PRACTICAL SESSIONS ON TROPICAL MEDICINE TRANSMISSION ROUTES OF TROPICAL INFECTIOUS DISEASES WEEK 3 Routes of transmission or acquisition of the Tropical Infectious Disease (TID) TID are suffered by millions of people around the world. Their transmission is easy and can extend surprisingly fast. Here you have the transmission routes which lead to people's infection. e 1. Arthropod bites: mosquito bites (malaria, filariasis, leishmaniasis, dengue, Zika, Chik, yellow fever); horsefly (filariasis); ticks (babesiosis); flies (African trypanosomiasis or sleeping sickness); triatoma infestans (trypanosoma cruzi or Chagas disease); blackflies (Onchocerciasis). * 2. Consumption of polluted water, include the danger of ice cubes : amebiasis, giardiasis.Routes of transmission or acquisition of the Tropical Infectious Disease (TID) « 3. Consumption of raw meat or barely cooked meat from mammals, birds, reptiles or amphibian: toxoplasmosis « 4. Consumption of raw fish or barely cooked: Amphimerus, Clonorchis & opisthorchis, Anisakis. 5. Consumption of raw vegetables: fascioliasis. 6. Consumption of unpasteurized dairy: toxoplasmosis, Tb bovis. « 7. Consumption of raw eggs, or barely cooked ones: salmonella, toxoplasmosis. . . Routes of transmission or acquisition of the Tropical Infectious Disease (TID) 8. Sexual contact: Trichomoniasis, HIV, herpes II. ¢ 9. Transplacental via: T. cruzi, Plasmodium spp., Toxoplasmosis, visceral leishmaniasis, malaria. e 10. soil contact: walking barefoot or being in direct contact with the ground or soil: ancylostomiasis & strongyliodiasis. ¢ 11. Contact with sweet water: swimming in rivers, swimming pools or lakes. Leptospirosis, Schistosomiasis, free living amoeba.1. VECTOR-BORNE DISEASES Tors (hppa fa ae Part roel ‘edited bane ect tough in preaion “ Teche lay goto eden Womutvesand exe ant quia der Ws ess oe ponchos go er “Anopheles Tiara (al isdn) ctr oy Thue es pest edentinrbe pha (Wc barat) kets ph brad at ath ane Caton eel ovat pew Dye Giine 9p Above encepabts og, panes encephlts, poy ovettpen * Stu enaphtis Wet le vi) i= esp Yel eve flaas areofan) ws Giger ab apha re aD as Say rd due eran (lord al fe pad wnsison 3ay fee Toca Sin, nd apes rs ™ “Now yt tel arn pane (hits lection utes aoe Bcf Pagal ean rela ‘eave lewis nto bro Sa ‘ele Cann np bones Tee iad dae Sep snes peesora rc adsense, Gntheneiege foe eet bee me) amin Gosia) Thue gabe) inate eit odin Blk hs Srl 9p) Ochre ive les (Oncaea na edo bu Ve gn Gap dae es eld gh Tope im ese ny tg 1. Anopheles spp. = Plasmodium spp (Malaria) ‘Anopheles mosquitaes are crepuscular (active MOSQUITO LIFE-CYCLE ‘at duskor dawn) or nocturnal (active at night). Reproduce in polluted and backwater ¢1. Anopheles spp. = Plasmodium spp (Malaria) salivary gland sporozoite ie 0 Gy at sporezolte merozoite Mosquito stage See 2. jl coayat schizont 20 Cee tere. : 5 eokinete trognozote Dring : zygote . QA ~ Blood stage CQ [@Xe} sO oe 4 gametes gametocytes Adult Anopheles species have slender bodies with three sections: head, thorax and abdomen. * Head is specialized for acquiring sensory information and for feeding. It contains the eyes and a pair of long, many-segmented antennae. The antennae are important for detecting host odors, as well as odors of breeding sites where females lay eggs. The head also has an elongated, forward-projecting proboscis used for feeding, and two maxillary palps. These palps also carry the receptors for carbon dioxide, a major attractant for the location of the mosquito's hostAdult