso development of apps to monitor the potential
symptoms of people, educate the population, then do infographics or, through social

(13:18):
networks, launch campaigns that can teachpeople how to avoid having stagnant water or
doing a washing. Very well fromthe places where it stores the water.
They have shown to do citizen sciencestrategies that have reduced the number of denque
cases that have not been done bysome pilots from our research center, particularly

(13:39):
in Villavicencio, to reduce that prevalenceof denk cases, but in itself is
one of the most powerful vector controlstrategies at this time. Of course,
and I have a question, Idon' t know anything about it.
So much, I don' tknow how to say it, but since
I say like a mosquito, thereis the reptolent. That also helps prevent

(14:01):
or not. If the most repellentforgives help, they help that. I
mean, what I have to avoidis the bite. So if you go
to an endemic area and I'm not saying that the only way for
me to come is for me tohave a Vincentian villa and even leticia the
Amazon. Here you can just goto flirt or in a poem a few

(14:22):
hours from Bogotá and you will alreadyfind the mosquito, then the repellent use,
the use of mosquito nets, alsohelps to avoid that contact. If
there is no bite, there willbe no transmission of the virus. Sure,
not very interesting. That' swhat you hear, because there'
s a repellent. I don't know if it works in this case,

(14:43):
because there are other types like Idon' t know if insects that
are resistant to repellent. I guessso, because it happens like antibiotics,
you take theotics and you take defenses, the impacterias themselves, bacteria and then
after that you don' t,the antiotic doesn' t make the all
- wanted phe. So I said, it' s probably the same thing
with repellent. It is useful andso, obviously it touches look also the

(15:07):
components that has the repellent. Butit has been observed that it works,
at least for that submission of thedeque of whether people are going to travel
to a zone of warm climate,what is recommended is the repellent use and
the use of mosquito nets to keepyou informed of the scientific sucis, do

(15:28):
not forget to follow us on oursocial networks as arroba or it was research
and follow our hashtag research or rosaryfollow us on social networks as a rosary
radio and with the hashtag informally welcomeBeside me this the segment where we challenge

(15:54):
popular beliefs, we maintain myths andexplore the truths behind different statements, with
the aim of offering a clear andinformed perspective on these complex issues. That
' s true, that' strue. No. Don' t you?
Don' t you? Don't you? Don' t you?
Don' t you? Don't you? Don' t you?
Don' t you? Don't you? Don' t you?
Don' t you? Well,yeah, tell me this good.
The question you' ve already beensolving. It is true that dengue can

(16:18):
be prevented. And so we alreadytalked about repellents, not leaving water stagnant,
doing constant washings. I remember thatI think that on television, because
above all national, they are madelike propaganda, like their laundry. Don
' t let, for example,that you don' t have the habit
of spending a little bit of waterand I leave it in a bucket or

(16:42):
in a container and it' slike it increases proliferation, but in what
other ways. In this case Iwill modify the question, in what other
ways can be prevented. Well,as I' ve already mentioned, the
most effective way is to work onpreventing the bite of the mosquito from happening.

(17:04):
That' s, like, themost effective strategy. However, in
recent years and with the development ofbiotechnology, strong efforts have been made to
seek prevention strategies. Hence, Iwould like to mention two strategies that have
proved useful over the past five years. And it is that, in the

(17:26):
intestines of mosquitoes there are many bacteria, millions of bacteria. People usually think
bacteria are bad and all bacteria arebad and they' re going to kill
us all. But if you know, if you look, and I say
microbiology in the biology program, Ialways tell my students, you would be
surprised that of all we know aboutbacteria, only ten percent of them are

(17:48):
already bad, ok and ninety percentare good. Or that in our intestines,
for example, there are millions ofbacteria that help digest food, even
in yogurt. In yogurt, forexample, and thanks to bacteria, we
have many other products. Mosquitoes alsohave millions of bacteria in their intestines and
there is a bacteria that was discoveredto be called Welvaquia and that bacterium.

(18:15):
When the mosquito of that Gipti wasintroduced, he was able to prevent the
dengue virus from reproducing. Ok thento some Australian researchers who said so easy
to inject them to smell here,to that bacteria, to the mosquitoes and
let them go and when they aregoing to bite someone to ingest the virus,

(18:38):
because the virus is not going toreplicate and so we will inhabit that
it is transmitted to the denque thenthey are known as transgenic mosquitoes, modified
mosquitoes to which a bacterium was insertedto prevent the virus from replicating. So
this in Australia has shown a significantdecrease in dengue fever. In Asia there

(19:00):
has also been a decline and thatgroup of Australian researchers who call it The
World Mosquito program O, the WorldMosquito Program, decided to release some in
Bejo Antiokia OK then to do more, to do the most local, and
they released mosquitoes, those mosquitoes modifiedwith bacteria. And in the last two

(19:23):
years there has been a decrease inthe number of denque cases. What happens,
because it' s an expensive strategy. He plays dropping mosquitoes every year,
so that there are no cases ofDenk then they let go. Two
years ago mosquitoes decreased the cases,but they are increasing again because mosquitoes could
not be released again then. It' s a strategy with biotechnology and the

(19:45):
other with vaccines. Making a Denkvaccine is very difficult. Why, because
it' s a virus that itsgenetic material is two or three times the
size of the covid virus then thevaccines became super fast because it was a
one The ethical material of the viruswas very small, even though it had

(20:06):
gene and had molecules that varied alot. It was a small age and
it was easy to build vaccines.Let' s put it this way,
but for dengue it has been verydifficult and it has been years of research
in generating effective denque vaccines that wecurrently have a vaccine that is already approved
by the Himbima, in fact andis ready to start applying in Colombia,

