When summer hits, mosquitoes sting. Amira El-Noshokaty goes out mosquito busting Click to view caption On a typical midsummer's night, it is not only the heat that can get to you; there are those tiny noisy creatures that suck your blood, tattoo your body with unsightly red spots and despite all your efforts to rid the world of their noise, they buzz brazenly around your ears, all night long: mosquitoes. The fact that one female mosquito, after having had its blood meal, will produce 250 eggs is disheartening. "Mosquitoes like other creatures multiply in hot environments," explained Maher El- Nawawy, head of the Vector Control Department at the Administration of Health Affairs, Cairo Governorate. "Their medium is stagnant water, whether in a basement, building shafts, or a small garden," he added. El-Nawawy heads a year-round programme by the Cairo Governorate to spray places where mosquitoes lay their eggs, focusing on areas where there is stagnant water. But that is not the only effort to rid the city of the pesky little insects. Another programme targets mosquitoes that have reached puberty by spraying a white fog-like insecticide from vans that roam the capital's streets. "The best time for spraying is before sunset when the insects are out. The best equipment is the fogging tank that is used to spray entire neighbourhoods. We use this technique from April through October. During those months, Cairo's 30 districts are sprayed once a week using our 33 fogging tanks," continued El- Nawawy. The insecticide used -- chosen after the approval of the World Health Organisation (WHO) and the Ministry of Health and Population -- aims to knock out the nervous system of the mosquito. This year, however, a common complaint has been that the mosquito population is more ferocious than ever. According to Atef Mohamed, a taxi driver who lives in the greater Cairo Ezbet Al- Nakhl district, the mosquito population is on the rampage. "Mosquitoes in my district are not limited to a specific season. They are a year- round phenomenon and we have learned not to open windows after sunset. They even come out of the drains," complained Mohamed who scoffed at the mention of the insecticide tanks. "Let me put it this way: if there were garbage trucks in our neighbourhood, then there would be no need for fogging tanks." He went on to point out that the clinics of Ezbet Al- Nakhl are crowded with children who suffer from respiratory problems from the excessive use of insecticides to kill mosquitoes. "We have complained to the Ministry of Environmental Affairs about the stagnant water in our area. The district authorities have promised to get rid of the garbage, but it is still there." According to the government, however, city inhabitants are culpable, at least in part, for the mosquito menace, having created the piles of garbage and pools of stagnant water in the first place. Manshiet Nasser, Al-Marg and Helwan are cited as examples of areas where there is a high density of mosquitoes. But then how to measure the mosquito population? "I cannot count them for you," quipped the governorate's El-Nawawy. The extent of mosquitoes' immunity to a given spray is, however, measurable. The governorate stopped using a brand called Jockey Plus this year when it became clear that mosquitoes are no longer affected by it. Now Cloro-Larva is the brand of choice. There are natural mosquito repellents, too, and certain kinds of trees seem to keep the insects at bay. "We are researching the possibility of using such trees," added El- Nawawy, "Currently we are using Gambusia fish which feed on the mosquito larvae in fresh water. This is what we call biological control," he noted. "This year Cairo's mosquito population has decreased by 20 per cent. We measure the density of mosquitoes, which varies from one area to the other and over time in a single area. We measure it in the water, where the average is a hundred larvae per square-foot." It is an ongoing and important battle, however, because mosquitoes are not just annoying -- they are a health hazard. According to Dr Hussein Kamal, director of Malaria, Filarial and Leish Control Department at the Ministry of Health and Population, there are two types of mosquitoes: the Anopheles that cause Malaria, and the Culex which is prevalent in Egypt, particularly outside of Cairo. This is the mosquito that causes lymphatic filariasis known commonly as elephantiasis. According to WHO, the thread-like, parasitic filarial worms that cause lymphatic filariasis live almost exclusively in humans. They live for years, producing millions of immature microfilariae that circulate in the blood and are picked up by mosquitoes that in turn transmit the infections to others. The Culex is commonly found in places where there are lots of ditches and swamps. In 1976 lymphatic filariasis cases in Qalyoubia, Al-Menoufia, Kafr Al-Sheikh, Assuit and Giza, ranged from 18 to 20 per cent of the populations. In 1999 the incidence dropped to about two to five per cent. The decrease is an indication of the success of both treatment of the disease and mosquito control practices. "It is very difficult to trace this disease because the symptoms only manifest themselves nine to 12 years later," explained Kamal to Al-Ahram Weekly, pointing out, "We used to sample blood, but the disease is in the blood stream only at night from 10pm to 2am." According to WHO, elephantiasis and lymphoedema are the most commonly recognised consequences of lymphatic filarial infection. Genital damage, especially hydrocoele (fluid-filled, balloon-like enlargement of the sacs around the testes) and elephantiasis of the penis and scrotum in men, and of the breasts in women, occurs much more frequently, but is generally kept hidden. More common, but only recently recognised, is the hidden damage to the kidneys and the lymphatic systems of infected individuals. Since 1976 a national health programme has been taking blood samples and treating those infected, with diethylcarbamazine pills, also known as DEC or by its trade name Hitrazen. In 2000, WHO picked Egypt as a leading country in combating lymphatic filariasis and joined the government in a new two-pronged programme: mass administration of drugs, where the population at risk is given an annual dosage of 99 per cent effective medicine starting two years of age and palliative treatment for those for whom the disease has already reached a late stage. "In the first year of the implementation of the new programme, which began in September 2000, we targeted 1,008,300 people. In September 2001, our goal became 2,330,000 people. In September 2002, we will target 2,500,000. Today, I can tell you, we have reached 95 per cent of our targeted population, surpassing WHO's predictions by 15 per cent," explained Kamal. As for the other kind of mosquitoes -- the Anopheles -- which causes malaria, there is not much information on it in Egypt, giving the impression that it is not present here. And while the mosquito-busters will be busy keeping the breeding grounds in control, one is left with the conventional options of putting screens on windows, wearing long sleeves, using insecticides and mosquito repellents as well as lemon scent which is an excellent natural repellent.
