Brynn Barineau

Tag: Zika

  • Dengue, Zika, Chikungunya, & Yellow Fever

    Dengue, Zika, Chikungunya, & Yellow Fever

    This is public enemy #1!
    Aedes aegypti. Know it and squish it!

    There are over 3,000 species of mosquitoes. A fact I think proves there’s no benevolent deity.

    This post is a run down of the basic info on the common mosquito born diseases in Brazil: dengue, zika, chikungunya, and yellow fever. It’s essential information if you’re visiting.

    Because the mosquitoes are winning.

    Last year in the wake of zika and the microcephaly epidemic in Brazil, the federal government mobilized troops to patrol for standing water basically declaring war against mosquitoes. The yellow fever outbreak this year is evidence of how well that went in the long term.

    So here’s everything you didn’t want to need to know about mosquito born illnesses in Brazil.

    DENGUE: Let’s start with dengue because it kills the most people every year. I know zika is the Kim Kardashian of the bunch, hogging all the media attention, but dengue is most likely to put you in the hospital. There were roughly 1.5 million registered cases of dengue in Brazil last year and of those 629 died. The severity depends on which of the four strains of the virus you get. The worst causes hemorrhaging, but most people just get incapacitating joint pain and high fever.

    Dengue is usually transmitted through the bite of an infected mosquito, but it can be passed from mother to fetus. The disease is asymptomatic in 40-80% of cases. The incubation ranges from 3 to 14 days.

    Symptoms

    • Sudden high fever
    • Severe headache
    • Severe joint pain
    • Moderate joint pain
    • Severe pain behind the eyes (basically your body will hurt a lot)
    • A skin rash that appears post fever
    • Fatigue
    • Nausea
    • Itching

    The Severe Case Symptoms (everything above plus…)

    • Bleeding from the nose and gums
    • Abdominal pain
    • Vomiting
    • Hypotension
    • Dizziness
    • Breathing difficulty

    In rare cases, sometimes after a second infection, a person can develop dengue hemorrhagic fever which leads to shock and death in 24 hours. Yeah, dengue totally sucks.

    There’s no vaccine. There’s no drug treatment. The only thing to do with dengue is treat the symptoms and be sure not use any aspirin because it increases the risk of hemorrhaging.

    Yeah, they’re all cute and cuddly until one drops dead of yellow fever.

    ZIKA: If you’ve been to Brazil in the last year and sneezed, you might have had zika. Or maybe you didn’t sneeze. You still might have had zika. Most cases are asymptomatic, about 80%.

    Of the most common mosquito borne diseases, zika results in the fewest hospital cases. In 2016 there were 214,193 cases of Zika in Brazil and 3 deaths. The global panic over zika is because of it’s link to microcephaly, a condition that babies develop in utero which prevents the brain and skull from developing normally.

    And let’s be clear. There IS scientific consensus that the zika virus is one of the causes of microcephaly. I believe in the CDC, WHO, and peer reviewed scientific journals. Conspiracy theorists can save themselves time and not bother commenting about genetically altered mosquitos. I will just delete them.

    The fact the disease is asymptomatic in the majority of cases makes it particularly scary for women who are or may become pregnant. It’s possible to have zika and never know until the baby develops complications. Even if you develop symptoms, they’re usually mild.

    Symptoms

    • low grade fever
    • headache
    • skin rash starting on the face and spreading over the body
    • red eyes
    • itching
    • fatigue
    • sore joints

    Less Common Symptoms

    • Muscle pain
    • Swelling
    • Sore throat
    • Vomiting or diarrhea
    • Swelling

    So now pregnant women all over Brazil can worry that their swollen legs and exhaustion is actually zika. Because there wasn’t enough for expectant parents to worry about. Fucking mosquitos.

    There’s no vaccine.

    CHIKUNGUNYA: Unlike zika and dengue, if you get chikungunya, you’ll know. 70% of cases develop symptoms. At least you don’t have to wonder whether or not you need a doctor.

    Last year there were 265,554 cases of chikungunya resulting in 159 deaths, so worse than zika but not as prevalent as dengue.

    Symptoms

    • Sudden onset of high fever
    • Severe joint pain mostly in feet, ankles, hands, wrists

    About the joint pain, almost every case has it and in rare cases it becomes chronic.

    Less Common Symptoms

    • Intense back pain
    • Headache
    • Muscle pain
    • Vomiting
    • Conjunctivitis
    • Fatigue
    • Photophobia
    • Sore throat

    Basically everything hurts like hell.

    Like the others, there’s no vaccine for chikungunya and no treatment beyond treating the symptoms.

    CDC’s risk area for yellow fever in South America

    YELLOW FEVER: The CDC’s website has a map of areas where yellow fever vaccines are recommended. The risk area for Brazil extends just up to the border of our state. So far this year 31 people have died from yellow fever in Esparto Santo. Dear CDC, you need to update your map.

    Yellow fever is typically passed via an infected monkey to mosquito to human, so areas without dense forests were considered safe. The incubation period is 3 to 6 days but most cases are asymptomatic.

    Symptoms

    • Sudden high fever
    • Severe headache
    • Back pain
    • Muscle pain
    • Nausea & vomiting
    • Fatigue
    • Weakness

    After a brief remission, 15% of cases will develop a severe form of the disease.

    Symptoms of Severe Form

    • High fever
    • Jaundice (hence the name)
    • Bleeding
    • Shock
    • Organ Failure

    Of cases that turn severe 20-50% die.

    We got our yellow fever vaccines!

    But good news! There’s a vaccine! Two doses taken ten years apart provide lifetime immunity. Yay science! If you’re thinking about visiting Brazil this year, double check to see if your hotel is located within one of the new expanded risk area. Be sure to use a Brazilian site. Remember, the CDC’s map is out of date.

