Medical Entomology

Linnaeus Classification system

(binomial nomenclature)
Example:
Kingdom: Animalia
Phylum: Arthropoda
Class: Insecta
Order: Diptera
Family: Muscidae
Genus: Musca
Species: domestica
Common name: houseflies

Medical Entomology  A branch of entomology which deals with

arthropods which affect the health and well-
being of human. In other words, medical
entomology is the medical science directly
concerned with insects or vectors that affect
human.
 The field of medical entomology also includes
other arthropods, the Class Arachnida, which are
not insects.

Arthropods (Phylum Arthropoda)  A bilaterally symmetrical organism with

Characteristic of insects (Class Insecta):
chitinous exoskeleton and have jointed legs.
 Eg. Lobsters, shrimps, ticks, spiders, insects
 Insects have three pairs of legs (six legs).
 Insects possess wings and antennae
 Insects undergo metamorphosis through stages
complete metamorphosis: eggs, larva, pupa and
adult incomplete metamorphosis: eggs, nymphs
and adult.
 Insects have compound eyes.
 Eg: ants, flies, fleas, mosquitoes, butterflies,
beetles

1
Frances

Characteristic of arachnids (Class Arachnida):
Class Insecta
• Order Diptera (flies & mosquitoes)
• Order Blattaria (cockroaches)
• Order Hemiptera (bugs)
• Order Anoplura (lice)
• Order Siphonaptera (fleas)
Medically important arthropods
Frances
Medical Entomology
 Arachnids do not undergo complete
metamorphosis, they develop from immature to
mature stages.
 Arachnids have eight legs
 Arachnids lack the wings and antennae.
 Arachnids have simple eyes.
Eg: scorpions, spiders, ticks and mites.
• Class Arachnida
• Order Acari
• Suborder Ixodida (hard and soft ticks)
• Suborder Astigmata (mites)
• Order Araneae (spiders)
• Order Scorpiones(scropions)
2
 Medical Entomology
Medically important arthropods
Nuisance/discomfort to human  Nuisance/discomforts to human: some insects and
arthropods bites people and cause great discomfort,
especially when they occur in large numbers (swarms).
 Examples: midges, mosquitoes, bees
Nuisance/discomforts cause
by insects
• Bites and allergic reaction

• Entomophobia: an abnormal and persistent fear of

insects

• Arachnophobia: an abnormal and persistent fear of

arachnids (eg; fear spiders)
Poisonous to human • Some of the insects and arachnids are poisonous. They
release toxin or venom when they bite or sting. Certain
toxins are very potent that can cause death to the victim.
Parasites of human • A few of the medically important insects are
subcutaneous tissue parasites.
• They resides within the subcutaneous tissues of its hosts
and obtain food from the hosts.
• Example: the screwworm and human bot fly that burrow
into wounds and feed on tissues and dead cells.
• Most of medically important insects are ectoparasites
such as lice. Ectoparasites reside outside of the hosts
body and obtain food by sucking on the body fluid of
the hosts. They are either permanent or temporary
ectoparasites
Vector of diseases • Many of the medically important insects are also vector
for diseases such as malaria, filariasis, dengue,
chikungunya, Zika and Japanese encephalitis.
• Insects that are vectors can transmit pathogens such as
virus, bacteria, protozoa and nematode worm while
feeding on the hosts.
• The pathogens transmitted are obtained from other hosts
known as reservoir hosts.

Definition
Vectors agents responsible for transmitting or transferring disease
causing organisms from one host to another.
Pathogens the disease causing organisms
Transmission the transfer of pathogens from a host to another host by a
vector.
Reservoir hosts (maintenance/amplifiying • animals or human harboring the disease-causing
hosts) organisms (pathogens), but may not show any
symptoms. Reservoir host will usually amplify the

3
Frances
 Medical Entomology
disease-causing pathogens.

Transmissions of insect-borne diseases

Mechanical transmission The organisms (pathogens) did not enter to develop

in insects, but utilize insects as vehicle for dispersal
or disease transmission (eg; pathogen transmitted by
houseflies)
Biological transmission The organisms (pathogens) must enter the insects,
live, develop and/or propagate inside the insect host
before they are transferred to another hosts.

