78 CONTROL OF COMMUNICABLE AND CERTAIN NONINFECTIOUS DISEASES

in this arena will likely stimulate the development of improved treatments for
infectious diseases in general, which will likely plague mankind for the fore-
seeable future.

INSECTBORNE DISEASES AND ZOONOSES

General
The diseases transmitted by arthropods, commonly known as insectborne dis-
eases, are those diseases that are usually transmitted by biting insects from
person to person or from animal to person. The ordinary housefly and roach,
mechanical carriers of many disease agents, are discussed separately in Chap-
ter 10 of the fourth edition. Zoonoses are defined as ‘‘those diseases and
infections which are naturally transmitted between vertebrate animals and
man.’’* 154

Insectborne Diseases
A list of insectborne diseases together with their important reservoirs is given
in Tables 1-11, 1-12, and 1-13. The list is not complete but includes some of
the common as well as less known diseases. Tick- or fleaborne diseases may
be spread directly by the bite of the tick or flea and indirectly by crushing
the insect into the wound made by the bite. Usually mosquitoes, lice, ticks,

TABLE 1-11 Some Exotic Insectborne Diseases (Not Normally Found in the
United States)
Incubation
Disease Period Reservoir Vector
Bartonellosis 16–22 days Man Sandflies (Phlebotomus)
Leishmaniasis
cutaneous Days to months Animals, dogs Sandflies (Phlebotomus)
Visceral 2–4 months Man, dogs, cats, Sandflies (Phlebotomus)
wild rodents
Loiasis (Loa loa) Years Man Chrysops. blood-
sucking flies
Sandfly fever 3–4 days Man, sandfly Sandfly (Phlebotomus)
Relapsing fever 5–15 days Man, ticks, rodents Lice, crushed in wound;
ticks
Trench fever 7–30 days Man Lice, crushed in wound
(Pediculus humanus)
Source: Ref. 3.

*WHO Tech. Rep. Ser., 378, 6 (1967) considers the definition too wide but recommends no change.
 TABLE 1-12 Characteristics of Some Insectborne Disease
Incubation
Disease Etiologic Agent Reservoir Transmission Period Controla
Endemic typhus Rickettsia typhi (R. Infected rodents, Rattus Bite or feces of rat flea Xenopsylla 7–14 days, First, elimination of rat flea by
(murine) mouseri) also possibly rattus and Rattus cheopis; also possibly ingestion usually 12 insecticide applied to rat runs,
(fleaborne)b Ctenocephalides felis norvegicus, also or inhalation of dust days burrows, and harborages, then rat
fleas, possibly contaminated with flea feces or control. Spray kennels, beds, floor
opossums urine. cracks.
Epidemic typhus Rickettsia prowazeki Infected persons and Crushing infected body lice 7–14 days, Insecticidal treatment of clothing and
(louseborne) infected lice Pediculus humanus or feces into usually 12 bedding; personal hygiene, bathing,
bite, abrasions, or eyes. Possibly days elimination of overcrowding.
louse feces in dust. Immunization. Delousing of
individuals in outbreaks.
Bubonic plague Pasteurella pestis, Wild rodents and Bite of infective flea X. cheopis, 2–6 days Immunization. Surveys in endemic
plague bacillus infected fleas scratching feces into skin, areas. Chemical destruction of flea.
(Yersinia pestis) handling wild animals, Community hygiene and sanitation;
occasionally bedbug and human rat control. (Plague in wild rodents
flea; pneumonic plague spread called sylvatic plague.)
person to person.
Q fever Coxiella burneti Infected wild animals Airborne rickettsias in or near 2–3 weeks Immunization of persons in close
(Rickettsia burneti) (bandicoots); cattle, premises contaminated by contact with rickettsias or possibly
sheep, goats, ticks, placental tissues; raw milk from infected animals. Pasteurization of
carcasses of infected infected cows, direct contact all milk at 145⬚F for 30 min or
animals with infected animals or meats 161⬚F for 15 sec.
Rocky Mountain Rickettsia rickettsii Infected ticks, dog Bite of infected tick or crushed 3–10 days Avoid tick-infested areas and crushing
spotted fever ticks, wood ticks, tick blood or feces in scratch or tick in removal; clear harborages;
Lone Star ticks wound. insecticides.
Colorado tick Colorado tick fever virus Infected ticks and Bite of infected tick, Dermacentor 4–5 days See Rocky Mountain spotted fever.
small animals andersoni
Tularemia Franciscella tularensis Wild animals, rabbits, Bite of infected flies or ticks, 1–10 days, Avoid bites of ticks, flies. Use rubber
(Pasteurella muskrats; also wood handling infected animals. usually 3 gloves in dressing wild animals;
tularensis) ticks Ingestion of contaminated water days avoid contaminated water;
or insufficiently cooked rabbit thoroughly cook rabbit meat.
meat.
Rickettsial-pox Rickettsia akari Infected house mice; Bite of infective rodent mites 10–24 days Mouse and mite control. Apply
79

