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PubMed2005

Tick-borne relapsing fever.

Tick-borne relapsing fever is characterized by recurring fevers separated by afebrile periods and is accompanied by nonspecific constitutional symptoms. It occurs after a patient has been bitten by a tick infected with a Borrelia spirochete. The diagnosis of tick-borne relapsing fever requires an accurate characterization of the fever and a thorough medical, social, and travel history of the patient. Findings on physical examination are variable; abdominal pain, vomiting, and altered sensorium are the most common symptoms. Laboratory confirmation of tick-borne relapsing fever is made by detection of spirochetes in thin or thick blood smears obtained during a febrile episode. Treatment with a tetracycline or macrolide antibiotic is effective, and antibiotic resistance is rare. Patients treated for tick-borne relapsing fever should be monitored closely for Jarisch-Herxheimer reactions. Fatalities from tick-borne relapsing fever are rare in treated patients, as are subsequent Jarisch-Herxheimer reactions. Persons in endemic regions should avoid rodent- and tick-infested areas and use insect repellents and protective clothing to prevent tick bites.

Animals↗
PubMed2004

West Nile Virus.

West Nile Virus (WNV), a mosquito transmitted disease, made its first appearance in North America in 1999 and quickly spread westward. It arrived in Kansas in 2002, re-emerged in 2003, and is expected again in 2004. The natural cycle is from infected bird to mosquito, with humans and horses as accidental (dead-end) hosts. WNV is usually asymptomatic in humans, but can cause a wide spectrum of disease. There is currently no human vaccine and treatment is symptomatic only. A best preventive measure combines personal protection to prevent mosquito bites with reducing the number of mosquitoes.

Animals↗
PubMed2005

[Extraction and determination of volatile constituents in leaves of Eucalyptus citriodora].

The volatile constituents in leaves of Eucalyptus citriodora, including oil fraction and water-soluble fraction, were extracted and determined. Oil fraction of volatile components was obtained through steam distillation. Ether was used as the solvent to extract the water-soluble fraction of volatile compounds from the liquid left after steam distillation in order to know the quantity and constituents of volatile compounds dissolved in the water phase. The oil yield in the oil fraction was 1.36%, and the oil yield in the water-soluble fraction was 0.48% (both on fresh weight basis). Both oil fraction and water-soluble fraction were analyzed by gas chromatography-mass spectrometry (GC-MS) method. The results showed that 37 compounds (97.36%) in the oil fraction and 10 compounds (82.05%) in the water-soluble fraction were identified. There were 12 hydrocarbon compounds and 25 oxygenated compounds identified in oil fraction. The major constituents in oil fraction were citronellal (57.00%), followed by citronellol (15.89%) and citronellyl acetate (15.33%). Alcohols dominated the compounds in water-soluble fraction. cis-p-Menthane-3, 8-diol (53.43%) and trans-p-menthane-3, 8-diol (16. 48%) were found to be the major compounds, which have the activity to repel insects. It is concluded that the comprehensive utilization value of leaves of Eucalyptus citriodora was enhanced owing to the extraction of water-soluble volatile components.

Acyclic Monoterpenes↗
PubMed2006

Eastern equine encephalitis--New Hampshire and Massachusetts, August-September 2005.

During August-September 2005, the New Hampshire Department of Health and Human Services reported seven cases of human eastern equine encephalitis virus (EEEV) disease, the first laboratory-confirmed, locally acquired cases of human EEEV disease reported from New Hampshire in 41 years of national surveillance. Also during August--September 2005, the Massachusetts Department of Public Health reported four cases of human EEEV disease, five times the annual average of 0.8 cases reported from Massachusetts during the preceding 10 years. Four of the 11 patients from New Hampshire and Massachusetts died. EEEV is transmitted in marshes and swamps in an enzootic bird-mosquito-bird cycle primarily by the mosquito Culiseta melanura. Bridge mosquito vectors (e.g., Coquillettidia perturbans, Aedes vexans, or Aedes sollicitans) transmit EEEV to humans and other mammals. This report summarizes the investigations of cases in New Hampshire and Massachusetts conducted by the two state health departments and CDC. The findings underscore the importance of surveillance for, and diagnostic consideration of, arboviral encephalitis in the United States and promotion of preventive measures such as local mosquito control and use of insect repellent.

