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The number of confirmed cases of Zika continues to climb in Central America and the Caribbean, except for Cuba. Cuban officials say that only three people there have contracted the virus from local mosquitoes.
And they credit the communist island's extensive health care system and intensive spraying against the insect. NPR's Carrie Kahn reports on the successful Cuban effort and why it isn't easy for other countries in the region to emulate.
CARRIE KAHN, BYLINE: Dionis Perez is one of hundreds of fumigators deployed around the island. He takes his job seriously. Check out his weapon of choice in the fight against Zika.
DIONIS PEREZ: (Speaking Spanish).
PEREZ: (Speaking Spanish).
KAHN: "It's called a bazooka," he says without cracking a smile. It's quite the crude contraption - looks sort of like a leaf-blowing machine with two small tanks strapped to the sides wrapped in chicken wire.
(SOUNDBITE OF ENGINE PUMPING)
KAHN: Perez pumps the engine a bit. Then he's off.
(SOUNDBITE OF FUMIGATOR)
KAHN: The grassy corner of this quiet Havana neighborhood is quickly engulfed in a white, thick cloud. Perez says he hits about a hundred houses on a good day. If someone refuses to let him fumigate, he writes them up. And they get a visit from a supervisor and a stiff fine. Anyone who reports to the local doctor with a fever also gets a visit from Perez.
PEREZ: (Speaking Spanish).
KAHN: "We'll go to the house of the person with the fever and fumigate inside and out and then all the houses on that block," he says. Cuba deployed thousands of military reservists across the island to fumigate homes and buildings since last February. It also sent workers door to door to seek out mosquito breeding grounds and educate citizens about prevention.
Three cases of Zika transmitted by local mosquitoes have been reported, as well as another 30 in people who contracted Zika in other countries before coming to Cuba. That's a fraction compared to the thousands of cases in nearby Honduras and Puerto Rico.
Carlos Espinal, director of the Global Health Consortium at Florida International University in Miami, says Cuba's approach is very different than that of other Latin American countries or even the United States.
CARLOS ESPINAL: We wait until we see the cases to start the intervention. And they do the opposite.
KAHN: Cuba's one-party system and massive surveillance apparatus, including community watch captains and a doctor in every neighborhood, has helped the state control Zika outbreaks. But it isn't one that can be easily replicated in neighboring democratic countries.
Zika outreach worker Josvani Burnett cuts a path through the tall grass surrounding an abandoned home in the southern city of Cienfuegos.
JOSVANI BURNETT: (Speaking Spanish).
KAHN: "The mosquitoes get in the grass. And who knows what's under there?" says Burnett. "Now that it's started raining, there could be standing water - perfect for the insects to breed," he adds. He makes a notation on his clipboard. He'll have workers come cut the grass and then fumigate.
World Health Organization director in Cuba Cristian Morales says Cuba's fight against Zika is admirable. He says it's unclear, though, how long they can keep it up.
CRISTIAN MORALES: We will see more cases coming. It's impossible to avoid.
KAHN: The country is facing tough economic times, as Venezuela, its main benefactor, has cut generous subsidies to Cuba. Leader Raul Castro has warned citizens that more belt tightening is coming. Zika worker Burnett says, now is not the time to let our guard down.
BURNETT: (Speaking Spanish).
KAHN: "If we do," he says, "then in one month, we'll have Zika all over here." Carrie Kahn, NPR News, Cienfuegos, Cuba. Transcript provided by NPR, Copyright NPR.