vector borne disease and vector control in essential areas of focus for us military personnel
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Vector Borne Disease and Vector Control in Essential Areas of Focus for US Military Personnel . Shalamar Georgia Walden University PUBH 8165, Summer 2012. Vector Borne Disease. What is it? - PowerPoint PPT PresentationTRANSCRIPT
Vector Borne Disease and Vector Control in Essential Areas of Focus for US Military Personnel Shalamar GeorgiaWalden UniversityPUBH 8165, Summer 2012
Vector Borne Disease What is it?
Disease that results from an infection transmitted to humans or animals by blood feeding arthropods. (Mims, 2004)
Vector Borne Disease Multiple types of microorganisms can be
transmitted as a vector borne disease
microbiologyonline.org.uk
microscopesblog.comprettyprotozoa.tumblr.com
ehagroup.com
Vectors of Disease
cdvr.ucr.edu
infectionlandscapes.org
kaieteurnewsonline.com pestcontrolrx.com
raywilsonbirdphotography.co.uk
publichealth.lacounty.gov
Vector borne Disease Globally
http://www.who.int/whr/2004/en/.
Countries of the Middle East Bahrain Cyprus Iran Iraq Israel Jordan Kuwait Lebanon Oman
Saudi Arabia Syria Turkey United Arab
Emirates Yemen
Conditions Affecting Disease Geography, climate and the culture
habibtoumi.com
msnbc.msn.com
rmc4peace.com
Diseases Profiles in the Middle East Within the Middle East there are two
distinct types of Vector Borne Disease Short Incubation –These are diseases with
incubation periods of less than 15 days Long incubation – these are diseases with
incubation periods that are longer than 15 days.
Short Incubation Period Disease These are diseases with 15 days or less of
required incubation that could be important to military personnel and are present in the Middle East Malaria Dengue Typhus Relapsing Fever (both Mite and Tick borne)
Malaria Found in Iran, Iraq, Israel, Oman, Saudi Arabia,
United Arab Emirates and Yemen (DPMIAC, 1999)
There IS drug resistant malaria present in these countries!!!
Vector is the mosquito Agent is Plasmoduim spp Treatment available Anti Malaria medication
available as for prophylaxis
Eastern Hemisphere wwwnc.cdc.gov
PREVENTION Netting for beds (
Impoinvil et al., 2007)
Drugs Mosquito Spraying No stagnant Water
malariasite.com
Dengue Fever Also called
Breakbone Fever Mosquito Vector Caused by Dengue Hemorrhagic Virus Present in ALL Middle Eastern Countries (DPMIAC,
1999) Large outbreak in Saudi Arabia in 1995 (CDC,
2004). Frequent ‘Carrier’ Cases
http://www.healthmap.org/dengue/index.php
afaq.wordpress.com
Prevention Use mosquito replant Spraying of vector breeding grounds
and habitat (Impoinvil et al., 2007) Protective clothing Avoid activity at high activity time frame
denguedisease.blogspot.com
vusolutions.com
Typhus Caused by the
bacterium Rickettsia prowasekii
Vector is the human body louse Pediculus humanaus
Sudden onset can include fever, rash.
Disease can last 3 weeks sciencedirect.com
Prevention Examination of clothing and body Avoid contact with bedding and clothing
of persons suspected to have louse Frequently wash clothing and bedding
where louse is suspected Most recent outbreaks have been in
Lebanon, Tel Aviv and Israel (DPMIAC, 1999)
http://sprojects.mmi.mcgill.ca/tropmed/disease/typhus/geo.htm
Relapsing Fever (Louse and Tick Borne) Two forms (Mims et al., 2004)
Louse Borne Caused by spirochete Borrelia recurrentis;
vector P. humanus Tick borne
Caused by spirochete Borrelia recurrentis; vector tick of the genus Orithodoros
Disease found in Iran, Iraq, Israel, Jordan, Syria, Saudi Arabia and Yemen (Safdie et al., 2010)
Prevention Between 1-10 relapses of disease (tick
borne disease usually lasts longer) (Safdie et al., 2010)
Proper clothing can assist in not acquiring infected ticks (Safdie et al., 2010)
Proper hygiene can prevent body louse Frequent washing of clothes and
bedding of infected personnel
Long Incubation Period Disease These are diseases with more than15
days of required incubation that could be important to military personnel and are present in the Middle East Leishmaniasis Schistosomiasis Bancroftian Filariasis
Schistosomiasis Caused by the blood
trematodes in the genus Schistosoma
Vector is the Snail Acute disease symptoms occur
2-8 weeks after infection and include fever, headache, diarrhea, vomiting and blood in the urine. (Mims, 2004)
Disease is present in Saudi arabia, Yemen, Oman, Lebanon, Syria, Iraq and Iran
http://dpd.cdc.gov/dpdx/html/Schistosomiasis.htm
http://www.nejm.org/doi/full/10.1056/NEJMicm0803551
Prevention Prevention of disease is most easily
controlled by avoiding fresh water areas where snails may be present WHO recommends assuming that all
freshwater in endemic areas be considered infected and avoided
Insect repellant with DEET has been shown to be effective
IF exposed, clean skin with rubbing alcohol
Most official military uniforms (BDU and ACUs) can offer resistance when worn appropriately (pants tucked in boots) (DPMIAC, 1999)
Prevalence of vector is higher during the day
Do not step on or crush snails found Most prevention methods focus on
removal of the snail host population using chemicals
http://relief.unboundmedicine.com/relief/ub/view/cdc-yellow-book/204110/all/Schistosomiasis
http://www.modernguidetohealth.com/conditions-diseases/schistosomiasis-symptoms-treatment-and-prevention.html
Leishmaniasis Caused by the protozoan from
the genus Leishmania Vector is the sand fly (Genus
Phlebotomus) Symptoms include skin and
soft tissue lesions, fever, anemia, enlarged liver and/or spleen and increased weakness
Visercal Leishmaniasis can have a 95% mortality rate when left untreated.