Types of biological transmission:

 Propagative (eg. viruses) organisms multiply
in host

 Cyclopropagative (eg. Plasmodium sp. )

organisms need hosts for completion of life
cycle; they develop and multiply in their hosts
 Cyclodevelopmental (eg. filarial worm)
organisms need hosts for completion of life
cycle and development, but do not multiply

Factors for successful transmission of insect-borne diseases

Susceptibility of the insects to infection and ability to The insect must be susceptible to the pathogen it
transmit it carries which means the insect is able to harbor the
4
Frances

Proximity of the breeding habitat of the insects.
Biting habits of insects: anthropophilic, zoophilic,
exophilic, or endophilic
Longevity of the insects.
Abundance of the insects.
Dispersal or flight range of the insects.
Interactions in the ecological systems.
Frances
Medical Entomology
pathogen without being harmed. The immune system
of insect should not react to the presence of pathogen.
The
pathogen should not affect the insect or kill the
insect, so that the insect will live and function as a
vector for the pathogen.
The proximity of the breeding places of insect must
be close to human. This will ensure the insect can
easily get source of blood to feed as soon as they
emerge and become adult. If breeding habitat is far,
the insect will need to fly far and may not be
successful to reach for their source of blood
 Blood-feeding insects that are anthrophophilic
(prefers human) may be more successful in
transmitting disease pathogens to human,
rather than the zoophilic (prefers animals)
blood feeding insect.
 Exophilic mosquitoes are more efficient in
transmitting disease pathogen during daytime
when people are mostly outside during day
time. Similarly endophilic mosquitoes are
more successful in transmitting pathogen
during night time, when most people are
inside houses.
 The longer the vector insect live, the more
probability for the insect to blood feed, thus
increase the chances of transmitting
pathogens.
 Mosquitoes live approximately 3 to 4 weeks.
 Flies live approximately 1 month Sandflies
can live 6 to 7 weeks
Insects that occur in high number will increase the
probability of acquiring and transmitting pathogens.
During certain seasons, the number of insect vector
can
increase due to favorable environmental condition.
For example, intermittent rain can produce favorable
condition for Aedes mosquito breeding. Thus will
increase the
density or abundance of the vector and increase
chance of disease transmission.
The further the flight range or dispersal of insects, the
higher the probability that the pathogen get dispersed.
Thus increase the chances of pathogen be transmitted
or reach to human
For transmission to be successful, host (human),
vector insect and pathogen (eg: parasites, protozoa,
5

Insects orders that are medically important
Order Blattaria (cockroaches)
Order Siphonaptera (fleas)
Order Anoplura (lice)
Pediculus humanus
Frances
Medical Entomology
bacteria etc) must be overlapped or interact in the
environment.
• Cockroaches are domestic pests.
• Cockroaches aid in mechanical transmission of
pathogenic bacteria, viruses and protozoa.
• Almost worldwide in distribution.
• Domestic infestation is due to insanitary condition.
• Prevention is by ensuring house or buildings are clean.
• Avoid leaving dirty dishes and food debris
• Avoid using papers for lining or keep cardboard boxes
• Use commercial insecticidal spray for cockroach
• Fleas are ectoparasites of human and animals and
distributed worldwide.
• Generally, they are a nuisance because of blood feeding
behaviour
• Only a few species that are medically important because
they can transmit pathogens.
• Fleas, Xenopsylla sp. transmit bacteria Yersinia pestis
that causes Bubonic plague or Black death.
• Head lice, body lice and pubic lice are ectoparasites of
human and feed on blood.
• Body lice is also capable of vectoring pathogens.
• They are distributed worldwide.
Symptom of head lice infestation
• Itching or pruritus is the most common due to an
allergic reaction to bites).
• A tickling feeling or a sensation of something moving in
the hair
6

Order Hemiptera (bedbugs)
Order Diptera (mosquitoes and flies)
Frances
Medical Entomology
• Irritability and sleeplessness
• Sores on the head caused by scratching, may cause
secondary infection.
Prevention from head lice infestation
i) Do not share personal belongings
ii) Avoid head to head contact
• Bedbugs are domestic pests and cause nuisance to
human by their bloodsucking behavior.
• They hide in cracks and crevices of buildings and only
come out to blood feed at night
• They are worldwide in distribution and not known to
vector any diseases.
Many fly species are mechanical vector of pathogens
such as helminths, virus, protozoa and bacteria. Some fly
species vector diseases. Some fly species are parasitic.
Parasitic flies can cause myiasis
Myiasisis infestation of living tissues with larval stage of
7
 Medical Entomology
flies (maggots)