    Vaccines are being developed for the other three. Several companies will have zika vaccines ready for clinical trials by the end of the year. Late stage clinical trials of dengue vaccines are already underway, and researchers have reported success with initial clinical trials for chikungunya vaccines. Unfortunately, we’re still years away from these vaccines being available to the public.

    In the meantime, don’t cancel your vacation. Just be prepared. Get a yellow fever vaccine. Pack repellent. Sleep with your windows closed and fan on. And for god’s sake, if you see a mosquito, kill it!

  • 10 Tips to Survive Rio de Janeiro

    10 Tips to Survive Rio de Janeiro

    IMG_2008Last week my family and I were waiting in the citizens service area of the US Consulate in Rio de Janeiro, and I overhead a young man pouring out a pretty tragic story to the consulate staff standing opposite the bullet proof glass. He’d been robbed and had lost every single form of id, all his credit cards, and all his cash. He was left with no proof of identity whatsoever.

    My husband and I cringed at the guy’s story. As a woman, I know we shouldn’t blame the victim. A person should be able to walk down any street with his house deed and gold bullion spilling out of his pockets without the threat of violence. But dude! You walked around Rio with all of your documents in your pockets? Come on!

    IMG_1990Because I have been a recently arrived foreigner in Rio without a word of Portuguese other than Obrigada and with the Rio Olympics opening in less than week, I’ve written down some tips to help visitors survive enjoy their time in Rio. The tips are gathered from my own experience in Rio and the advice my Carioca (native of Rio de Janeiro) husband gave me when I first arrived.

    1. Leave Your Passport in the Hotel Safe  Do not walk around Rio with your passport in your back pocket. Take a driver’s license, or even better a student id, just something with a picture and name so that your body could be identified. (I’m not saying you’ll be shot. Even though Rio does have an incredibly high violent crime rate, you’re much more likely to die in a car accident or crushed by a hastily constructed bikeway.)
    2. Carry Cash Only or 1 Credit Card at Most Every touristy area in the world has pickpockets and canceling stolen cards is a major pain. Save yourself the worry. Also, withdraw a bunch of cash at the airport (Don’t carry it all at once or in the same pocket), so you can leave your ATM card back at the hotel too.
    3. Speaking of Cash…Always Have Small Bills  Many taxi drivers will tell you they cannot break a fifty. They will swear to it on their mother’s life, and then demand you pay them with what you have. Unless you enjoy arguing in Portuguese, always have 10s and 20s on you. Small bills are also more convenient for food vendors and stalls in the markets.
    4. Carry a Purse/Backpack But Don’t Put Your Cards or Phone In It  This advice I got from my husband my first day in Rio. Many women in Rio carry dummy purses with an old wallet that has some cash. Their credit card and id are in a back pocket.
    5. Don’t Wear A Lot of Jewelry  I know. We should all be able to wear whatever we want whenever we want, but maybe while on vacation in a foreign country it’s best to accept reality as is and save showy displays of wealth for your home turf. Wearing your gold necklaces and diamond rings will not in anyway improve your trip. Leave them at home. Besides Cariocas are generally a casual beach people. If you want to blend in, you should be going around in shorts and flip flops anyway.
    6. And if you want to Blend in…Sunscreen!  The surest way to find the tourists strolling through Ipanema is to look for the pinkest people. Even though it’s winter in Brazil, last week was 80 in Rio, and the sun was intense. I know. We had to walk around downtown in direct sun with an impatient preschooler. Pack sunscreen (It will be crazy expensive in Rio) and use it.
    7. What You Bring to the Beach: Towel, Flip Flops, and Cash Tucked in Your Bathing Suit  That’s it people. You leave the hotel already in your bathing suit & cover up and carry nothing other than your towel. You can rent chairs and buy snacks on the beach. This was a huge cultural adaptation for me. I come from Atlanta, and my family’s summer trips to the beach involved a cooler, a half dozen canvas totes, and a wheelbarrow. True statement.
    8. The Ocean is For Admiring Not Swimming At this point most people have heard about Rio’s toxic bay and surrounding waters. I do feel a bit like I’m beating a dead horse that died from a super bacteria picked up after drinking out of Guanabara Bay, and I have taken lots of pictures of children playing happily in the water at Ipanema and Leblon beaches. But those local kids have immunity that visitors don’t. If you want to take the very real risk of spending your vacation hydrating on a bathroom floor, then by all means, dive in.
    9. Deet I recommend insect repellent with the highest level of deet that doesn’t immediately give you cancer. Mosquitoes are a problem in Rio. Any exploration around the bay or into the forests around Rio absolutely demands bug spray. You do not want dengue! Sorry…what about zika? Oh sure, zika is terrible if contracted while pregnant for its potential to pass on devastating birth defects. Dengue can straight up kill you. It did kill 843 people in Brazil last year, and this years there’s been about 9 times more dengue cases than zika. Either way, dengue or zika, you’re gonna want to use repellent.
    10. Be Alert Don’t be the idiot that’s so focused on getting the perfect selfie you’ve failed to realize you’re group of obvious tourists is alone on the street. My husband looks over both shoulders every few seconds when walking through Rio out of habit. He’s confirmed this level of vigilance is every bit as exhausting you’d imagine, but he developed the habit after being robbed twice. Just pick a designated driver for your group. Someone who can be in charge of risk management while everyone else has a good time.

    IMG_0033This is the most depressing list of travel advice. I realize that. But before angry Cariocas start posting in the comment stream about the foreigner who doesn’t appreciate their magnificent city, I’m going to do a second post on all the great experiences in Rio. Now that everyone knows how to stay safe, I can recommend awesome things to do with the free time not being used up with emergency trips to the consulate or hospital. Come back on Wednesday for 10 Tips to Enjoy Rio.

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