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    Puerto Rico Without DEET? What Was I Thinking?

    mosquitos 3 stages version 2

    By Brenda Goodman
    WebMD Health News

    Editor’s note: WebMD senior writer Brenda Goodman is following CDC Director Tom Frieden’s visit to the island territory in response  to the growing threat of Zika virus infections there.

    I’m in Puerto Rico, and I’m kicking myself.

    I’m here to cover the visit of CDC Director Tom Frieden, MD, to the Commonwealth, which officially starts today.

    He’ll be touring the agency’s emergency operations center, which has been on high alert since Puerto Rico’s governor declared the Zika virus to be a public health emergency in February.  He’ll also make stops at the CDC labs where Zika and dengue, another mosquito-borne virus, are studied.

    Mosquitoes are no idle threat here. Dengue fever causes a sudden fever, joint pain and other utterly miserable and lay-you-flat-on-your-back-in-bed symptoms.  Most people are OK after a single bout. But get it a second time, like my colleague, WebMD Medical Editor Brunilda Nazario, MD, who is Puerto Rican, and you risk serious complications like a stroke or even death.

    I knew all of this. I even brought two bottles of DEET with me. But somehow I neglected to put it on.

    I had what I’m sure are the usual excuses. I was on an airplane and in airports.  No mosquitoes there, I thought. I’m busy running around and trying to navigate my way around a huge city, but I’m mostly in cars and buildings.

    And that’s where I made my mistake.

    Mosquitoes haven’t caused a major disease outbreak in the U.S. since the 1850s with malaria.  Even Florida hasn’t seen really widespread mosquito-borne disease since the 1930s, when the state had more than a thousand cases of dengue fever.

    We haven’t had to fear mosquitoes in the U.S. — really fear them — for a long time.

    And like most Americans, I’m not used to thinking of mosquitoes as an indoor pest. But the mosquitoes that spread Zika, dengue and another awful virus called chikungunya, live indoors, right alongside people.

    Jonathan Day, PhD, a professor at the University of Florida, told me they lay their eggs in sink drains and potted plants.  He used to do studies in Puerto Rico where he would go into homes with a big vacuum device to collect mosquitoes.

    He told me he always found them in two places—in closets, where they can rest in the dark and damp, and under couches.  A couch, he said, is a great deal for a mosquito. All they have to do is wait for someone to come home and turn on the TV.

    What’s worse, the mosquitoes that live here have become resistant to permethrin, the spray that street crews are using to try to kill them.  It doesn’t kill them anymore.

    The CDC is urgently testing other chemicals to try to find an alternative.

    Zika has been tied to a birth defect called microcephaly in babies of infected pregnant women. It causes babies to be born with abnormally small heads and can be fatal or result in lasting brain damage. With the rainy season just a few months away, and 36,000 pregnant women on the island, the threat couldn’t be more real for Puerto Ricans or the challenge more daunting.

    As for me, I put my DEET on this morning as soon as I stepped out of the shower. Long sleeves, long pants. And hopefully I’ll make it back home no worse for wear.


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