Impact of an outbreak of dengue fever: A case study from rural Puerto Rico

This study documents the impact of an outbreak of dengue fever for the people who experienced the disease in Lares, a rural municipality in Puerto Rico. Symptomatology presented by reported cases of the fever corresponds to the clinical picture of the mild form of the dengue virus. The study utilizes a combined quantitative/qualitative methodological approach. The findings indicate that social status is a significant factor in terms of who is affected by the dengue fever. The impact of the outbreak was greater for poor communities in the urban and semi-rural areas, particularly for women who described themselves as housewives and mothers, and their children. Social expectations and the family's demands for these women to fulfill the role of caretaker superseded their own sick role. In addition, they experienced the greatest loss of time as a consequence of the outbreak The main effect of the outbreak on work activities not traditionally remunerated with money, such as housework, was the inability of adult females in the household to perform their routine activities to maintain family life. Moreover, the monetary costs of health care absorbed a significant percentage of the household weekly income. The impact on psychological well-being was related to the stress produced by the clinical, social, and economic consequences of the outbreak for women. Implications of salient results for dengue fever prevention and control, as well as for the field of applied medical anthropology are discussed.