possibly mites miticides to infested areas;

incinerators.
80

TABLE 1-12 (Continued )

Incubation
Disease Etiologic Agent Reservoir Transmission Period Controla
Scabies Sarcoptes scabiei, a mite Persons harboring itch Contact with persons harboring Several days or Personal hygiene, bathing, chemical
mite; also found in mite and use of infested weeks treatment, clean laundry; machine
dogs, horses, swine garments or bedding; also during laundering. Exclude children from
(called mange); do sexual contact school until treated. Prevent crowded
not reproduce in living.
skin of humans
Trypanosomiasis, Trypanosoma cruzi Infected persons, dogs, Fecal material of infected insect 5–14 days Screen and rat proof dwellings; destroy
American cats, wood rats, vectors, conenosed bugs in eye, vectors by insecticides and on
opossums nose, wounds in skin infested domestic animals.
Scrub typhus Rickettsia tsutsugamushi Infected larval mites, Bite of infected larval mites 10–12 days Eliminate rodents and mites; use
wild rodents repellents; clear brush.
Trypanosomiasis, Trypanosoma gambiense Humans, wild game, Bite of infected tsetse fly 2–3 weeks Fly control; treatment of population;
African (sleeping and cattle clear brush; education in prevention.
sickness)c
Lyme disease Borrella burgdorferi White-footed field Bite of infected deer tick nymph 3–32 days, Identify and post infested areas and
mice in eastern and adult average 7 educate public to avoid ticks. Use
United States and days repellent—deet or pemethrin. Inspect
lizards and jack- for presence of ticks, also cats and
rabbits in the West; dogs, and remove without crushing.
ixodid tick feeds on Early treatment if bitten. See Ticks,
and survives on Chapter 10.
white-tailed deer

Source: Various sources and ref. 3.

