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Biting back. The West Nile virus and more-dangerous insect-carried relatives are in the U.S. to stay.
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West Nile disease: are you prepared for the next outbreak?
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Information from your family doctor. West Nile virus.
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Intervention possibilities on the biologic cycle of malaria towards endemism control.
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[Malaria and pregnancy].
In regions where malaria is endemism, the disease is a recognised cause of complications of pregnancy such as spontaneous abortion, premature delivery, intrauterine growth retardation and foetal death. Malaria is seldom seen in pregnant women in Denmark but, during the past two years, the authors have treated four patients in the University Hospital in Copenhagen. These pregnancies were all successful but two of the mothers required emergency Caesarean section on account of threatening intrauterine asphyxia. The patients came relatively late for treatment which may be because not only the patients but also their practitioners were unaware that malaria can occur several years after exposure. Three out of the four patients had employed malaria prophylaxis. As resistance to malarial prophylactics in current use is increasing steadily, chemoprophylaxis should be supplemented by mechanical protection against malaria and insect repellents. As a rule, malaria is treated with chloroquine. In cases of Falciparum malaria in whom chloroquine resistance is suspected, treatment with mefloquine may be employed although this should only be employed in cases of dire necessity in pregnant patients during the first trimester. Severe cases should be treated with infusion of quinine. During pregnancy, benign malaria may run a violent course and pregnant women with malaria should be monitored in maternity departments and should be treated in cooperation with specialists in tropical medicine.
[Control of onchocerciasis of cattle].
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Causes and effective management of insect bites in the UK.
Insects play an important role in maintaining the world's ecosystem (Zhu and Stiller, 2002) but many of them feed on other animals. Humans are relatively hairless and provide an easy target, especially when partly clothed (Cohn, 2003). Biting insects common to the UK include midges, gnats, mosquitoes, flies, fleas, lice, mites, ticks, and bedbugs (Fig 1).
[Prevention and control of leishmaniasis vectors: current approaches].
Phlebotomine sandflies (Diptera: Psychodidae) are the suspected or proven vectors of Leishmania spp. in at least 88 countries, including over 40 Phlebotomus species in the Old World and a further 30 belonging to the genus Lutzomyia in the New World. In recent years, both cutaneous (CL) and zoonotic visceral leishmaniasis (ZVL) have become increasingly prevalent in urban areas, including large Latin American cities. A similar trend has been recorded in all Mediterranean areas during the last decade. Based on mathematical models, insecticidal control of sandflies appears to represent a more effective way of reducing Leishmania infantum transmission than the present strategy of culling infected dogs in Latin America as well as being more acceptable to the human population. Since man is a dead-end host of most Leishmania species, treatment of existing human cases generally does not affect transmission. Interruption of the cycle by vector control may offer a cheaper, more practical solution to treatment and improved knowledge of the alternatives available could lead to preventative measures being undertaken in more leishmaniasis foci. In this note a review of current knowledge on sandfly control is presented. Different measures to control phlebotomine sandflies, including residual spraying of dwellings and animal shelters, insecticide treated nets, application of repellents/insecticides to skin or to fabrics and impregnated dog collars are discussed. Although effective in urban areas with high concentrations of sandflies, residual spraying of insecticides is no often longer tenable in most situations. In rural areas where dwellings are more dispersed and surrounded by large, untargeted "reservoir" populations of sandflies, residual spraying of houses may be both impractical for logistic reasons and ineffective. Actually, this control measure depends on the availability of a suitable public health infrastructure, including adequate supplies of insecticide, spraying equipment and trained personnel. Ideally such personnel should be trained in insecticide application, monitoring techniques and interpretation of sampling data, as well as safety techniques. To date reports of resistance refer to one insecticide (DDT) in only three species (Phlebotomus papatasi, P. argentipes and Sergentomyia shorti) in one country (India), although there are reports of increased tolerance to this compound in several countries. Fortunately the insects remain susceptible to all the major insecticidal groups. Impregnated bednets may offer the best solution in rural areas where transmission is largely intradomiciliary. This measure has the advantage that it can be employed at the individual household level and affords collateral benefits such as privacy and control of other biting insects such as mosquitoes, fleas and bedbugs. Sandfly larvae are generally difficult to find in nature so control measures that act specifically against immatures are not feasible, although the effectiveness of a few biological and chemical agents has been demonstrated in laboratory evaluations. In ZVL foci, where dogs are the unique domestic reservoir, a reduction in Leishmania transmission would be expected if we could combine an effective mass treatment of infected dogs with a protection of both healthy and infected dogs from the sandfly bites. Laboratory and field evaluations have shown that impregnated dog collars and topical application of insecticides could protect dogs from most sandfly bites by means of both anti-feeding and killing effect of the pirethorids used.