Maggot therapy

Order Diptera • Mosquitoes are the most important diptera because

Mosquitoes
Major mosquito-borne diseases in Malaysia
• Dengue and dengue hemorrhagic fever (DHF)
• Japanese encephalitis (JE)
• Lymphatic filariasis
many are vector of diseases.
• The most important genuses are Anopheles, Aedes,
Culex and Mansonia.
• Mosquitoes can transmit pathogens such as protozoa,
viruses, and nematodes which can cause malaria, dengue,
chikungunya, Zika and filariasis.

Dengue and dengue hemorrhagic fever (DHF) Japanese encephalitis (JE) 日本腦炎 Lymphatic filariasis 象
皮病
登革热出血热
• Dengue is a disease caused by dengue virus • Prevalent over the
and is transmitted through the bite of infected tropical world
mosquitoes. •Affects 120 million
• The first reported epidemics of dengue fever people in 72 countries
occurred in 1779-1780 in Asia, Africa, and • Leading viral encephalitis in Asia •Transmission of the
North America. • Estimated 30,000 to 70,000 cases per parasite is by several
• Global pandemic of dengue started in year species of mosquitoes
Southeast Asia, after the World War II. • Estimated 13,000 to 20,000 death per • No multiplication of
• Subsequent infection can cause the severe form year, mostly children nematode parasites in

8
Frances
 Medical Entomology
of dengue, the DHF. • 30 billion people in 24 countries are at the vector.
• DHF was first recognized in the 1950’s in the risk • Adult worm may live
Philippines and Thailand. By 1975 it become the • Increased cases are due to deforestation, in human host up to 10
leading cause of hospitalization and death among agricultural years.
children in the region. development, and irrigation or rice • Disfigurement of the
• DHF has extended to Sri Lanka, India, cultivation. disease cause social
Maldives and Pakistan followed by epidemics and economical
with multiple serotype in the Indian continent, Pathogens: Japanese encephalitis virus problem to the
Peoples Republic of China, Taiwan, East Africa from affected person &
and Saudi Arabia. the family Flaviviridae family
• Now dengue is found in tropical and Reservoirs: birds and pigs • A disease that
subtropical regions around the world, in urban Vectors: Culex sp. mosquitoes commonly seen
and semi-urban areas. • Culex tritaeniorhynchus among the poor.
• Dengue is endemic in 129 countries, in Africa • Culex vishnui
the Americas, The Eastern Mediterranean, • Cules pseudovishnui
South-east Asia and the Western Pacific (WHO). • Culex gelidus
• WHO estimated about 3.9 billion people are at
risk from dengue.
• Modelling estimates with about 390 million
cases of dengue infection worldwide every year,
and 70% are in Asian countries.
Pathogens: The vector – Culex mosquitoes Vectors: Mosquitoes
 There are four closely related viruses • Culex mosquitoes breed in dirty water from the genus
from the family of Flaviviridae that cause usually unfit for Anopheles, Aedes,
dengue. This virus is subdivided into four drinking such as in drainage and sewage Culex and Mansonia.
serotypes: DEN-1, DEN-2, DEN-3 and tanks.
DEN-4. • Other aquatic habitats: rice fields,
 Infection with one serotype does not marshes and swampy area.
provide cross-protective • Their eggs are laid in raft form (clusters)
immunity so a person living in dengue • Adults of Culex bite throughout night.  Aquatic habitat
endemic area can have up to four dengue of Mansonia
infections during their lifetime. sp. is swampy
areas with
 Reservoirs: human (main reservoir) and
vegetation.
primates (jungle reservoir)
Mansonia sp.
 The larval
stage have
modified
siphon that
hook to aquatic
plants roots
 Adults bite
during the day
and at night.
Breeding places of
Mansonia larvae

9
Frances
 Medical Entomology

Water hyacinth
 Pathogens:
Nematode
worm (Brugia
malayi and B.
timori,
Wuchereria
bancrofti)
 Reservoirs:
human,
primates,
domestic cats