a
Investigation and survey usually precede preventive and control measures. See also Chapter 10.
b
‘‘The association of seropositive opossums with human cases of murine (endemic) typhus in southern California and the heavy infestation of the animals with
Ctenocephalides felis which readily bite man, suggest that opossums and their ectoparasites are responsible for some of the sporadic cases of typhus in man.’’ W.
H. Adams, R. W. Emmons, and J. E. Brooks, ‘‘The Changing Ecology of Murine (Endemic) Typhus in Southern California,’’ Am. J. Trop. Med. Hyg., March 1970,
pp. 311–318.
c
African trypansomiasis, or Chagas disease, affects 16–18 million people with 90 million at risk according to the WHO, Nation’s Health, July 1990, p. 9.
 TABLE 1-13 Mosquitoborne Diseases
Incubation
Disease Etiologic Agent Reservoir Transmission Period Control
Dengue or Break- Viruses of dengue fever Infected vector mos- Bite of infected 3–15 days, Eliminate Aedes vectors and breeding
bone fevera quitoes, humans, and Aedes aegypti, A. albopictus, A. commonly places; screen rooms; use mosquito
possibly animals, in- scutellaris complex 5–6 days. repellents.
cluding the monkey
Encephalitis, anthro- Virus of Eastern equine, Possibly wild and do- Bite of infected mosquito, probably Usually 5–15 Destruction of larvae and breeding
podborne viral Western, St. Louis, mestic birds and in- Culiseta melanura and Aedes for days places of Culex vectors. Space
Venezuelan equine, fected mosquitoes, Eastern; Culex tarsalis for West- spraying, screening of rooms; use
Japanese B, Murray ring-necked pheas- ern; Culex tritaeniorhynchus for mosquito bed-nets where disease
Valley, West Nile, and ants, rodents, bats, Japanese; present. Avoid exposure during bit-
others reptiles Culex pipiens-quinquefasciatus ing hours or use repellents. Public
for St. Louis, also Culex nigri- education on control of disease. Vac-
palpus cination of equines.
Filariasisa (elephan- Nematode worms, Wuch- Blood of infected per- Bite of infected mosquito: Culex 3 months; mi- Antimosquito measures. Determine in-
tiasis after pro- ereria bancrofti and son bearing microfi- fatigans, C. pipiens; Aedes crofilariae do sect vectors, locate breeding places,
longed exposure) W. malayi liariae, mosquito polynesiensis and several species not appear in and eliminate. Spray buildings. Edu-
vector of anopheles blood until at cate public in spread and control of
least 9 disease.
months
Malariaa Plasmodium vivax, P. Humans and infected Bite of certain species of infected Average of 12 Residual insecticide on inside walls
malariae, P. falcipa- mosquitoes, found anopheles and injection or trans- days for fal- and places where anopheles rests.
rum, P. ovale between 45⬚ N and fusion of blood of infected per- ciparum, 14 Community spraying. Screen rooms
45⬚ S latitude and son for vivax, 30 and use bed-nets in edemic areas.
where average sum- for malariae; Apply repellents to skin and cloth-
mer temperature is sometimes ing. Eliminate breeding places by
above 70⬚F or the delayed for drainage and filling; use larvicides:
average winter tem- 8–10 months oil and Paris green. Suppressive
perature is above drugs, treatment, health education.
48⬚F or the average Gambusia affinis fish for larvae con-
winter temperature is trol.
above 48⬚F
81
82

TABLE 1-13 (Continued )

Disease Etiologic Agent Reservoir Transmission
a
Rift Valley fever Virus of Rift Valley Sheep, cattle, goats, Probably through bite of infected
fever monkeys, rodents mosquito or other blood-sucking
arthropod; laboratory infections
and butchering
Yellow fevera Virus of yellow fever Infected mosquitoes, Bite of infected A. aegypti. In
persons, monkeys, South Africa, forest mosquitoes,
marmosets, and Haemagogus spegazzinii, and
probably marsupials others; in East Africa, Aedes
simpsoni, A. africanus, and oth-
ers; in forests of South America,
by bite of several species of
Naemagogus and Aedes leucoce-
laenus; Aedes albopictus in
Asia, Pacific, also southern
United States and
Brazilb
Incubation
Period Control
Usually 5–6 Precautions in handling infected ani-
days mals. Protection against mosquitoes
in endemic areas. Care in laboratory.
3–6 days Control of Aedes breeding places in
endemic areas. Intensive vaccination
in South and East Africa. Immuniza-
tion of all persons exposed because
of residence or occupation. In epi-
demic area spray interior of all
homes, apply larvicide to water con-
tainers; mass vaccination, evaluation
surveys.

Source: Various sources and ref. 3.

a
Normally not found in United States. The WHO estimates that 90 million people have lymphatic filariasis with 900 million at risk: The Nation’s Health, July
1990, pp. 8–9.
b
PAHO Bulletin, 21(3), 314 (1987).