Leishmaniasis acquired in the Iraqi Theater of Operations: lessons learned.
Between August 2002 and February 2004, the Department of Defense identified 522 cases of cutaneous leishmaniasis in military personnel. This commentary examines reasons why there were so many cases of leishmaniasis during this conflict as compared with Operation Desert Storm. Lessons learned can be applied to reduce the risk to US personnel during future conflicts. Among the factors to be considered are environment, exposure, vector control, and the failure to deliver insect repellent to deployed US personnel.
Effect of topical agents on cercariae of Schistosoma mansoni.
DEET (N, N-diethyl-m-toluamide) is one of the reliable and most widely used insect repellents. The present work was planed to evaluate the effect of free DEET, controlled release DEET and white precipitate ointment on the viability of cercariae of S. mansoni in-vitro. They were also topically applied to mice to study their efficiency in preventing cercarial skin penetration. Free DEET and controlled release DEET formula caused immobilization and death of cercariae within twenty and five minutes respectively. The number of adults detected after application of free DEET and white precipitate ointment to mice skin prior to infection were significantly lower than the control group. When controlled release DEET was applied no adults could be detected indicating failure of cercariae to enter through the skin. This was confirmed by histopathological study of the liver which was free of granuloma. Scanning electron microscopy revealed tegumental changes in cercariae exposed to both free DEET and controlled released DEET. So, topical application of any of the three chemicals was effective in controlling S. mansoni infection. The best was with controlled release DEET.
Self-help for the traveler who becomes ill.
While infections commonly occur in travelers, most can be prevented by avoiding fresh fruit (unless it is peeled), fresh vegetables, unpasteurized milk and cheeses, nonbottled water and ice; by taking antimalarial drugs; by using insect repellents in areas where indicated; and by using common sense. Remember also that travel does not prevent you from getting many of the illnesses you might get at home. It is essential to take any regular medications along with you. I recommend that you take such medications in your carry-on baggage, for airlines have a propensity for losing baggage that contains critical items. If you do become ill, you can take care of most illnesses yourself if you have planned ahead.
Disseminated and chronic Lyme borreliosis in Norway, 1995 - 2004.
Lyme borreliosis is the most common tickborne infection in Norway. All clinical manifestations of Lyme borreliosis other than erythema migrans are notifiable to Folkehelseinstituttet, the Norwegian Institute of Public Health. During the period 1995-2004 a total of 1506 cases of disseminated and chronic Lyme borreliosis were reported. Serological tests were the basis for laboratory diagnosis in almost all cases. The annual numbers of cases showed no clear trend over the period, but varied each year between 120 and 253 cases, with the highest number of cases reported in 2004. Seventy five per cent of cases with information on time of onset were in patients who fell ill during the months of June to October. There was marked geographical variation in reported incidence rates, with the highest rates reported from coastal counties in southern and central Norway. Fifty six per cent of the cases were in males and 44% in females. The highest incidence rate was found in children aged between 5 and 9 years. Neuroborreliosis was the most common clinical manifestation (71%), followed by arthritis/arthralgia (22%) and acrodermatitis chronica atrophicans (5%). Forty six per cent of patients were admitted to hospital. Prevention of borreliosis in Norway relies on measures to prevent tick bites, such as use of protective clothing and insect repellents, and early detection and removal of ticks. Antibiotics are generally not recommended for prophylaxis after tick bites in Norway.
Larvicidal activity of a neem tree extract (Neemarin) against mosquito larvae in the Islamic Republic of Iran.
An insecticide containing azadirachtin, a neem tree (Azadirachta indica) extract, was tested against mosquito larvae in the Islamic Republic of Iran under laboratory and field conditions. LC50 and LC90 values for Neemarin were 0.35 and 1.81 mg/L for Anopheles stephensi, the main local malaria vector, and 0.69 and 3.18 mg/L for Culex quinquefasciatus. The mortality in the pupal stage was significantly higher than the other stages. In field trials, using recommended dosages of 1 and 2 L/hectare, mortality of Anopheles spp. larvae was also higher than Culex spp. Prevention of adult emerged and pupal mortality was the main activity of this compounds. The maximum time of efficacy was 7 days at the highest concentration (2 L/hectare).