MEDICAL ENTOMOLOGYMEDICAL ENTOMOLOGY

Subjects :1. Medical Entomology (Introduction)

2. Mosquitoes and flies3. Mites

Subjects :1. Medical Entomology (Introduction)

2. Mosquitoes and flies3. Mites

Compared to the number of species of mammals, protozoa and helminthes, insect species outnumbers them all

ARTHROPODS

MEDICAL ENTOMOLOGY MEDICAL ENTOMOLOGY

Introduction

Definition: entomology Definition: entomology Science that study insects (Entomon = Science that study insects (Entomon =

Insecta) and other species belonging to Insecta) and other species belonging to Phylum Arthropoda, Phylum Arthropoda, in relation toin relation to health, and its controlhealth, and its control

Medical entomology Medical entomology Study of Study of vectorvector,, vector borne diseases vector borne diseases

and abnormalities caused by insectsand abnormalities caused by insects

Introduction

entomology Medik (Kedokteran) entomology Medik (Kedokteran) Ilmu yang mempelajari tentang Ilmu yang mempelajari tentang vectorvector,,

disease dan kelainan yang disebabkan disease dan kelainan yang disebabkan oleh insectsoleh insects

VectorVector Vector are mostly insects which carry and Vector are mostly insects which carry and

transmit disease agents from patient to transmit disease agents from patient to healthy person; or from disease sources to healthy person; or from disease sources to uninfected food or drinks uninfected food or drinks

Introduction

ARTHROPODAARTHROPODA

- Divided into 5 classes- Divided into 5 classes

I. Class Insecta --- I. Class Insecta --- Medically important insect :Medically important insect :

* Order Diptera* Order Diptera

* Order Anoplura* Order Anoplura

* Order Hemiptera* Order Hemiptera

* Order Siphonaptera* Order Siphonaptera

II. Class ArachnidaII. Class Arachnida

III. Class CrustaceaIII. Class Crustacea

IV. Class ChilopodaIV. Class Chilopoda

V. Class DiplopodaV. Class Diplopoda

Characteristic

Phylum Arthropoda Phylum Arthropoda Multicellular animal (metazoa)Multicellular animal (metazoa) Symmetric, bilateralSymmetric, bilateral Segmented body Segmented body Possess an exoskeletonPossess an exoskeleton Appendages : antennae, palpa etc.Appendages : antennae, palpa etc.

MetamorphosisMetamorphosis Morphological changes and development Morphological changes and development

in the life cycle of Arthropodsin the life cycle of Arthropods

Two type metamorphosisTwo type metamorphosis Complete metamorphosisComplete metamorphosis Incomplete metamorphosisIncomplete metamorphosis

Metamorphosis

Complete Metamorphosis Complete Metamorphosis Marked changes and development in the Marked changes and development in the

morphology and biology (natural morphology and biology (natural habitat, types of food, etc)habitat, types of food, etc)

Eggs - Larva - Nymphs - AdultsEggs - Larva - Nymphs - Adults

Incomplete Metamorphosis Incomplete Metamorphosis Eggs/ova - (Larva) - Pupa - AdultsEggs/ova - (Larva) - Pupa - Adults

Metamorphosis

Insects may act asInsects may act as

Vector/transmitter of disease agentsVector/transmitter of disease agents

As direct cause/etiology of disease or As direct cause/etiology of disease or

injuryinjury

Role as vector

ROLE OF ARTHROPODS

Mode of transmission

Two modes of transmission Two modes of transmission

As mechanical vector As mechanical vector

As biological vectorAs biological vector

ROLE OF ARTHROPODS

House flies

Role as mechanical vectorRole as mechanical vectordisease agents do not develop or multiply disease agents do not develop or multiply

inside the vectorinside the vectorExample : gastroenteritis agents in flies Example : gastroenteritis agents in flies

and cockroachand cockroachTransmission occurs through the Transmission occurs through the

proboscis, legs, body, wingsproboscis, legs, body, wings

ROLE AS BIOLOGICAL VECTORROLE AS BIOLOGICAL VECTOR

- Disease agents develop or multiply inside the - Disease agents develop or multiply inside the vectorvector

- Example :Example :PlasmodiumPlasmodium sp. sp. at at Anopheles sp.Anopheles sp.- Transmission occurs through the proboscisTransmission occurs through the proboscis

Role as vector

Anopheles , vector of malariaAedes aegypti , vector of dengue

hemorrhagic fever

ROLE OF ARTHROPODS

Role as the cause of disease

Disease or injury may be caused by insects through various means :- Mechanical injury- Injection of poisonous substances- Allergies- Psychosis

Role of Arthropods

Role as the cause of disease

Mechanical causeMechanical causeBites - sting - piercing and bloodsucking - Bites - sting - piercing and bloodsucking -

larval movementlarval movementArthropods may act as :Arthropods may act as :

Endoparasites : larva of flies causing myiasis Ectoparasites: headlouse Permanent parasites : fleas Intermittent parasites: mosquito