(20:29):
but that, because there are alot of administrative obstacles that we will not
talk about. But that vaccine hasbeen shown to be effective up to seventy
percent in preventing severe dengue fever andeven in avoiding pri the main symptoms of
denque virus in vaccines. A vaccineis available in Brazil. Work is being
done on another vaccine from the ButantanInstitute, which also shows an interesting effectiveness

(20:53):
in preventing the disease. So,in addition to vector control, we have
this biotechnological strategy of transgenic mosquitoes andwe also have vaccines and the idea is
to continue research to prevent the spreadof this virus. Of course not very
interesting. That I hadn' tasked myself if there was a vaccine and

(21:15):
the transgenic mosquitoes I find very curious. Actually, yes, it' s
a biological control strategy. Let's say it like that. There are
also many researchers who oppose it,because we are releasing a bacterium into a
natural environment and that can lead toa negative impact on the ecosystem, etcetera,
etcetera. But so far, interventionshave been good. The number of

(21:38):
cases. If you have any issuesin mind that you would like us to
deal with in this podcast, don' t forget to write to us on
our social networks like arroba or itwas research. And well, it'
s almost close to closing at theend and because our last section, because

(22:00):
it has as a component a littlebit more sad or, because we know
that these research topics focused, especiallyon health, can become very exhausting and,
above all, disappointing. That's not why we have yoursademia.
Yours for the academy. So wewant to know what exceptions, what bad

(22:26):
times you' ve had investigating thisissue, which broke your heart. What
you wanted to investigate and couldn't your ademia. Well, being a
researcher is being resilient, because it' s you who climbs three steps and

(22:47):
you get four down once. Andthere are many factors that are thus opposed
to you moving forward. But westill have to go on. And from
here, I want to remember onein particular that happened to us and is
that, in conclusion, the emergencywas variant of this cosmopolitan variant in which
I mentioned to them the zerotype two, because here, in Colombia there is

(23:10):
no factory of many, of manyreagents to be able to know if it
circulates or not. It' stests we do in the lab. So
it was up to us to contacta company in the United Kingdom that would
bring us the reagents and then nationalizethe reagents and, after nationalizing the reagents,
to release the reagents? Why didn' t I have that brand at

(23:33):
the time, didn' t havea representation for Colombia or we needed that
to continue processing the samples we hadfrom the Meta Department to find out if
there was this cosmopolitan variant and notor not. Then we had bought the
reagents that you will understand, theywere quite expensive and we have a reduced

(23:56):
budget because, unfortunately, the Ministryof Sciences of Colombia does not have much
funding for these research projects. Andwhat happened, because the company dispatched,
the reagents arrived in Bogotá and atthat time I don' t know who
ens at customs checked and thought theywere medical devices. So since they were

(24:18):
medical devices, they were going todestroy them because that had to be nationalized
by a special company. Oh,and that' s when they call me
from customs to tell me they're going to destroy the reagents. And
I' m telling you, sir, you don' t know what I
' m cheating about. Yeah,I mean, you don' t know
what' s going on. Thisis the destruction of these reagents because first
they cost a lot, of course, and second, because we need it

(24:45):
to do important research in Media Colombiaand the impact on public health. He
didn' t tell me. Thatwas under the decree where it' s
a medical device. I' mgoing to destroy all that and they destroyed
it. No, and I feellike this is the worst you ever heard.
And they destroyed it And then,for what I did, for I
complained, but it was of noavail. And then, because I remember

(25:07):
that I was with another teacher,Professor Marina Muñoz, at the time and
we said like what we do,because the worst we can do, the
only thing we can do is writeto the company, that is, what
happened to us. And yes,well, they' re going to tell
us that no, that is,it' s not their fault. Then
I wrote the mail, so withthe tear in the mail, telling them

(25:30):
ideas that the customs system destroyed thereagents, thinking they were. I don
' t know what, but wedon' t have a way to buy
reagents and send it to the company. And or surprise, the company said
don' t worry. We're going to send him here again,
yes, but tell us how wecould mark them, so that you don

(25:51):
' t have the problem. Thenwe contacted the Rosario Legal Office, which
supported us very much. Thank youvery much, by the way, and
finally it was possible to nationalize rectisand process the samples. But, for
these are the things one has toface. Sure, not good, but
at least there was a good ending, a good ending, but, because
it' s just one of manyother things that can happen in these research

(26:15):
processes. Not sure, Dalio Landoniohurt, but also very empathetic. They,
then, understand affectionately, they aresuper complex, yes, ah no,
but then nothing, you have toknow how to handle those situations.
Yes, of course and so endsthis episode of informally, which was under

(26:40):
the direction of Mara Bruja. Sheis a scientific outreach coordinator and was supported
by Omar Bedoya in master' scontrol. To you, netizens, thank
you for sharing with us another episodeof learning Charladito y parchadito. Don'
t forget that you can find uson all social networks such as arroba,

(27:03):
uber research and tell us to listento us with the hashtag informally if you
want to share or repeat this episode, don' t forget to look for
us in Spliaker or Spotify. Ibid farewell from this space led by the
Directorate of Research and Innovation, withthe support of the School of Human Sciences
and of u Rosario Radio. Iam Laura Pratto, a journalism student at

(27:25):
the Universidad del Rosario and host ofthis episode, who was supported by Mario
Castro, director in charge of uRosario Radio. I' ll be waiting
for you in a next edition ofthis Grand Podcast Chao Chao. This was
reported by an initiative of the Directorateof Research and Innovation of the University of

(27:48):
Rosario with the support of the Schoolof Human Sciences and or Rosario ORN