By: EHJ Gutiérrez
An easy way to empathize with almost any other human is to comment on how annoying flies are. Houseflies are abundant and gross, gnats are annoying, and mosquitoes are more likely to lead to your demise than any other animal on Earth (Figure 1).
We, as a species, have the best reason to be obsessed with finding new ways to eliminate these little bastards. Yet, we have been nearly helpless for thousands of years to prevent against the rampant transmission of mosquito-borne disease. Why is that?
The Aedes aegypti mosquito (the focus of my PhD work) is the primary vector of several viruses including dengue, chikungunya, and yellow fever. The diseases caused by infection with these viruses are considered to be ‘Neglected Tropical Diseases’, or NTDs. These diseases have been, and continue to be neglected for several reasons- One of which is that infection rates tend to be sharply divided along geographic and socio-economic lines. As a result, companies have little economic-incentive to invest in the research, development, and preventative measures that would otherwise protect us from NTDs. The infected just aren’t rich enough! Darn.
Absent the vaccines and curing elixirs we so desperately need, humanity clings to mosquito control. Globally, we (as a species) regularly spray, fog, and dunk pesticides that are effective in selecting against a large proportion of insects (and bats and birds) in pursuit of that elusive moment when we might achieve “mosquito control”. In spite of our insecticides, the recent and nearly unimpeded spread of zika virus throughout the Americas is a giant warning to those of us that feel we have mosquito control under control.
In my view, NTDs are a symptom of a global economic system which requires that a subset of humanity live in perpetual sickness and poverty. For a globalized species to be truly safe from disease, we need to re-create and manage our environments so as to protect our most vulnerable from easily preventable disease. In fact, via comprehensive urban and sub-urban environmental management (aka strong sanitation departments), yellow fever and malaria have been eradicated before; Cuba, 1902 and Panama in 1906.
“The case which I reported on September 26, 1901, was really the last which occurred in Havana. Of course we did not know it at the time, but this case marked the first conquest of yellow fever in an endemic center; the first application of the mosquito theory to practical sanitary work in any disease.” ― William Crawford Gorgas, Sanitation in Panama
“Over a century now after Dr. William Gorgas wiped Yellow Fever out of Havana and Panama, and by that out of an entire continent, and more than half a century after Fred Lowe Soper led the eradication of Anopheles gambiae out of Northeast Brazil, their names are unknown, their carefully-detailed, boots-on-the-ground methods that they described in detail to leave expressly for generations to study and learn from to apply to malaria - and specifically they both had the desire for the destruction of malaria in Africa on their minds - is unread. The mistakes they warned about, the assumptions that they discovered to be useless and ineffectual in the field against disease-bearing mosquitoes are repeated today, while what Gorgas and Soper found to be effective and efficient in real-life conditions are routinely ignored or unknown, avoidable errors blithely doomed to be repeated thanks to modern ignorance of their incredibly important and transformative historical successes in public health. In the battles against malaria, to be ignorant of Gorgas’ and Soper's work in eradicating the mosquito that carries it is to be hobbled by the lack of hard-earned field knowledge, practical and effective discoveries that remain completely relevant and critical to success in eradicating malaria today.” ― T.K. Naliaka
Disease isn’t always complicated. Revolutions in sanitation enabled humanity to live in high-density, urban environments. Forgetting about the importance of those revolutions constitutes a major risk to the stability of our society- and leaves the window wide open for a zombie apocalypse.
Disclaimer: The author was born in Hospital Gorgas, in the former Panama Canal Zone. She owes a huge thanks for her existence to Dr. General William Gorgas’ eradication of mosquito-borne disease in the Panama Canal Zone. Without Dr. Gorgas’ leadership in convincing the U.S. government to invest in the formation and continuous support of the Canal Zone Sanitation Division, the American effort to build the canal would have failed.
Resources
Gorgas, William Crawford. The Work of the Sanitary Department of Havana; With Special Reference to the Repression of Yellow Fever. New York, 1901.
Gorgas, William Crawford. A Short Account of the Results of Mosquito Work in Havana, Cuba. Carlisle Pa., 1903.
Gorgas, William Crawford. A Few General Directions with Regard to Destroying Mosquitoes, Particularly the Yellow Fever Mosquito. Washington: Government Printing Office, 1904.
Isthmian Canal Commission (U.S.). Annual Report of the Isthmian Canal Commission for the Year Ending…. Washington: Government Printing Office, 1906–1914.
Canal Zone. Dept. of Health. Mosquito–Borne Diseases. Washington: G.P.O., 1914.
Gorgas, William Crawford. Sanitation in Panama. New York: D. Appleton, 1915.
Isthmian Canal Commission (U.S.). Health Dept. Population and Deaths from Various Diseases in the City of Panama, by Months and Years, from November 1883 to August 1906: Number of Employees and Deaths from Various Diseases Among Employees of the French Canal Companies, by Months and Years, from January 1881 to April 1904. Washington: G.P.O., 1906.
Le Prince, Joseph Albert Augustin and A.J. Orenstein. Mosquito Control in Panama; The Eradication of Malaria and Yellow Fever in Cuba and Panama. New York: Putnam, 1916.
Nelson, Wolfred. Aperçu de Quelques Difficultés a Vaincre dans la Construction du Canal de Panama. Paris: T. Symonds, [1887].
