Cuba's Health Crisis Intensifies with Overlapping Mosquito-Borne Viruses Unacknowledged by the Regime

Cuba is currently grappling with one of its most intricate epidemiological crises in recent years, characterized by the simultaneous circulation of three mosquito-borne viruses—dengue, chikungunya, and Oropouche. This situation, referred to by international experts as "combined arbovirosis," is not officially acknowledged by Cuba's Ministry of Public Health (MINSAP), which has yet to adjust its monitoring and treatment protocols to address this emerging threat.

Since July, the province of Matanzas has emerged as the epicenter of a sustained wave of infections that have spread across various provinces in the western and central regions of the country. Although authorities have admitted to "active dengue transmission" in seven provinces, they have refrained from acknowledging the presence of other viruses, despite medical and community reports describing unusual symptoms and prolonged fever episodes.

The Overlapping Threat of Three Viruses

Dr. Francisco Durán, the national director of Epidemiology, has publicly acknowledged cases of chikungunya and suspicions of the Oropouche virus in certain areas of Matanzas. However, the official narrative continues to treat each outbreak in isolation, hindering the understanding of the full scope of the crisis and limiting the healthcare response on the ground.

Dengue, chikungunya, and Oropouche are arboviruses—transmitted by arthropods like the Aedes aegypti and Culicoides paraensis mosquitoes—that exhibit similar clinical symptoms: fever, muscle pain, intense headaches, skin rashes, and general weakness. This similarity makes it challenging for doctors to differentiate among them without specific tests, which are virtually impossible in Cuba due to the lack of reagents and basic laboratory equipment.

In hospitals in Cárdenas and Colón, medical professionals have reported the absence of essential blood tests necessary to detect early signs of severe dengue, a claim that authorities have attempted to refute. "We are treating patients with high fever without being able to confirm whether it's dengue, chikungunya, or something else," a healthcare worker told CiberCuba anonymously. "Without a diagnosis, we're treating them blindly."

The Challenge of Combined Arbovirosis

This deficit is compounded by the scarcity of essential medicines, from pain relievers and intravenous fluids to basic antihistamines. Additionally, fumigation efforts are sporadically stalled due to shortages of fuel, insecticides, and volunteer manpower, which the regime admits are at "critical levels."

Although the term "combined arbovirosis" is absent from Cuban official discourse, it is well-documented in international scientific literature. It describes scenarios where multiple mosquito-borne viruses circulate concurrently within a population or infect the same individual simultaneously.

A global review published in ScienceDirect, titled "Global prevalence of dengue and chikungunya coinfection," confirms numerous clinical cases of dengue-chikungunya coinfections and warns that their actual incidence is underestimated due to a lack of differential diagnosis in resource-poor countries.

Medical Implications and Resource Limitations

Another study in PLOS Biology highlights that the cocirculation of viruses transmitted by Aedes aegypti presents an overlooked public health challenge that can disrupt outbreak dynamics and clinical outcomes. Research conducted on the Colombia-Venezuela border revealed the simultaneous presence of dengue, chikungunya, and Zika in patients with acute fever, while studies in Brazil confirmed the coexistence of multiple arboviruses within the same neighborhood.

Laboratory findings show that these viruses can interact, either enhancing or inhibiting each other based on the order of infections. A study from Frontiers in Cellular and Infection Microbiology demonstrated that prior chikungunya infection could partially suppress dengue replication in human cells, while the reverse—dengue preceding chikungunya—could exacerbate symptoms.

Clinically, combined arbovirosis increases the severity of feverish illnesses and complicates medical responses. Studies in Colombia found that up to 22% of hospitalized children diagnosed with dengue also had chikungunya infections. Coinfected patients may experience persistent fever, bleeding, rashes, debilitating joint pain, and liver or central nervous system disturbances.

Without laboratory tools, differentiating between severe dengue and complex viral coinfections is impossible, potentially leading to inappropriate or delayed treatments. In Cuba, these limitations are glaringly apparent. The hospital network lacks molecular testing (PCR) for arboviruses, and research centers capable of conducting such tests, like the Institute of Tropical Medicine "Pedro Kourí," operate with minimal resources and cannot cover the entire nation.

Inadequate Conditions for an Effective Response

Internationally recommended measures to contain viral cocirculation are not feasible in the current Cuban context. Mass fumigation is sporadic or non-existent in many areas due to a lack of insecticides and fuel. Vector control programs operate with reduced brigades and without consistent technical oversight.

In hospitals, shortages of basic medications like paracetamol, oral rehydration salts, or intravenous solutions hinder the proper management of feverish patients. Public health education campaigns are unsustainable, and there are no integrated surveillance systems for the three viruses.

Meanwhile, the official discourse reduces the entire issue to dengue, disregarding that the Aedes aegypti—prevalent throughout the country—can transmit more than one virus simultaneously. This lack of acknowledgment prevents the development of unified protocols for diagnosis, isolation, and treatment, leaving doctors and patients vulnerable to a silent and more dangerous epidemic.

Scientific consensus affirms that the cocirculation of arboviruses is a real biological and epidemiological phenomenon, and institutional denial only exacerbates its effects. As concluded in the PLOS Biology review, "the lack of multipathogen surveillance can hinder early detection of coinfections and delay public health responses."

In Cuba, where information is centralized and health reports are delayed, this warning takes on heightened significance. Each week without diagnosis or effective fumigation is time gained by mosquitoes and lost by public health. Recognizing the existence of a combined arbovirus crisis is not merely a semantic issue; it is the first step in addressing a reality already affecting thousands of Cubans. As long as the country continues to treat dengue as an isolated problem, the virus—and its counterparts—will continue to spread invisibly and in combination throughout the archipelago.