General Study Guide - 2

• For each insect/pathogen combination:

– How prevalent/serious is the threat?
– What host-pathogen-insect factors are
involved in the transmission-disease cycle?
– What general categories/terms apply to the
various components?
– In what situations would you expect to
encounter the problem (geographical location,
season, ecological setting, specific sites/times
of day, etc.).
– What are the general management options?
 Current Status of Plague
•Between 1998 and
2008, nearly 24,000
cases have been
reported, including about
2,000 deaths
•In 2003, 9 countries
reported 2118 cases and
182 deaths.
•98.7% of those cases
and 98.9% of those
deaths were reported
from Africa.
•Most serious current
epidemic is in the Congo
(FKA Zaire).
• August, 2009, outbreak
in Qinghai, China
US Human
Cases
1970 - 1997

US normally has 10 – 20
cases/year
 Diptera
• One of the largest orders of insects.
• By far, the most medically-important order.
• Only order to have significant presence in all
major categories of damage:
– Direct:
• Biting – exsanguination
• Invasion - myiasis
• Toxins
• Disturbance/Irritation
– Indirect:
• Disease / pathogen transmission
• Secondary Reactions - Allergies, weakening
• Psychoses – entomophobia, dilussory parasitosis
 General Characteristics of Diptera
• Holometabolus
• One pair of flight wings,
one pair of halteres
• Many larvae are
aquatic/semiaquatic
• Adult mouthparts are
usually adapted for taking
liquid food (some are non-
functional or absent).
 Nematocera vs. Brachycera

Character Nematocera Brachycera

Mosquito House
Body shape like Fly like

Obtect Coarctate
Pupae

Antennae cf. Usually longer Usually shorter

Fig. 10.4 than the head than the head
 Principal Dipteran Families That
We Will Discuss
• Psychodidae – Sand flies
• Simuliidae – Black flies
• Culicidae – Mosquitoes
• Muscidae – House flies, Livestock_Flies
• Glossinidae – Tsetse flies
• Tabanidae – Horse flies
• Hippoboscidae - Louse flies & Keds
• Oestridae – Bot flies
 Psychodidae - Psychodinae
• One of two subfamilies that have medical
significance and this one is minor.
• AKA Moth flies, Drain flies.
• Non-biting species
• A few are sometimes nuisance species
• Drain flies can be problems in insect-
sensitive areas.
 Phlebotominae
• This subfamily has great medical significance
• 700 spp. in 5 genera.
• Female adults are blood feeders, about 1/3 to ½
the size of a mosquito, bite is somewhat more
painful. Feed on blood to acquire protein for egg
production.
• Males and females also feed on plant sap/nectar
for carbohydrates.
• Very poor fliers, adults typically found at
vegetation edges, immatures characteristically
difficult to find.
 Two groups of Phlebotomines
• New World Species – Those found in the
Americas. Most important genus is
Lutzomyia
• Old World Species – Those found outside
of the Americas. Most important genus is
Phlebotomus.
• Most of the species that feed on mammals
can transmit a variety of disease (cf. Table
11.1)
At least two species in Kentucky
• L. shannoni feeds on
mammals and L. vexator
feeds on reptiles.
• First found in 2005 in very
low numbers.
• Now common in Western Ky
• Ky is the northern limit of the
range for most species.
• Probably competent vector
of several pathogens.
• Likely a more serious
veterinary threat than
human one.
 Leishmaniasis
• Most serious disease transmitted by Phlebotomines.
• Caused by protozoans in the genus Leishmania, several species &
many strains.
• Leishmania is one of the 5 genera in the Trypanosomatida
– Another genus is Trypanosoma
– All are parasitic on animals. Most are exclusively insect blood parasites.
• 12 million cases worldwide, 1.5 – 2million new cases/year. Increasing in
prevalence.
• Causes characteristic lesions on the affected tissue
• A group of diseases that are broadly classified into three forms:
– Cutaneous – Lesions on the skin, most common form, mainly disfiguring.
– Visceral – Involvement of internal organs, especially the spleen & liver
– Mucotaneous – Expression in the upper repiratory tract and/or oral mucosa.
South American forms are usually associated/preceded by one of the above
two. Old world forms are not.
 Cutaneous
(Oriental sore, Delhi ulcer, Baghdad boil)
• Papule appears at the infection site 1-2
weeks (or as long as 1-2 months) after
the bite.
• The papule gradually grows to form a
relatively painless ulcer.
• The center of the ulcer encrusts while
satellite papules develop at the periphery.
• The ulcer heals in 2-10 months, even if
untreated but leaves a disfiguring scar.

Diagnosis is via
skin biopsy which
reveals vacuoles
lined with
amastigotes.
Leishmania spp. is
confirmed via
PCR.
 Visceral Leishmaniasis
(kala-azar, dumdum fever)

• Systemic form of the disease

• Usually fatal if not treated.
• Often relapses as kind of
cutaneous Leishmaniasis in
survivors.

Profile view of a teenage boy suffering

from visceral leishmaniasis. The boy
exhibits splenomegaly, distended
abdomen and severe muscle wasting.
 Mucotaneous Leishmaniasis
(espundia, Uta, chiclero)
• Found primarily in Brazil, Bolivia, and Peru.
Probably in Paraguay as well.
• ‘uta’ – Quechua (Inca) for the nasal/oral
disfiguration.
• Known from Incan pottery > 2,000 years old.
• Generally thought to be caused by the same
Leishmania species as in cutaneous but is
transmitted by different fly species. Different
pathogen strains likely as well.

Result with treatment

Result without treatment

 Reservoirs
• Dogs & rodents are efficient
reservoirs.
• Dogs can acquire Leish.
without sand flies through
an unknown process. Early Stage Canine Leish.

sub corneal pustular dermatitis End Stage

 Prevalence
• Prevalence increasing -
>500% increase in
cases in the last 10
years.
• Now endemic in 88
countries
• Increase due to:
– Expansion into new vector
habitat
– Expansion of vector range
– Coincident increase with
HIV.
 Exam is through this point
• Through Chapter 11, Excluding all sandfly-
vectored disease EXCEPT Leishmaniasis.
• Includes all of Chapter 10 but you do NOT
need to know the family names of the
“minor medical or veterinary interest”
groups beginning on p. 142. However,
you might get a question on this material.