Anopheles species have slender bodies with three sections: head, thorax and abdomen * Thorax is specialized for locomotion. Three pairs of legs and a pair of wings are attached to the thorax. « Abdomen is for food digestion and egg development. This segmented body part expands considerably when a female takes a blood meal. The blood is digested over time, serving as a source of protein to produce eggs, which gradually fill the abdomen 2. Sandflies (“manta blanca”) =2. Sandflies (“manta blanca”) = LEISHMAMASIS Lethmane parasites CUTANEOUS VISCERAL MUCOSAL = es nn ‘et wy 2. Leishmaniasis Sandfly Stages: ‘Human Stages sor ay ims 9 ions et © rrorassgess ae Oman aR = a 4 § abs a Fe o® i: a — muon cet ee Fee : ; Scene on. . Seana © 2209 totes 9 eto ow eeAdults 1.5-3.0 mm long and yellowish in colour, black eyes, and hairy bodies, wings, and legs. The oval lanceolate wings are erect on the humped thorax. Adults are nocturnal. During day stay in dark humid places such as bark, foliage, leaf, in animal burrows, and in cracks and crevices. At nightfall they emerge to feed on sugary secretions plants. The female needs a blood meal before it can reproduce; some species feed on mammals including humans. The sandfly is a weak flier and takes short flights to find a victim, adopting a “hopping’ style. Some sandflies are “exophagic’, living entirely out of doors, while others are "endophagic" and invade houses. The adults have short mouthparts and In Ecuador the popular name is “manta blanca” are unable to bite through clothing. Leishmaniasis ‘COLOMBIA Coast, Amazo! some interAndTriatominae = Chagas disease In general most species are nocturnal, and during the day they remain in their resting places, although they may sometimes go out to suck blood during the day under adverse conditions. Adult triatomines are 1.5-3 cm long, with an elongated head, chitinous thorax and double wings. The natural habitats of triatomines are trees, burrows and rocks, where they feed on mammals, birds and reptiles. 3. Triatominos (chinchorros) = Chagas Disease Development from egg to adult includes five nymphal stages . They are obligatory hematophagous insects in all phases of their development. The amount of blood ingested varies according to the species as well as in relation to the stage.Collecting Triatominae in palms (Esmeraldas) Live bait traps (mice) Areas endémicas 4. Aedes aegypti & albopictus = Dengue, Zika, Chik, Yellow fever, Mayaro virus. Mosquitoes are small, midge-like flies that constitute the family Culicidae. Females of most species are ectoparasites feeding on vertebrates’ blood through piercing the hosts’ skin to suck the blood* Ae. aegyptiand Ae. albopictus are worldwide distributed between 35° N and 35’ §S, latitudes. ¢ The species are highly adaptedtourban= environments, breeding in stagnant water found in manufactured containers, garbage heaps, and tyres. Ae. aegypti is an arthropod closely associated with humans and their habitats. They are mostly anthropophilic with high preference to the urban environment. The mosquito lays her eggs on the sides of containers with Water, and eggs hatch into larvae after a rain or flooding. A larva changes into a pupa in about a week and into a postin in2days. | The Aedes main habitat is aquatic, and they can thrive better from tree cavities to toilets. People also furnish shelter as Ae. aegypti preferentially rests in darKer cool areas, such as closets leading to their ability to bite ac indoors. es5. Black flies = Onchocerca volvulus (Oncocercosis) HOA