Adolescent↗
PubMed2006

Locally acquired mosquito-transmitted malaria: a guide for investigations in the United States.

Recent outbreaks of locally acquired mosquito-transmitted malaria in the United States demonstrate the continued risk for reintroduction of the disease. Since 1957, when CDC's Malaria Branch started conducting malaria surveillance, 63 outbreaks have occurred, constituting 156 cases (annual range: 1-32) that were a result of locally acquired mosquitoborne transmission. This report describes the steps that should be taken to 1) investigate a case that might have been acquired locally, 2) prevent a small focus of malaria cases from becoming a source of sustained transmission, and 3) inform clinicians regarding the process of an investigation so they can effectively address concerns and questions from patients. Although these locally acquired mosquito-transmitted outbreaks frequently involve only a limited number of infected persons, they frequently raise concerns in the community and require substantial public health resources. For example, as a result of the most recent local outbreak of eight malaria cases in Florida in 2003, reverse 911 telephone calls (a community notification system) were made to approximately 300,000 residents; insect repellent, postcards, flyers, and posters in multiple languages were distributed; public announcements were made through the media and to schools and homeless shelters; and notifications were sent to local hospitals and physicians to inform residents of that community. When a local health department investigates a potential locally acquired mosquito-transmitted case, the systematic inquiry should include epidemiologic, environmental, and laboratory components. Local and state health departments inquiring about the proper approach to investigate and control a potential locally acquired case frequently request urgent assistance and tools from CDC. This report provides a starting point for such investigations to local and state health departments by providing them with the tools necessary to initiate an investigation.

Animals↗
PubMedDate not supplied

Seroprevalence of West Nile virus in Saskatchewan's Five Hills Health Region, 2003.

BACKGROUND: The Five Hills Health Region of Saskatchewan reported the highest West Nile virus (WNV) case rates in the 2003 outbreak. A serologic and telephone survey was undertaken to assess the seroprevalence of the virus and the knowledge, attitudes and behaviours of the residents. METHODS: Respondents had to be at least 18 years of age, and residents of the Five Hills Health Region between July 1st and September 15th, 2003. Blood samples of respondents were tested at the National Microbiology Laboratory for flavivirus immunoglobulin using a WNV IgG ELISA and plaque reduction neutralization test. Descriptive analyses performed related to respondents' demographics, knowledge, attitudes, behaviours, and seropositivity. WNV infection risk was assessed using odds ratio. RESULTS: There were 619 questionnaire respondents, of whom 501 donated a blood sample. The seroprevalence of WNV in the Five Hills Health Region was 9.98% (95% CI 7.37-12.59%). Seropositivity of rural areas was 16.8% and urban was 3.2%. Most (97%) of participants thought WNV was an important health issue. Forty-eight percent of the participants used insect repellents containing DEET most of the time. There was good knowledge regarding WNV transmission and prevention of the spread of WNV. Rural compared to urban residents were six times more likely to be positive for WNV (OR=6.13, 95% CI 2.82-13.34). INTERPRETATION: This is the highest seroprevalence rate of West Nile virus recorded in North America thus far. Many factors could have influenced this outbreak, such as eco-region, early prolonged hot weather, level of mosquito control programs, urban and rural community differences, and personal protective behaviours.

Adolescent↗
PubMed1991

Preventive therapy for malaria.

The incidence of malaria in travelers returning to the United States has been increasing. Persons visiting areas where malaria is endemic should use insect repellent, wear clothing that covers the arms and legs, and remain in screened areas between dusk and dawn. Chemoprophylaxis for travelers consists of weekly doses of chloroquine; a new drug, mefloquine, should be used in the increasing number of countries where chloroquine-resistant malaria is found. Travelers to these areas should carry three tablets of pyrimethamine-sulfadoxine, which should be taken for presumptive treatment of malaria at the onset of chills and fever. It is essential that chemoprophylaxis be continued for four to five weeks after departure from endemic areas. In travelers who develop symptoms of malaria after returning from an endemic area, it is imperative that treatment be started even if blood smears are negative.

