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Diseases (Flies (Ceratopogonidae (Biting Midges):Control • Personal…

- - - - Visceral
        • (O.W & N.W)
        Symptoms:
         Prolonged Irregular fever
         Hepatomegaly
         Splenomegali
         Anemia , Leukopenia and Thrombocytopenia
         Lymphadenopathy
         Weight loss , Weakness , Fatigue , Anorexia ,
        Cachexia
         Coughing and chronic diarrhea
         Darkening of the skin
        Treatment:
        First-line medecines:
        -Pentavalent antimonial (Sb5+)
        • Glucantime
        • Pentostam
        Second-line medecines:
        -Amphotericin B
        -Allopurinol
        -Miltofosine
        -Pentamidine
        -Paromomycin (aminosidine)
        -Azoles medicines
        
        African Kala-azar
        
        Agent:  L. donovani: AVL , East Africa
         L. infantum: ZVL , North and West Africa
         L. archibaldi: Sudan
        
         Sporadic: ZVL / Reservoir: Arvicanthis niloticus
         Epidemic: AVL / Reservoir: Humans
        
        Indian Kala-azar
        
        agent: L. donovani
        
        principal reservoir hosts: Humans
        
        Mediterranean Kala-azar
        
        Agent: L. infantum
        
        reservoir hosts: Wild canids, domestic dogs and Rodents (R.
        rattus in Europe) Zoonotic
      - Cutaneous
        • (O.W & N.W)
        Treatment:
        Physical methods
        -Thermotherapy
        -Cryotherapy
        Chemical methods
        -Topical : Paramomycin ointment
        -Intralesional + systemic pentavalent antimonials
        
        ACL
        
        reservoir
        
        Primary: Human
        
        Secondary: Dog and rodent
        
        Vector
        
        Primary: P. sergenti
        
        Secondary: P. papatasi & P. caucasicus
        
        Agent: L. tropica
        
         Solitary nodules/plaques--> dry ulcer on
        face
         I.P.: 2-8 months; Heal within 8–12 months
        
        ZCL
        
        Agent: L. major
        
        Primary reservoir: Rodents (Gerbilinae & Muridae)
        
        Psammomys obesus
        (western Asia & northern
        Africa)
        
        Rhombomys opimus
        (Central Asia) main in Center & North-east Iran
        
        Arvicanthis niloticus
        (Senegal & Sudan)
        
        Meriones libycus (main in Center & South Iran)
        
        vectors
        
        Primary: P. papatasi &
        P. duboscqi (Senegal)
        
        Secondary:
        • P. caucasicus
        • P. mongolensis
        • P. ansari
        • P. salehi
        
         Multiple ulcerative nodules/plaques on
        limbs
         Furnucolid, edematous, inflamed
         I.P. :3 weeks - 4 months; Heal within 2- 6
        months
        
        DCL
        
        Reservoir: Hyrax
        
        Vectors: P. pedifer & P. longipes
        
        Agent: L. aethiopica
        
         Multiple diffuse spreading plaques and
        nodules (Usually face) and no ulceration
         Long-lasting infection and cannot
        be spontaneously healed
         It may look similar to Lepromatous
        leprosy
         Infection is chronic and may reoccur
        despite treatment
      - Mucocutaneous
        • (N.W)
  - - - Clinical:
        Three main symptoms (occur 1-3 yrs after initial infection):
         Skin lesions (microfilariae in dermis)
         Painless nodules (where tissues thin, bone)
         Eye lesions (blindness – assoc. with dead microfilaria)
      - Epid: 95%: in Africa in poor rural areas
      - Control:
        principal method for control: break cycle of transmission by
        eliminating the black fly. (larvae: insecticides through aerial spraying of breeding sites in fast-flowing rivers) cycle interrupted for 14 yrs--> reservoir of adult worms dies out in the human population
        Treatment: Ivermectin kills larval worms
        (Ivermectin binds to glutamate gated Cl channels in nervous system--> open
        Albendazole: keeps the worm from absorbing glc Diethylcarbamazine: hyperpolarization of nerve membr and flaccid paralysis of nematode-->removed by normal peristalsis)
  - - - Calliphoridae (obligate or facultative)
      - Sarcophagidae (obligate or facultative)
      - Oestridae (obligate parasites)
    - - Cutaneous
        
        Furuncular
        
        Creeping
        
        agents: horse bot flies (Gasterophilus) + cattle bot flies (Hypoderma) (both Oestridae)
        
        Painful “Migrating lumps” and the production of long tunnels ;(Gasterophilus tunnels: epidermal layer + Hypoderma tunnels: subcutaneous); may lead to paralysis if gets into spinal column, or blindness if it gets into eyes
        
        Larvae typically do not develop in humans
        
        Wound
        
        agents: Screwworm Flies - Cochliomyia hominivorax, Chrysomya bezziana; Wohlfahrtia magnifica (family Sarchphagidae); Bluebottle flies
        
        Larvae feed and travel through living flesh; fatal if left untreated; can develop into other forms of myiasis depending on where;
        
        Flies deposit eggs or larvae on outer margins of a wound or sore
      - Nasopharyngeal
        
        agent: Sheep bot fly (Oestrus ovis)-->in ppl around livestock
        
        extensive damage to nose, sinuses + pharynx due to feeding on living + necrotic tissue; In some cases migrate out of sinuses into
        eyes, ears, mouth or brain causing myiasis in those locations
        
        Fly inserts larva into the nostril of host
      - Oral
        
        infestation: Sheep bot fly
        
        Migratory larvae/opportunistic infection of a sore or lesion (wound
        myiasis): varejeira fly - Cochliomya hominivorax
      - Opthamomyiasis
        