Role of Arthropods

AllergiesAllergiesDyspnea /asthma : caterpillar, Dyspnea /asthma : caterpillar,

butterflies butterflies

PsychosisPsychosisEntomophobiaEntomophobia

A boy with allergy from mosquito biteA boy with allergy from mosquito bite

Injection of Toxic substanceInjection of Toxic substancePoison enters through :Poison enters through :

Direct contact (caterpillars), bites (spider), sting (scorpion), piercing (mosquito)

Common symptoms :Common symptoms : Itching, swelling, urticaria (mosquito,

caterpillars) Hemolysis (scorpion) bleeding (bees) Nerve damage (scorpion)

Insect as cause of injury and disease

Scorpion Spider

Role of Arthropods

Bedbugs: (1) female; (2) male; (3) bloodsucking activity

(3)(1) (2)

Centipedes

Life cycle

MosquitoMosquito

Life span: 2 weeks Complete Metamorphosis (eggs - larva - pupa - adults).

Eggs laid on water surface :

– White 1-2 hours - Turns black 2-4 days - Larva ( stage I -

IV) 6-8 days - Pupa 1-3 day - Adults male and female

1. Mosquito bites may cause urticaria, and dermatitis2. As vector transmitter of many diseases :

Example 1:Malaria (Plasmodium) Main vectors of malaria in Jawa and Bali : Anopheles

sundaicus, A. aconitus, A. subpictus, A. maculatus, A. balabacensis, A. sinensis.

Medical importance

Dengue (by Dengue virus) Based on severity, clinical dengue may

manifest as Dengue Fever (DF), Dengue

Hemorrhagic Fever (DHF) or Dengue Shock

Syndrome (DSS). Vector: Aedes aegypti, Ae. albopictus, Ae.

scutelaris, Ae. togoi

Dengue (by Dengue virus) Based on severity, clinical dengue may

manifest as Dengue Fever (DF), Dengue

Hemorrhagic Fever (DHF) or Dengue Shock

Syndrome (DSS). Vector: Aedes aegypti, Ae. albopictus, Ae.

scutelaris, Ae. togoi

Medical importance

vector of disease : Example 3.

Yellow fever - by Yellow Fever virus Primary vectors : Aedes aegypti, Ae. simpsoni

Yellow fever - by Yellow Fever virus Primary vectors : Aedes aegypti, Ae. simpsoni

Japanese B. encephalitis and St. Louis

encephalitis (by JBE and SLE virus) Primary vectors : Culex pipiens, C. tarsalis, Ae. togoi

Japanese B. encephalitis and St. Louis

encephalitis (by JBE and SLE virus) Primary vectors : Culex pipiens, C. tarsalis, Ae. togoi

Medical importance

vector of disease : Example 4 & 5

Medical importance

Aedes aegypti , vector of dengue fever

Family PsychodidaeGenus Phlebotomus = Sandflies11

Family SimuliidaeGenus Simulium = black fly = buffalo gnats 22

Family Ceratopogonidae/HeleidaeGenus Culicoides = midges = no-see-um = punkies33

Bloodsucking Flies Bloodsucking Flies

Flies

Sub ordo BrachyceraFamily TabanidaeGenus Tabanus = horse flyGenus Chrysops = deer flyGenus Hybomitra

44

55Sub ordo Athericera = CyclorraphaFamily MuscidaeGenus Glossina = Tsetse FliesGenus Stomoxys = Stable Flies

Bloodsucking Flies Bloodsucking Flies

Flies

Medical importance The bites may cause dermal papules, intense pain,

itching, nausea, fever, malaise As vector of the following diseases :

Flies

Phlebotomus fever = demam papataciDisebabkan virusTerdapat di laut Tengah, Arab, Asia selatanvectornya Phlebotomus papataci

BartonellosisDisebabkan Bartonella baciliformisTerdapat di Pegunungan Andesvectornya Phlebotomus verrucosum

Kala azar By Leishmania donovaniOriental soreBy Leishmania tropicaAmerican Leishmaniasis By Leishmania braziliensis

Phlebotomus sp.Phlebotomus sp.

Medical importance Painful bite, causing itch and fever Act as vector of disease (as intermediate host of

Filarial worm) : Culicoides grahami, and C. austeni, as vector of

Acanthocheilonema perstans Culicoides grahami as vector of Dipetalonema

streptocerca Culicoides furens and C. paraensis as vector of

Mansonella ozzardi

Culicoides sp.Culicoides sp.

Flies

Source : Color Atlas of Medicine and parasitesology. 1977W. Peters & H.M. Gillers

Adults Culicoides sp.

Culicoides sp.Culicoides sp.

Flies

Medical importance vector Arfiican sleeping disease

Trypanosoma gambiense, vector is Glossina

palpalis Trypanosoma rhodesiense, vector is Glossina

morsitans

Glossina sp.Glossina sp.