An easy way to empathize with almost any other human is to comment on how annoying flies are. Houseflies are abundant and gross, gnats are annoying, and mosquitoes are more likely to lead to your demise than any other animal on Earth (Figure 1).
We, as a species, have the best reason to be obsessed with finding new ways to eliminate these little bastards. Yet, we have been nearly helpless for thousands of years to prevent against the rampant transmission of mosquito-borne disease. Why is that?
The Aedes aegypti mosquito (the focus of my PhD work) is the primary vector of several viruses including dengue, chikungunya, and yellow fever. The diseases caused by infection with these viruses are considered to be ‘Neglected Tropical Diseases’, or NTDs. These diseases have been, and continue to be neglected for several reasons- One of which is that infection rates tend to be sharply divided along geographic and socio-economic lines. As a result, companies have little economic-incentive to invest in the research, development, and preventative measures that would otherwise protect us from NTDs. The infected just aren’t rich enough! Darn.
Absent the vaccines and curing elixirs we so desperately need, humanity clings to mosquito control. Globally, we (as a species) regularly spray, fog, and dunk pesticides that are effective in selecting against a large proportion of insects (and bats and birds) in pursuit of that elusive moment when we might achieve “mosquito control”. In spite of our insecticides, the recent and nearly unimpeded spread of zika virus throughout the Americas is a giant warning to those of us that feel we have mosquito control under control.
In my view, NTDs are a symptom of a global economic system which requires that a subset of humanity live in perpetual sickness and poverty. For a globalized species to be truly safe from disease, we need to re-create and manage our environments so as to protect our most vulnerable from easily preventable disease. In fact, via comprehensive urban and sub-urban environmental management (aka strong sanitation departments), yellow fever and malaria have been eradicated before; Cuba, 1902 and Panama in 1906.
“The case which I reported on September 26, 1901, was really the last which occurred in Havana. Of course we did not know it at the time, but this case marked the first conquest of yellow fever in an endemic center; the first application of the mosquito theory to practical sanitary work in any disease.” ― William Crawford Gorgas, Sanitation in Panama
“Over a century now after Dr. William Gorgas wiped Yellow Fever out of Havana and Panama, and by that out of an entire continent, and more than half a century after Fred Lowe Soper led the eradication of Anopheles gambiae out of Northeast Brazil, their names are unknown, their carefully-detailed, boots-on-the-ground methods that they described in detail to leave expressly for generations to study and learn from to apply to malaria - and specifically they both had the desire for the destruction of malaria in Africa on their minds - is unread. The mistakes they warned about, the assumptions that they discovered to be useless and ineffectual in the field against disease-bearing mosquitoes are repeated today, while what Gorgas and Soper found to be effective and efficient in real-life conditions are routinely ignored or unknown, avoidable errors blithely doomed to be repeated thanks to modern ignorance of their incredibly important and transformative historical successes in public health. In the battles against malaria, to be ignorant of Gorgas’ and Soper's work in eradicating the mosquito that carries it is to be hobbled by the lack of hard-earned field knowledge, practical and effective discoveries that remain completely relevant and critical to success in eradicating malaria today.” ― T.K. Naliaka
Disease isn’t always complicated. Revolutions in sanitation enabled humanity to live in high-density, urban environments. Forgetting about the importance of those revolutions constitutes a major risk to the stability of our society- and leaves the window wide open for a zombie apocalypse.
- EHJ Gutiérrez
Disclaimer: The author was born in Hospital Gorgas, in the former Panama Canal Zone. She owes a huge thanks for her existence to Dr. General William Gorgas’ eradication of mosquito-borne disease in the Panama Canal Zone. Without Dr. Gorgas’ leadership in convincing the U.S. government to invest in the formation and continuous support of the Canal Zone Sanitation Division, the American effort to build the canal would have failed.
Resources
Gorgas, William Crawford. The Work of the Sanitary Department of Havana; With Special Reference to the Repression of Yellow Fever. New York, 1901.
Gorgas, William Crawford. A Short Account of the Results of Mosquito Work in Havana, Cuba. Carlisle Pa., 1903.
Gorgas, William Crawford. A Few General Directions with Regard to Destroying Mosquitoes, Particularly the Yellow Fever Mosquito. Washington: Government Printing Office, 1904.
Isthmian Canal Commission (U.S.). Annual Report of the Isthmian Canal Commission for the Year Ending…. Washington: Government Printing Office, 1906–1914.
Canal Zone. Dept. of Health. Mosquito–Borne Diseases. Washington: G.P.O., 1914.
Gorgas, William Crawford. Sanitation in Panama. New York: D. Appleton, 1915.
Isthmian Canal Commission (U.S.). Health Dept. Population and Deaths from Various Diseases in the City of Panama, by Months and Years, from November 1883 to August 1906: Number of Employees and Deaths from Various Diseases Among Employees of the French Canal Companies, by Months and Years, from January 1881 to April 1904. Washington: G.P.O., 1906.
Le Prince, Joseph Albert Augustin and A.J. Orenstein. Mosquito Control in Panama; The Eradication of Malaria and Yellow Fever in Cuba and Panama. New York: Putnam, 1916.
Nelson, Wolfred. Aperçu de Quelques Difficultés a Vaincre dans la Construction du Canal de Panama. Paris: T. Symonds, [1887].