        Often by migrating larvae/ flies that preferentially infect soft
        and susceptible tissues
        
        Affects eyes, orbits, periorbital tissue--> destruction through feeding + migration-> blindness if not treated
      - Intestinal
        
        often accidental: Ingestion of eggs/larvae in water/contaminated food + subsequent larval development within intestines
        
        migration of larvae
      - Cerebral: Extremely rare
        
        traumatic skull fracture followed by depositing of eggs/larvae: human bot flies + Screwworm Flies
        
        Migration into brain from another area of body: cattle bot flies (Hypoderma)
  - - - endemic to beach areas in the Caribbean
      - Most infected ppl completely asymptomatic; However, joint pains,
        headaches, coldness of the legs, inguinal adenitis, and itchy red spots have been described in conjunction w/ infection.
    - - Mansonella streptocerca can cause skin manifestations including pruritus, papular eruptions and pigmentation changes.
      - perstans, while often asymptomatic, can be associated with angioedema, pruritus, fever, headaches, arthralgias, and neurologic manifestations.
- - - - African Yellow Fever
        
        Transmission: Transovarial
        
        vectors: • Ae. Africanus (sylvatic)
        • Ae. Bromeliae (rural)
        • Ae. Aegypti (urban)
      - Central and South America
        Yellow Fever
        
        Vectors: • Haemagogus spp. (jungle)
        • Haemagogus spp. (rural)
        • Ae. Aegypti (urban)
        
        Transmission: Transovarial
      - Reservoir
        
        Human-mosquito in urban cycle
        
        Monkey-mosquito in forest cycle
      - Clinical: Most infections: mild, but the disease can cause
        severe, life-threatening illness.
        • Symptoms of severe infection: high fever, chills, headache, muscle aches, vomiting, and backache. After a brief recovery period, the infection can lead to shock, bleeding, and kidney and liver failure. Liver failure-->jaundice
      - Prevention and Treatment
        • General precautions to avoid mosquito bites;
        • Yellow fever vaccine: single dose--> lasting immunity of 10 yrs or more. (Live virus vaccine)-->Booster dose every 10 yrs
        • Treatment: No real treatment, drink plenty of fluids, most people get better over a long recovery period.
      - Diagnosis: blood test.
    - - Reservoir
      - VECTORS:
        • Aedes aegypti (Yellow fever Mosquito)
        • Aedes albopictus (Asian Tiger Mosquito)
        • Aedes scutellaris
        • Aedes polynesiensis
      - Host
      - Signs and Symptoms
        • Sudden onset of fever usually high fever,
        severe headache, backache, joint pains,
        nausea and vomiting, eye pain, and rash.
        • Dengue hemorrhagic fever (more severe form)
      - Pathogen
      - Treatment and Prevention
        • no specific medication for treatment
        • analgesics w/ acetaminophen + avoid those containing aspirin. + rest + drink plenty .
        • General precautions to avoid mosquito bites;
  - - - agent: anthroponosis- Bancroftia
      - Vectors
        
        Anopheles spp.
        
        Aedes spp.
        
        Cx. pipiens pipiens
        
        Cx. pipiens quinquefasciatis
    - - agent: An anthroponosis or zoonosis– Brugian
      - Vectors
        
        Anopheles spp.
        
        Aedes spp.
        
        Mansonia (genus)
  - - - stephensi
      - culicifacies
      - fluviatilis
      - maculipennis
      - d’thali
      - superpictus
      - sacharovi
- - - - Viral
        
        Tick-borne encephalitis/forest encephalitis
        
        CCHF(one type: Xinjiang hemorrhagic fever)
        
        via: bite, or crushing tick on skin
        
        clinical: acute febrile illness with hemorrhagic symptoms
        
        vector: human epidemics associated w/ Hyalomma (esp marginatum)
        
        epid: Russian states, Asia, Africa, Europe
        
        agent: Bunyaviridae, genus Nairovirus
        
        control:
        
        Environmental management
        
        Chemical measure: acaricides
        
        Personal protection
        
        reservoir/host: zoonotic
      - Non-viral
        
        Relapsing fever (Borrelia species)
        
        Tularemia (Francisella tularensis)
        
        Ehrlichia species
        
        RMSF (Rickettsia rickettsii)
        
        Babesia microti (malaria-like)
        
        Tick typhus (Rickettsia sp.)
        
        Lyme Disease (Borrelia burgdorferi)
        
        Anaplasmosis (Anaplasma sp.)
        
        Q fever
    - - Otoacariasis - auditory canal infestation, poss.
        secondary infection
      - Exsanguination - anemia can result from heavy
        infestation
      - Dermatosis - inflammation, itching , swelling at site of
        bite
      - Tick paralysis (envenomization)
      - Predispose to myiasis and infection
  - - - Chigger dermatitis: Scab: The inflammatory response gives rise to the
        raised, reddened wheal with a depressed
        center characteristic of chigger bite.
      - Scrub typhus
        
        agent: Orientia tsutsugamushi (a bacteria)
        
        vector: chigger
        
        clinical: prostration, headache, fever, body
        rash and CNS abnormalities; Epidemic hemorrhagic fever?
        
        Prevention + Control:
        1) Environmental management (x weed + rat/mice)
        2) Chemical measure: DTT.
        3) Personal protection
        
        Diagnosis: History (grassy area) + Fever, itching papules, scab
    - - agent: Sarcoptes scabiei
      - clinical: hypersensitivity from mite excretions + Secondary bacterial infections may also occur,
      - Prevention + control:
        1) All clothing and bedding laundered.
        2) 10% Brimstone ointment
      - Diagnosis: Symptoms:sinuous tracks in the skin, inflammation,
        itching; + Find the mites in the skin.