'People are very scared': fighting dengue fever in Brazil – in pictures

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Dengue fever is one of the most deadly mosquito-borne diseases – half the world’s population is at risk from it. Adrienne Surprenant’s photos from the World Mosquito Program in Brazil capture the fight against it

Main image: A child waiting to be vaccinated as part of the TV003 dengue vaccine trial Photograph: Adrienne Surprenant/Collectif © Wellcome

  • The breeding section at the World Mosquito Program (WMP) in Brazil produces mosquitoes that carry Wolbachia bacteria, which reduces their ability to transmit viruses such as Zika, dengue, chikungunya and yellow fever. Wolbachia are naturally occurring bacteria found in 60% of all insect species and are safe for humans, animals and the environment.• The winner of the 2019 Wellcome photography prize will be announced on 3 July, and will be on show with the shortlisted entries and Adrienne Surprenant’s commission at the Lethaby Gallery London N1C, from 4-13 July 2019.
    The breeding section at the World Mosquito Program (WMP) in Brazil produces mosquitoes that carry Wolbachia bacteria – this means they have a reduced ability to transmit viruses like Zika, dengue, chikungunya and yellow fever. Wolbachia are naturally occurring bacteria found in 60% of all insect species, and are safe for humans, animals and the environment.

  • The WMP in Brazil produces nearly 2bn Wolbachia mosquitoes a week in their Rio de Janeiro laboratory. Brazil had 1.6m cases of dengue in 2015, with 800 deaths reported between 2009 and 2014. It was also the country most severely affected by the Zika epidemic in 2016.
    The WMP in Brazil produces nearly two billion Wolbachia mosquitoes a week in their Rio de Janeiro offices. Brazil had 1.6m cases of dengue in 2015, with 800 deaths reported between 2009 and 2014. It was also the country most severely affected by the Zika epidemic in 2016.

  • Marcos, who has been working with the WMP for a year, releases Wolbachia mosquitoes in Niterói. His car contains 900 tubes that he releases every 50 metres. Mosquitoes carrying Wolbachia are less able to transmit dengue, and, over time, they breed with the wild mosquito population, leading to a decrease in the spread of infection.
    Marcos, who has been working with the World Mosquito Programme for a year, releases Wolbachia mosquitoes in Niteroi. His car contains 900 tubes that he will release every 50 metres. Mosquitoes carrying Wolbachia are less able to transmit dengue, and, over time, they breed with the wild mosquito population, leading to a decrease in the spread of infection.

  • Camila Camarjo, 28, and Igor Silva, 30, work with the WMP as scientific communicators. On St Sebastian’s Day, they have a stand to explain the Wolbachia method of control to people. “For me, it’s more than just a job,” Igor says. “It’s a battle for a better future.” But lots of people ask him: “We already have so many mosquitoes – why add more?”
    20/01/2019: Camila Camarjo, 28, and Igor Silva, 30, work with the World Mosquito Program as scientific communicators. On the day of Saint Sebastian, the patron saint of Rio de Janeiro, they have a stand to explain to people the Wolbachia method of control. Igor says: “For me it’s more than just a job, it’s a battle for a better future.” But lots of people ask him: “We already have so many mosquitoes, why add more?”

  • Renan Perreira distributes pamphlets at the church of St Sebastian to worshippers visiting on the feast day of the patron saint of Rio de Janeiro.
    20/01/2019: Renan Perreira distributes pamphlets in front of the church of Saint Sebastian to worshippers visiting the church on the day of the patron saint of Rio de Janeiro

  • A health visitor in Vila Kennedy goes door to door to provide care and carry out check-ups. Vila Kennedy is one of the most dangerous favelas in Rio. Shootings happen almost every day and, located in a valley that is up to three degrees warmer than the rest of Rio de Janeiro, it is a hotspot for dengue.
    A health agent in Vila Kennedy goes door to door to provide care and carry out check-ups. Vila Kennedy is one of the most dangerous favelas in Rio. Shootings happen almost every day and, located in a valley that is up to three degrees warmer than the rest of Rio de Janeiro, it is a hotspot for dengue.

  • Juliana has brought her children, Enzo, 4, and Victor, 2, to a clinic to be vaccinated as part of the dengue vaccine trial. The TV003 dengue vaccine is being tested in 17 of Brazil’s 27 states, the last phase is now being conducted in Rio on children.
    Juliana has brought her children, Enzo, 4, and Victor, 2, to the Clinica da Familia Armando Palhares Aguinaga be vaccinated as part of the dengue vaccine trial. The TV003 dengue vaccine is being tested in 17 of Brazil’s 27 states, the last phase is now being conducted in Rio on children.

  • Enzo sits on his mother’s lap to be vaccinated, while Victor plays with a Minion.
    Enzo sits on his mother’s lap to be vaccinated, while Victor plays with a Minion.

  • Andrea Silva Borda Nascimento had her three children vaccinated as part of the dengue vaccine trial. “We have a family history. I had dengue, and my son Zika. In our apartment block, out of four families and a total of 18 people, eight had dengue. As the vaccine has already been tested for years, I was confident it could be good,” she says. “But people are very scared of dying from the vaccine or it having any side-effect.”
    Silva Borda Nascimento got her three children vaccinated as part of the TV003 dengue vaccine trial. “We have a family history. I had dengue, and my son Zika. In the apartment block, out of 4 families and a total of 18 people, 8 had dengue. As the vaccine has already been tested for years, I was confident it could be good. But at first I thought it was for everything, dengue, Zika and chikungunya!. I talked about the programme but people are very scared of dying from the vaccine or it having any collateral effect.”

  • Micaelly, 11, Rafaella, 6, and Ana Clara, 7, also participated in the vaccination trial. Their mother admits she was very scared until a week had passed and none of them had problems. Their grandmother remains furious, saying the parents used their children as “guinea pigs”.
    23/01/19: Micaelly, 11, Rafaella, 6, and Ana Clara, 7, also participated vaccination trial. Their mother admits she was very scared until the week after, when none of them had problems. Their grandmother remains furious, saying the parents used their children as “guinea pigs”.

  • Fabiola holds her son on the porch where she was shot while pregnant with him three years ago. She was rushed to a health centre, where she remembers waking up in a pool of blood. She named the boy Moises, “as he too had crossed a bloody river”. Now Fabiola is worried because the closest public health clinic is closing due to funding cuts, and the private clinics are unaffordable. “What will I do if I have an emergency?” she asks.
    29/01/2019: Fabiola holds her son on the porch where she was shot while pregnant with him three years ago. She was rushed to a health centre, where she remembers waking up in a pool of blood. She named the boy Moises, “as he too had crossed a bloody river”. Now, Fabiola is worried because the closest public health clinic is closing due to funding cuts, and the private clinics are unaffordable. “What will I do if I have an emergency?” she asks. Almost everyone in her building has suffered from a virus transmitted by mosquitoes and they will be even more vulnerable without access to healthcare.

  • Karine Avelino da Silva, 23, has been sick for a day. She has headaches behind her eyes (a symptom of dengue), fever and her stomach hurts. She has come to the Barra health centre to be examined. Everyone in her house, and some neighbours, had the Chikungunya virus (transmitted by mosquitoes) a few months ago.
    31/01/2019: Karine Avelino Da Silva, 23, has been sick for a day. She has headaches behind her eyes (a symptom of dengue), fever, and her stomach hurts. She has come to the Health Center Barra to be examined. Everyone in her house, and some neighbours, had the Chikungunya virus (transmitted by mosquitos) a few months back. Health services are free in Brazil.
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