Flies

Source : Atlas parasitesologi Kedokteran. 1994Juni Prianto, Tjahaya P.U., Darwanto

Source :A Colour Atlas of Clinical parasitesology. Tomio Yamaguchi

Alih Bahasa : Lesmana Padmasutra, dkk.

Glossina sp.Glossina sp.

Stomoxys sp.Stomoxys sp.

Flies

Medical importance Painful bites; mostly on cattle and

horses which may cause anemia Mechanical vector of :

Trypanosoma evansi – which causes a disease in animals called surra

- Example: Stomoxys calcitrans

Stomoxys sp.Stomoxys sp.

Family Muscidae– Musca domestica = House flies 11Family Sarcophagidae– Meat flies – Characteristic : viviparous– Lay its larva on meat Example :– Genus Sarcophaga : myiasis semi-

systemic and accidental – Genus Wohlfahrtia : specific– myiasis

22

Non-biting Flies Non-biting Flies

Flies

Family Calliphoridae– Blow flies– Example : Chrysomyia bezziana– Specific Myiasis on open wound,

nostril, ear holes (myiasis of the skin and atrial openings)

33

Family Drosophilidae– Species: Drosophila melanogaster– Also called fruit flies, may cause

accidental intestinal myiasis 44

Non-biting Flies Non-biting Flies

Flies

Medical importance Adult flies may act as mechanical vector of

many disease agents : protozoa, worm eggs, bacteria, virus.

Larva stage may invade human tissue causing a disease called myiasis

Lalat rumah

Musca domesticaMusca domestica

Flies

Musca domestica (House flies )

Musca domesticaMusca domestica

Flies

Definition: Infestation of human or

animal tissue or organs by

maggot (larva stage) of certain

non-biting flies

This larva live from tissue, body liquid, or food from This larva live from tissue, body liquid, or food from

the hospes the hospes

MYIASISMYIASIS

MyiasisMyiasis

Larvae in necrotic tissue

TRANSMISSIONTRANSMISSION

Infestations occur when the insects put their Infestations occur when the insects put their eggs on the injury skin or open abscess. eggs on the injury skin or open abscess.

Species that cause myasis, for example Species that cause myasis, for example Passeromyia longicomis larvae. Passeromyia longicomis larvae.

Species that cause myasis dermal only, for Species that cause myasis dermal only, for example example Cordylobia anthropophage Cordylobia anthropophage and and Cordylobia hominis.Cordylobia hominis.

Diagnosis Diagnosis

For Ophtalmomyasis, irrigation of lacrimal For Ophtalmomyasis, irrigation of lacrimal gland until the parasite come out. gland until the parasite come out.

One drop of cocaine for paralyzing the One drop of cocaine for paralyzing the movement, then lifted by using tweezer movement, then lifted by using tweezer ( forceps ). Same as dermal myasis. ( forceps ). Same as dermal myasis.

Myasis intestinal : feces examination. Myasis intestinal : feces examination.

MITES

IntroductionIntroduction

Classified under ordo Acarina Causing acariasis Medically most important mites :

Family Sarcoptidae (Scabies mite)

Family Trombiculidae

MITES

Scabies , Sarcoptic mange Scabies , Sarcoptic mange Etiology : Sarcoptes scabiei

Family Sarcoptidae Order : Acarina Disease : scabies,

sarcoptic mange Ectoparasite, inhabit the

skin creating tunnels under the stratum corneum where female lay eggs

Predilection sites : thin skin folds (between fingers, armpit, wrist, genital fold) Source :A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi.

Translation : Lesmana Padmasutra, dkk.

Common among children and adults of poor personal hygiene

Among inhabitants of prisons, orphanages, boarding houses and military barracks

Source :A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi. Translation : Lesmana Padmasutra, dkk.

Scabies Mites Scabies Mites

Clinical symptoms Night itch caused by :

Female activity of tunnel burrowing Host reaction against metabolic wastes

Pruritus, vesicules and pustula along the tunnel

Pustula is the result of bacterial secondary infection

Scabies Mites Scabies Mites

Predilection sites of Scabies in man

Source : Basic Clinical Parasitology. 1994. Neva F.A. & Brown H.W.

Scabies MitesScabies Mites

Chronic Scabies of the scrotum

Source :A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi.. Translation : Lesmana Padmasutra, dkk.

Scabies of labia majora and the surrounding areas

Scabies Mites Scabies Mites

Clinical D/By finding specific skin infection in the area of

predilectionsObserving patient scratching specific area of predilection

Laboratory D/Potassium Hydroxide (KOH) Test : Skin scraping from

predilection area is placed on a glass slide, add one drop of 10% KOH, warm the slide, cover with slide cover glass, and examine under the microscope to find the adult mite or the eggs.

Dark Ink Test : place a drop of ink on the suspected skin surface, press slightly to allow ink to enter the tunnel, rinse and observe the ink filled tunnels

Diagnosis

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