Adult↗
PubMed1991

Medical aspects of Persian Gulf operations: serious infectious and communicable diseases of the Persian Gulf and Saudi Arabian Peninsula.

The countries surrounding the Persian Gulf are remarkable for the variety of infectious and contagious diseases that will affect those deployed to this area. In addition to the common gastrointestinal problems often seen in deployed troops, they will be exposed to such unusual problems as malaria, schistosomiasis, leishmaniasis, and rabies. Medical personnel will need to consider diseases that they have never before treated or diagnosed, and will have to educate their troops regarding control of vectors, avoidance of exposure, and personal hygiene and sanitation. Proper predeployment vaccination, use of appropriate prophylaxis, and use of countermeasures such as insect repellent will keep the spread of disease minimal.

Diarrhea↗
PubMed1990

Effectiveness of repellent/insecticidal bars against malaria and filariasis vectors in peninsular Malaysia.

Field tests were conducted to compare the degree of protection from bites of Mansonia species and Anopheles maculatus by applying two repellent/insecticidal bars, MOSBAR and MOSKIL, to exposed arms and legs. Human test subjects were exposed to natural populations of mosquitos for an 8-hour night time period while using the repellent/insecticidal bars. MOSBAR gave good protection against the bites of Mansonia and An. maculatus. MOSKIL was effective against An. maculatus but not against Mansonia. High mortality was observed among the mosquitos collected from human test subjects treated with the repellent/insecticidal bars. Use of MOSBAR in terms of cost-effectiveness and safety by field and health workers entering into malaria and filariasis endemic areas is discussed.

Animals↗
PubMed1991

Repellency of two deet formulations and Avon Skin-So-Soft against biting midges (Diptera: Ceratopogonidae) in Honduras.

Two U.S. military issue deet repellent formulations (75% deet liquid and 33% deet lotion) and Avon Skin-So-Soft were tested against ceratopogonid midges under field conditions in Honduras. Test subjects were U.S. military personnel deployed to Honduras for training. Culicoides furens accounted for 96.3% of all midges collected. The liquid and lotion formulations of deet and Avon Skin-So-Soft provided 97.9, 95.9 and 71.4% protection, respectively, compared with the untreated control. Both deet formulations provided significantly better protection (P less than 0.05) than Avon Skin-So-Soft. The latter provided protection by trapping the midges in the oily film and not by repelling the insects as did the deet formulations.

Animals↗
PubMed1990

Fenvalerate/N,N-diethyl-m-toluamide (Deet) toxicosis in two cats.

Toxicosis attributable to fenvalerate and N,N-diethyl-m-toluamide (Deet) exposure was suspected in 2 cats. Clinical signs of toxicosis developed within 4 to 6 hours of dermal application of the pesticide. Clinical signs of toxicosis seen in both cats included hypersalivation, ataxia, and depression. In addition, seizures were seen in 1 cat. Both cats died. Analysis of skin, kidney/urine, liver, and brain tissues confirmed the presence of fenvalerate and Deet. The pyrethroid fenvalerate and the insect repellent Deet are used for the control of fleas and ticks on cats. Suspected fenvalerate/Deet toxicosis in cats is associated with tremors, hypersalivation, ataxia, vomiting, depression, and seizures.

Animals↗
PubMedDate not supplied

Metabolism of N,N-diethyl-meta-toluamide by rat liver microsomes.