BLANCA ETS Sele eee Beta coe SMe ee nem esal it waterways, in tropical and subtropic Foresite nite Always from 500 m altitud. ie elt Teele TaN ee CLE Ne SES Pst e In Ecuador they exist in the Coast, Sierra and Oriente. LL Sere Teel TALL ele ely fel Tei sele ro TUM LMSC ee UN eA Ute) Role Esmeraldas. There are small pockets in the north of Manabi BS lela e er me slo slole pean) eliminated from Ecuador. But blackflies SRC6. Fleas - Plague ( Yersinia pestis), endemic/murine typhus (Rickettsia typhi, bartonellosis, and cat scratch disease (Bartonella henselae), dwarf tapeworm (Hymenolepis nana) The flea is dark brown in color, wingless and possesses a laterally compressed chitineous abdomen. The glossy surface of the body allows easy movement through hair and feathers. Compoun eyes are absent, but some species have large or small simple eyes. The legs are long, strong and adapted for leaping. In some species there are a number of large spines on the head and the thorax known as ‘combs’ or ctenidia. There may be a genal comb on the cheek (gena) TTROPICAL INFECTIONS Mother to child Congenital/vertical Transplacental transmission Malaria, Trypanosomiases (Chagas disease)7. Food borne TROPICAL INFECTIONS = Amphimerus spp. Humans & other animals (dogs, cats) acquire Amphimerus eating raw or smoked freshwater fish. PUTCO source of infection Manabas (raw/undercooked fish (ceviche)) Chachis (smoked fish)Matcercariae are in fish’s muscle Amphimerus sp. Geographical Distribution in Ecuador 1 Eameraldas Rio Gayanas... POSIT. 71(28%)297, Nenias NES ano 2. Esmeraldas-Rio Onzole... POSITS (O25. 3. Sto Dgo Teachias-6 comunid Tacha POSIT yo se508 4 Bolivar Balzepamba- Cadial. NEG O27 5 ManabiP Games .. POSIT 77(20%4)/383 6 LojaZapot Ceina gde* . POSIT 1(0.59%4)213, 7. Chimborarc-Alaus-Guapeas . Pendent 8. Sucumbios-Cuyabeno ..NEG 0186 9 Orellane-Ro Napo-N. Rocatuerte...NEG 088 10, Napo-Ahvano...NEG 0125 11 Napo-Tena (Rio Napo). NEG 01159 12 PastazecArajuno NEG 086Eggs are found in feces Measurements: 30 x 15 um Are operculated at one end Adults are located in bile ducts of definitive hosts (human, dogs, cats). Measurenment: 1 to 2 cm Is ahelminth Trematode 2 suckers: oral & ventralAmphimerus spp. ECUADOR. Adult morphology Vitelline duct inal Ventral sucker Uterus Seminal or Acetabulum receptacle Ovary Intestine Excretory +» Pharynx bladder” Genital pore Vitellaria Testes \ Oral sucker Food borne TD Clonorchis y Opistorchis Metacerceriae in flesh or y Amphimerus prethelare Hendley _ Ciclo vital A % Cat, dogs, ia aes Didelphis mars, Free-swimming cercariae peyote: ‘encyst in the skin or flesh BEES te es: Ae ee f ~~ ANG — oe passed in feces. bitary duct8. Through skin penetration = Strongyloides stercoralis, Larva migrans cutaneaEcuador: Zonas tropicales de la Costa (+playas) y Amazonia -Zoonosis -Los adultos de Ancylostoma canimum festdn en los intestinos de los perros. 9. Soil transmitted Helminths (STH) infections = Ascaris lumbricoides, Trichiura trichuris, Hookworms (Ancylostoma duodenalis & Necator americanus)9. Soil transmitted Helminths (STH) infections = Ascaris lumbricoides, Trichiura trichuris, Hookworms (Ancylostoma duodenalis & Necator americanus) Ecology of infection with Ascaris, trichiura and hookworms10. Water borne: Parasite ova/cysts Infections caused by nematodes, trematodes, cestodes, protozoa (Entamoeba histolytica, Cryptosporidium spp. ng rivers, swimming pools 11, Contact with sweet water: swimmi ee living amoeba. or lakes. Leptospirosis, Schistosomiasis, esc