MEDICAL ENTOMOLOGY Subjects 1 Medical Entomology Introduction

MEDICAL ENTOMOLOGY Subjects : 1. Medical Entomology (Introduction) 2. Mosquitoes and flies 3. Mites

ARTHROPODS Compared to the number of species of mammals, protozoa and helminthes, insect species

MEDICAL ENTOMOLOGY Introduction Definition: entomology n Science that study insects (Entomon = Insecta) and other species belonging to Phylum Arthropoda, in relation to health, and its control

Introduction Medical entomology n Study of vector, vector borne diseases and abnormalities caused by insects

Introduction Vector n entomology Medik (Kedokteran) Vector are mostly insects which carry and n Ilmu yang mempelajari tentang vector, transmit disease agents from patient to disease dan kelainan yang disebabkan healthy person; or from disease sources to oleh insects uninfected food or drinks

ARTHROPODA - Divided into 5 classes I. Class Insecta --- Medically important insect : * Order Diptera * Order Anoplura * Order Hemiptera * Order Siphonaptera II. Class Arachnida III. Class Crustacea IV. Class Chilopoda V. Class Diplopoda

Characteristic Phylum Arthropoda n Multicellular animal (metazoa) n Symmetric, bilateral n Segmented body n Possess an exoskeleton n Appendages : antennae, palpa etc.

Metamorphosis n Morphological changes and development in the life cycle of Arthropods Two type metamorphosis n Complete metamorphosis n Incomplete metamorphosis

Metamorphosis Complete Metamorphosis n Marked changes and development in the morphology and biology (natural habitat, types of food, etc) n Eggs - Larva - Nymphs - Adults Incomplete Metamorphosis n Eggs/ova - (Larva) - Pupa - Adults

ROLE OF ARTHROPODS Role as vector Insects may act as À Vector/transmitter of disease agents Á As direct cause/etiology of disease or injury

ROLE OF ARTHROPODS Mode of transmission Two modes of transmission ý As mechanical vector ý As biological vector

Role as mechanical vector ý disease agents do not develop or multiply inside the vector ý Example : gastroenteritis agents in flies and cockroach ý Transmission occurs through the proboscis, legs, body, wings House flies

ROLE AS BIOLOGICAL VECTOR - Disease agents develop or multiply inside the vector - Example : Plasmodium sp. at Anopheles sp. Transmission occurs through the proboscis

ROLE OF ARTHROPODS Role as vector Anopheles , vector of malaria Aedes aegypti , vector of dengue hemorrhagic fever

Role of Arthropods Role as the cause of disease Disease or injury may be caused by insects through various means : - Mechanical injury - Injection of poisonous substances - Allergies - Psychosis

Role of Arthropods Role as the cause of disease Mechanical cause ý Bites - sting - piercing and bloodsucking larval movement ý Arthropods may act as : û Endoparasites : larva of flies causing myiasis û Ectoparasites: headlouse û Permanent parasites : fleas û Intermittent parasites: mosquito

Injection of Toxic substance ý Poison enters through : û Direct contact (caterpillars), bites (spider), sting (scorpion), piercing (mosquito) ý Common symptoms : û Itching, swelling, urticaria (mosquito, caterpillars) û Hemolysis (scorpion) û bleeding (bees) û Nerve damage (scorpion) Allergies ý Dyspnea /asthma : caterpillar, butterflies Psychosis A boy with allergy ý Entomophobia from mosquito bite

Role of Arthropods Insect as cause of injury and disease Scorpion Spider

(1) (2) (3) Bedbugs: (1) female; (2) male; (3) bloodsucking activity Centipedes

Mosquito Life cycle ý Life span: 2 weeks ý Complete Metamorphosis (eggs - larva - pupa adults). ý Eggs laid on water surface : – White 1 -2 hours - Turns black IV) 6 -8 days - Pupa 1 -3 day 2 -4 days - Larva ( stage I - - Adults male and female

Medical importance 1. Mosquito bites may cause urticaria, and dermatitis 2. As vector transmitter of many diseases : Example 1: Malaria (Plasmodium) - Main vectors of malaria in Jawa and Bali : Anopheles sundaicus, A. aconitus, A. subpictus, A. maculatus, A. balabacensis, A. sinensis.

Medical importance ý vector of disease : Example 3. Dengue (by Dengue virus) - Based on severity, clinical dengue may manifest as Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS). - Vector: Aedes aegypti, Ae. albopictus, Ae. scutelaris, Ae. togoi

Medical importance ý vector of disease : Example 4 & 5 Yellow fever - by Yellow Fever virus - Primary vectors : Aedes aegypti, Ae. simpsoni Japanese B. encephalitis and St. Louis encephalitis (by JBE and SLE virus) - Primary vectors : Culex pipiens, C. tarsalis, Ae. togoi

Medical importance Aedes aegypti , vector of dengue fever

Flies Bloodsucking Flies 1 2 3 Family Psychodidae Genus Phlebotomus = Sandflies Family Simuliidae Genus Simulium = black fly = buffalo gnats Family Ceratopogonidae/Heleidae Genus Culicoides = midges = no-see-um = punkies

Flies Bloodsucking Flies 4 5 Sub ordo Brachycera Family Tabanidae Genus Tabanus = horse fly Genus Chrysops = deer fly Genus Hybomitra Sub ordo Athericera = Cyclorrapha Family Muscidae Genus Glossina = Tsetse Flies Genus Stomoxys = Stable Flies