• Symptoms: chill, fever, nausea, vomiting

seizures.
• Children usually are severely affected
and become ‘vegetative state’ with the
infection
• Diagnosis: serological tests of blood and
spinal fluid
• Treatment: no specific treatment but
prevention with vaccine is available
Dengue is transmitted by mosquito from the Symptoms of the
genus Aedes. disease
• Aedes albopictus is a rural mosquitoes and - usually fever,
breeds in the leaf axil, treeholes and other symptoms do
natural water containers. not show for a long
• Aedes aegypti is an urban species and breeds in period of time
artificial containers such as vase, cans, barrels - adult parasitic worms
and old tyres. will live in
• These mosquitoes biting activity is early nodules and block the
morning and at dusk. lymph nodes
- blockage caused the
limbs to swell; a

10
Frances
 Medical Entomology
condition called
elephantiasis

Dengue vectors  Diagnosis:

blood smear
for
microfilariae
 Treatment:
anti-filarial
drugs, eg.
ivermectin,
albendazole

Symptoms of dengue and dengue haemorraghic

fever
- headache, fever, skin rashes
- pain behind the eyes
- muscle and joint pain
- loss of appetite, abdominal pain,
- vomiting, nausea
- symptoms are more severe in the case of
dengue hemorraghic fever (plasma leakage)
Diagnosis: serological tests
Treatment: no drugs for treatment,
patient management

Rashes

11
Frances
 Medical Entomology

Plasma leakage

Other insect-borne diseases

African Trypanosomiases
Leishmaniases
Onchocerciasis
Loasis
Plague
African Trypanosomiases (African sleeping sickness) Vector: Tsetse flies, Glossina sp. (Order Diptera)
非洲锥虫病（非洲昏睡病 Pathogen: Typanosoma sp. (flagellated protozoa)
Reservoirs: Human, pigs, dogs

Tsetse fly
Leishmaniases 利什曼病 Vector: Phlebotomussp. (sandfly, Order Diptera)
Pathogen: Leishmania sp. (flagellated protozoa)
Reservoir: mammals

Sandfly

Cutaneous leishmaniasis
Onchocerciasis (river blindness) Vector: Simulium sp. (black flies, Order Diptera)
Pathogen: Onchocerca volvulus (nematode)
Reservoir: human and primates
12
Frances
 Medical Entomology

Loasis (eye worm) Vector: Chrysop sp. horseflies (Order Diptera)

Pathogen: Loa loa (nematode)
Reservoir: human, horses

Bubonic plague (Black death) Vector: Fleas, Xenopsylla cheopis(Order Siphonaptera)

Pathogen: Yersinia pestis(bacteria)
Reservoir: Wild and domestic rodents

Controls of medically important mosquitoes

• Biological controls
13
Frances

• Chemical controls
• Mechanical controls
• Environmental management
• Integrated management
Biological control agents:
Chemical controls:
Mechanical controls:
Environmental management
Integrated vector control programs:
Frances
Medical Entomology
use of natural organisms
- pathogens ( bacteria, fungi, nematodes)
- predators ( Toxorhynchytes larva, guppy,
tilapia fish)
Advantage: environmentally friendly
Disadvantage: less effective
use of synthetic chemicals
- chlorinated hydrocarbon (DDT),
- organophosphates (malathion)
- carbamates(carbaryl)
- pyrethroides (permethrin)
- insect growth regulators (juvenile hormones)
- chitin inhibitors (benzylphenylureas)
Advantage: highly effective
Disadvantage: costly, not environmentally friendly,
vector develops resistance
Mechanical controls: creating a barrier
- house screening
- bed nets
- proper clothing
Advantage:
environmentally friendly
Disadvantage: costly
- source reduction
- drainage
- swamp alteration
- sanitary measures
Advantage: eliminate vector breeding site
permanently
Disadvantage: disrupt ecology, not
environmentally friendly
Employment of several control methods to ensure
effective measures against vectors.
Example:
1) source reduction and spraying insecticide for
14
 Medical Entomology
controlling Aedes mosquito.
2) using bednets impregneted with permethrin
3) install window netting to prevent mosquito from
entering houses
Preventive measures against insect-borne diseases.
• Health education/awareness about insect-borne diseases
• Vaccination (JE-yes, Dengue-almost: Denvaxia)

~End

15
Frances