Biting Back at Dengue — Another Way to Break the Cycle

In an earlier post, I looked at how Dengue is still here, and what our earlier work on dengue epidemiology might still contribute.  Researchers in Australia have developed a new way to intervene in the re-enforcing cycle of mosquitoes getting infected with dengue and spreading it by biting other people.  They inject a common natural bacterium called Wolbachia into the mosquito population, and this bacterium keeps the mosquitoes from spreading dengue.  You can see a cool 3-minute video of how this works.

From our systems-modeling perspective of the dengue epidemiology, work we did at the Mexican Secretariat of Health in 1995, this Wolbachia intervention breaks the link between the “Contagious Mosquito” biting the “Susceptible Person.”  This stops the “Epidemic Spread” feedback loop, without having to deal with the other “Vector Control Intervention Loops.” For details of how to read the following systems map of the dengue epidemiology, click here.

Dengue Systems Map

Dengue — A New Problem, Once Again, Again

Dengue persists, as does the multitude of very expensive solutions, such as today’s news about Brazilian mosquito factories. While many solutions are required to fight this huge problem, I still see that we lack an integrated, systems-level view of what is happening epidemiologically, how to address it, and how to communicate the required multi-pronged approach to the large communities where it hits.

I offer an example in the earlier blogpost below of how we attempted to understand, intervene, and communicate a systemic, multi-pronged approach to dengue in Mexico in the 1990s.

Jim Ritchie-Dunham

Dengue is back, with a vengeance, again.  “Dengue has emerged as a worldwide problem only since the 1950s…With more than one-third of the world’s population living in areas at risk for transmission, dengue infection is a leading cause of illness and death in the tropics and subtropics. As many as 100 million people are infected yearly. Dengue is caused by any one of four related viruses transmitted by mosquitoes. There are not yet any vaccines to prevent infection with dengue virus (DENV),” says the dengue website for the Centers for Disease Control and Prevention.

That dengue is back suggests that we have to learn again how to deal with it.  Much recent research is trying to understand why dengue is making inroads into the US, and what to do about a virus that makes mosquitoes better spreaders of dengue.  The Institute for Strategic Clarity made a small…

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Dengue — A New Problem, Once Again

Dengue is back, with a vengeance, again.  “Dengue has emerged as a worldwide problem only since the 1950s…With more than one-third of the world’s population living in areas at risk for transmission, dengue infection is a leading cause of illness and death in the tropics and subtropics. As many as 100 million people are infected yearly. Dengue is caused by any one of four related viruses transmitted by mosquitoes. There are not yet any vaccines to prevent infection with dengue virus (DENV),” says the dengue website for the Centers for Disease Control and Prevention.

That dengue is back suggests that we have to learn again how to deal with it.  Much recent research is trying to understand why dengue is making inroads into the US, and what to do about a virus that makes mosquitoes better spreaders of dengue.  The Institute for Strategic Clarity made a small contribution to the practice of working with the epidemiology of dengue back in the 1990s, as part of its work with the Mexican Secretariat of Health.  Two published papers described a simulator we developed on the Advisory Board to the Secretary of Health, in which the epidemiologists were able to simulate the conditions at the onset of the dengue epidemic and the impact of different intervention strategies.  Maybe this simulator could be useful again to those trying to understand the dynamics of dengue intervention.  It helped us in Mexico in the 1990s.

You can download for free:

  • the dengue simulator we used (click here), and the free iThink software to run the simulator (click here)
  • a technical paper describing the context in which we developed and used the simulator, along with the code for the simulator (click here)
  • a paper, in Spanish, about the experience from the Secretariat’s perspective (click here)

Managing from Clarity: Identifying, Aligning and Leveraging Strategic Resources

Past-cast Series — Seeing relevance in earlier publications

Ritchie-Dunham, James, and Hal Rabbino. 2001. Managing from Clarity: Identifying, Aligning and Leveraging Strategic Resources, Chichester: Wiley.

In searching for the organizational ‘magic’ that makes some businesses thrive and other fail, management gurus, academic seers and business leaders strive to articulate a single reason for success. Managers are then faced with analyzing numerous findings and trying to integrate the best elements from each view that makes sense to them.

Managing from Clarity integrates the different views into one, streamlined structure which includes organizational as well as operational dynamics and moves it into the realm of strategic management. A host of tools and processes are presented, which offer leaders the means to make informed and deeply thought decisions on how best to balance multiple strategic issues. This books shows managers how to:  describe an individual’s mental map of the world as a basis for decision-making; clearly articulate and map key relationships across the entire organization; describe the basis for developing a common, systemic platform for communication of strategic issues; provide a rigorous and straightforward method for testing strategic hypotheses; identify the essential strategic resources within a firm; and so harness the enormous potential for performance improvement that comes from integrating and aligning the mental methods of the individuals of the firm around the global goals of the organization.

Evaluating Epidemic Intervention Strategies with Systems Thinking: A Case Study of Dengue in Mexico

Past-cast Series — Seeing relevance in earlier publications

Ritchie-Dunham, James and Jorge Mendez Galvan. 1999. Evaluating Epidemic Intervention Strategies with Systems Thinking: A Case Study of Dengue in Mexico, System Dynamics Review, 15(2), 119-138.

In developing national epidemiological control strategies, understanding the environment in which an epidemic develops, the complex interrelationships of the relevant variables and their resulting behavior requires responsible health decision makers to develop comprehensive, effective policies. Systemic decision models can help managers understand the impact of alternative strategies for addressing disasters such as national epidemics. This paper discusses an interactive, systemic decision model developed in the Secretariat of Health of Mexico, at the advisory level, highlighting how the change in decision-making perspective provided valuable insight into strategically managing the control of dengue, a potentially catastrophic epidemic.

Las Organizaciones Inteligentes en la Toma de Decisiones en Salud: El Caso del Dengue

Past-cast Series — Seeing relevance in earlier publications

Ortiz-Quesada, Federico, Jorge F. Méndez-Galvan, James Ritchie-Dunham, F. Javier Rosado-Muñoz. 1999. Las Organizaciones Inteligentes en la Toma de Decisiones en Salud: El Caso del Dengue, Salud Pública Méx, Vol. 37(sup 1):77-87.

An article I co-authored (1995) on organizational learning at the Mexican Secretariat of Health, when dealing with dengue.

Las Organizaciones Inteligentes (OI) son un instrumento de gran ayuda para organizar y conducir acciones de vigilancia, prevención y control. Son tecnología de punta en la administración; permiten generar esquemas del comportamiento de estructuras y políticas de organizaciones, describen sistématicamente problemas e integran modelos computarizados. Con esto se desarrollan pensamientos sistémicos; producen una visión compartida; crean modelos mentales de aprendizaje y superación continuos; se aprende en equipo; y se mejora el dominio personal. El avance científico-tecnológico ha producido una información impresionante en medicina, concomitante crecimiento de sus organizaciones y dificultad en las respuestas debido a cambios e innovaciones repentinos y constantes; por ello se justifican las oi. Este trabajo está orientado a probar la utilidad de la tecnología de oi en el ordenamiento y sistematización de la información sobre los acontecimientos de las ciencias médicas. Se seleccionó el dengue para ejemplificar la aplicación de dicha tecnología porque representa un problema de creciente importancia en el continente y en México, es complejo, puede evolucionar a formas de mayor gravedad en la población y es factible de analizarse en forma sistémica.