Flies Phlebotomus sp. Medical importance ý The bites may cause dermal papules, intense pain, itching, nausea, fever, malaise ý As vector of the following diseases : Kala azar Bartonellosis donovani Phlebotomus fever = demam papataci - By Leishmania -Disebabkan virus Bartonella baciliformis Oriental sore -Terdapat di laut Tengah, Andes Asia selatan Pegunungan Arab, By Leishmania tropica -vectornya Leishmaniasis verrucosum American Phlebotomus papataci - By Leishmania braziliensis

Flies Culicoides sp. Medical importance ý Painful bite, causing itch and fever ý Act as vector of disease (as intermediate host of Filarial worm) : û Culicoides grahami, and C. austeni, as vector of Acanthocheilonema perstans û Culicoides grahami as vector of Dipetalonema streptocerca û Culicoides furens and C. paraensis as vector of Mansonella ozzardi

Flies Culicoides sp. Adults Culicoides sp. Source : Color Atlas of Medicine and parasitesology. 1977 W. Peters & H. M. Gillers

Flies Glossina sp. Medical importance - vector Arfiican sleeping disease û Trypanosoma gambiense, vector is Glossina palpalis û Trypanosoma rhodesiense, vector is Glossina morsitans

Glossina sp. Source : Atlas parasitesologi Kedokteran. Source : A Colour Atlas of Clinical parasitesology. Tomio Yamaguchi 1994 Juni Prianto, Tjahaya P. U. , Darwanto Alih Bahasa : Lesmana Padmasutra, dkk.

Flies Stomoxys sp. Medical importance - Painful bites; mostly on cattle and horses which may cause anemia - Mechanical vector of : Trypanosoma evansi – which causes a disease in animals called surra - Example: Stomoxys calcitrans

Stomoxys sp.

Flies Non-biting Flies 1 Family Muscidae – Musca domestica = House flies 2 Family Sarcophagidae – Meat flies – Characteristic : viviparous – Lay its larva on meat Example : – Genus Sarcophaga : myiasis semisystemic and accidental – Genus Wohlfahrtia : specific – myiasis

Flies Non-biting Flies 3 Family Calliphoridae – Blow flies – Example : Chrysomyia bezziana – Specific Myiasis on open wound, nostril, ear holes (myiasis of the skin and atrial openings) 4 Family Drosophilidae – Species: Drosophila melanogaster – Also called fruit flies, may cause accidental intestinal myiasis

Flies Musca domestica Medical importance - Adult flies may act as mechanical vector of many disease agents : protozoa, worm eggs, bacteria, virus. - Larva stage may invade human tissue causing a disease called myiasis

Flies Musca domestica (House flies )

MYIASIS Definition: Infestation of human or animal tissue or organs by maggot (larva stage) of certain non-biting flies This larva live from tissue, body liquid, or food from the hospes

Myiasis Larvae in necrotic tissue

TRANSMISSION Infestations occur when the insects put their eggs on the injury skin or open abscess. n Species that cause myasis, for example Passeromyia longicomis larvae. n Species that cause myasis dermal only, for example Cordylobia anthropophage and Cordylobia hominis. n

Diagnosis For Ophtalmomyasis, irrigation of lacrimal gland until the parasite come out. n One drop of cocaine for paralyzing the movement, then lifted by using tweezer ( forceps ). Same as dermal myasis. n Myasis intestinal : feces examination. n

MITES Introduction n Classified under ordo Acarina n Causing acariasis n Medically most important mites : ðFamily Sarcoptidae (Scabies mite) ðFamily Trombiculidae

MITES n n n Etiology : Sarcoptes scabiei Family Sarcoptidae Order : Acarina Disease : scabies, sarcoptic mange Ectoparasite, inhabit the skin creating tunnels under the stratum corneum where female lay eggs Predilection sites : thin skin folds (between fingers, armpit, wrist, genital fold) Scabies , Sarcoptic mange Source : A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi. Translation : Lesmana Padmasutra, dkk.

n Common among children and adults of poor personal hygiene n Among inhabitants of prisons, orphanages, boarding houses and military barracks Source : A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi. Translation : Lesmana Padmasutra, dkk.

Scabies Mites Clinical symptoms n Night itch caused by : ð Female activity of tunnel burrowing ðHost reaction against metabolic wastes n Pruritus, vesicules and pustula along the tunnel n Pustula is the result of bacterial secondary infection

Scabies Mites n Predilection sites of Scabies in man Source : Basic Clinical Parasitology. 1994. Neva F. A. & Brown H. W.

Scabies Mites n Scabies of labia majora and the surrounding areas n Chronic Scabies of the scrotum Source : A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi. . Translation : Lesmana Padmasutra, dkk.

Scabies Mites Diagnosis n n Clinical D/ ðBy finding specific skin infection in the area of predilections ðObserving patient scratching specific area of predilection Laboratory D/ ðPotassium Hydroxide (KOH) Test : Skin scraping from predilection area is placed on a glass slide, add one drop of 10% KOH, warm the slide, cover with slide cover glass, and examine under the microscope to find the adult mite or the eggs. ðDark Ink Test : place a drop of ink on the suspected skin surface, press slightly to allow ink to enter the tunnel, rinse and observe the ink filled tunnels

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