Diagnosis is difficult and treatment is long and expensive. The treatment drug is not registered within the US.
http://dpd.cdc.gov/dpdx/html/Leishmaniasis.htm
missinglink.ucsf.edu
Prevention Normal mosquito netting will
allow passage of sand flies, so smaller mesh must be used (Impoinvil et al., 2007)
Sticky paper traps can be used to catch the flies and should be placed near plants and/or vegetables. They should also be placed around burrows, rocks and crevices and construction debris
http://www.who.int/leishmaniasis/burden/hiv_coinfection/burden_hiv_coinfection/en/index.html
commons.wikimedia.org
Bancroftian Filariasis Caused by the nematode
Wuchereria bancrofti Spread through a mosquito vector After 8-12 months of incubation
microlarvae are released. Females will continue to reproduce for 15-18 years (DPMIAC, 1999)
Infected individuals are usually asymptomatic in early infection (Mims et al., 2004)
Swelling of the lymphatic glands occurs and will obstruct flow in legs and genitalia (elephantiasis)
http://dpd.cdc.gov/dpdx/HTML/Frames/A-F/Filariasis/body_Filariasis_w_bancrofti.htm
http://www.thailabonline.com/sec8filariasis.htm
Prevention Occurs in Iran, Oman,
Yemen and Saudi Arabia Reduction of the mosquito
population is the easiest way to prevent disease occurrence (El-Setouhy et al., 2007), (Impoinvil et al., 2007) Spraying of aerosols during
periods of high activity (evening)
Spray both indoors and outdoors
Wear protective clothing
http://www.neglecteddiseases.gov/target_diseases/lymphatic_filariasis/index.html
http://www.kimayahealthcare.com/AilmentDetail.aspx?AilmentID=366&AboutID=1
Conclusion Many factors can influence vector borne
disease The Middle East is a diverse location both
geographically and culturally While disease is prevalent in these
countries, standard preventative measures can be used to prevent disease
Our troops should be educated on basic precautions when entering an endemic area that cover both the ecological and cultural risk factors
Thank You References:
Defense Pest Management Information Analysis Center. (1999). Regional Disease Vector Ecology Profile: The Middle East. Walter Reed Army Medical Center. Washington DC.
J.B. Derbyshire. (2002). The eradication of glanders in Canada. Can Vet J. 2002. 43(9). 722-726
World Health Organization. (2004). World Health Report. Retrieved July 17, 2012 from http://www.who.int/whr/2004/en/.
Mims, C., Dockekrell, HM., Goering, RV., Roit, I., Wakelin, D., Auckerman, M. (2004). Medical Microbiology 3rd Edition. Mosby Publishing.
El-Setouhy, M., Abd Elaziz, K. M., Helmy, H., Farid, H. A., Kamal, H. A., Ramzy, R. M. R., . . . Weil, G. J. (2007). The Effect of Compliance on the Impact of Mass Drug Administration for Elimination of Lymphatic Filariasis in Egypt. The American Journal of Tropical Medicine and Hygiene, 77(6), 1069-1073.
Hotez, P. J., Savioli, L., & Fenwick, A. (2012). Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence, Distribution, and Opportunities for Control. PLoS Negl Trop Dis, 6(2), e1475. doi: 10.1371/journal.pntd.0001475
Impoinvil, D. E., Ahmad, S., Troyo, A., Keating, J., Githeko, A. K., Mbogo, C. M., . . . Beier, J. C. (2007). Comparison of mosquito control programs in seven urban sites in Africa, the Middle East, and the Americas. Health policy (Amsterdam, Netherlands), 83(2), 196-212.
Safdie, G., Farrah, I. Y., Yahia, R., Marva, E., Wilamowski, A., Sawalha, S. S., . . . Fishman, Y. (2010). Molecular Characterization of Borrelia persica, the Agent of Tick Borne Relapsing Fever in Israel and the Palestinian Authority. PLoS ONE, 5(11), e14105. doi: 10.1371/journal.pone.0014105