The other side of dengue surveillance: the fumigators

Since arriving in Venezuela, I have caught a glimpse into the realm of environmental health and the steps to control the carrier of the dengue virus.  It’s been great applying all that I’ve been learning from the epidemiology and more clinical side of the cases.

Recently, I was at the Environmental Health Department—which is a regional entity—and witnessed their operations on a bit of a broader scale, including how the department receives information for the different counties.

The integration and communication between the two branches of public health was of particular interest as I continue to think about the evaluation of the current system and what I am reading in the literature. Because the department’s laboratory didn’t have any samples to show, I wasn’t able to see how the blood testing and ELISA-IgM tests work to confirm cases of dengue; thus, I will be returning to see that piece of the surveillance puzzle.

I was eventually bombarded with vector control information (and very good information!) I admit to being a bit overwhelmed at times, since I’ve just been trying to get down the epidemiology side of things with the patients and cases and all of that reporting.

Overall, it was great learning about the other side of dengue surveillance, that of entomology and vector control (ie, the mosquito).


The vector control team invited me to go on a ride out into the community in order to see how they do the fumigation (spraying to kill the adult mosquitoes), abatization (putting chemicals in the water to kill off the eggs and larva) and education of the community while they work.

I arrived to the office early, and hung out with one of the fumigator ladies who took me under her wing a bit. She was pretty hilarious and quite a character. She always introduced me as “David, es de Oregón no de orejón” (Spanish for big ear-I’m still not quite sure why it was so funny, but she found it quite amusing). There weren’t any dengue cases to go and do the normal drill, however, there was a request for us to come out into an apartment in Los Guayos, a county that was about 45 minutes away and one that raised an eyebrow among the students I was told. It’s more of an industrial center and, at the least the apartments we saw, a bit more impoverished than here in Valencia, although the stray dogs, interesting smells, blaring reggaeton, and blazing sun are found all over Venezuela.

I went with the spokesperson to talk with the lady who requested our services and then talked to the various community people to figure out what needed to be done. Essentially, the large tanks of water for each building needed about ten pounds of the abate in order to eliminate all of the eggs and larva that were in the 42,000L of water. There is a pretty specific formula to make sure that the concentration is just right to be effective, but not too much. Unfortunately, we were unprepared with that large of an amount of abate, and they decided that a night team would come back to do the fumigación nocturna.  Still, the two-truck team of about seven people were more than happy to show me all of the equipment and explain how things usually work.

The ride back was also quite pleasant. The radio blaring and racing down the autopista through the mountains of Carabobo, it was fun to get out a bit and see the people and the conditions that I’ve mainly been reading and looking at data for. I’m mostly excited for the hospital this week so that I can see the people behind all of the numbers I’ve been working with the past couple of weeks.