The NADPH- and oxygen-dependent metabolism of N,N-diethyl-m-toluamide (deet insect repellent) has been studied at 37 degrees C in suspensions of liver microsomes from phenobarbital-pretreated male Wistar rats. In pH 8 Tris-HCl buffer and at a substrate concentration of 200 microM, metabolic reactions corresponded to benzylic hydroxylation and N-deethylation, and to combinations of these reactions, leading to N,N-diethyl-m-hydroxymethylbenzamide, N-ethyl-m-toluamide, N-ethyl-m-hydroxymethylbenzamide, and m-toluamide. These compounds and N,N-diethyl-m-formylbenzamide were detected in methyl t-butyl ether extracts by capillary gas chromatography using three fused silica columns of different polarities. The structures of the in vitro metabolites were verified by comparisons with samples of authentic standards using combined gas chromatography-mass spectrometry. A selective derivatization procedure with acetic anhydride and pyridine facilitated the detection of the two alcohols. The major metabolites, N,N-diethyl-m-hydroxymethylbenzamide and N-ethyl-m-toluamide, were quantitatively determined in derivatized extracts with an internal standard of N,N-dipropyl-m-toluamide, a capillary column of DB-1, and a nitrogen-phosphorus detector. The mean enzymatic yield of these two products was 69% in three replicated experiments.

Animals↗
PubMedDate not supplied

Metabolism of N,N-diethyl-m-toluamide (DEET) by liver microsomes from male and female rats. Simultaneous quantitation of DEET and its metabolites by high performance liquid chromatography.

A simple and sensitive HPLC procedure was developed to separate and quantitate N,N-diethyl-m-toluamide (DEET) and its in vitro metabolites using a gradient elution, a reversed phase C18 column, and an internal standard. This procedure was applied to examine the metabolism of this insect repellent in liver microsomes from normal (untreated) male and female Wistar rats. At a pH of 8.6 and at a substrate concentration of 200 microM, the microsomal preparations from males degraded DEET faster than did those from females. The half-life of DEET was 10 min and 15 min, respectively. The benzylic methyl hydroxylated metabolite and the N-deethylated metabolite were determined over 2 hr in fortified microsomal suspensions. Rate constants for appearance of the metabolites showed significantly higher values for males than for females. These observations suggests that a sex difference may be present in the metabolism of DEET.

Animals↗
PubMed1986

Population movement, socio-economic behavior and the transmission of malaria in northern Thailand.

This paper examines the socioeconomic aspects of malaria transmission in northern Thailand. Preliminary field investigation suggests that high malaria incidence persists in two geographical setting: remote villages near upland forests; and border areas. This study has found that malaria transmission in these areas is associated with illegal activities that expose villagers to malaria vectors in the forest; or which bring large numbers of infected workers from Burma into the country. Some such activities relate directly to economic development projects in the area. Current control measures, stressing the use of mosquito nets, insect repellent, and residual insecticides designed primarily for the less mobile population of rice-farming communities are less effective among more mobile people. Control programmes should be targeted at these high risk groups in ways that are appropriate for their socioeconomic activities and that respond to their cultural and geographical backgrounds at least until alternative employment can be provided.

Attitude to Health↗
PubMed1985

The acute toxicity and primary irritancy of 2-ethyl-1,3-hexanediol.

2-Ethyl-1,3-hexanediol (EHD), an insect repellant, was found to have acute peroral LD50 values in the rat of 9.85 ml/kg (males) and 4.92 ml/kg (females). Acute percutaneous LD50 values in the rabbit were 10.8 ml/kg (males) and 9.51 ml/kg (females). There were neither deaths nor signs of toxicity during or following a 6 hr exposure to a statically or dynamically generated substantially saturated vapor atmosphere. A 4 hr exposure to a high concentration (3.8 mg/liter) of a respirable aerosol of EHD (mass median aerodynamic diameter of 2.0 um) produced only minor signs of irritation during exposure, but no signs of toxicity. Occluded dermal contact with EHD on rabbits (4 and 24 hr) produced mild local erythema and, in several animals, edema. Contamination of the eye with EHD (0.005 to 0.1 ml) produced marked to severe conjunctivitis, with moderate iritis and diffuse corneal injury; healing occurred in most animals within 3 to 7 days. The major acute hazards with EHD are by swallowing and, to a greater extent, by contamination of the eye.

Administration, Oral↗