MEDICAL ENTOMOLOGY. Subjects : 1. Medical Entomology (Introduction) 2. Mosquitoes and flies 3. Mites. Compared to the number of species of mammals, protozoa and helminthes, insect species outnumbers them all. ARTHROPODS. MEDICAL ENTOMOLOGY. Introduction. Definition: entomology
MEDICAL ENTOMOLOGY Subjects : 1. Medical Entomology (Introduction) 2. Mosquitoes and flies 3. Mites
Compared to the number of species of mammals, protozoa and helminthes, insect species outnumbers them all ARTHROPODS
MEDICAL ENTOMOLOGY Introduction Definition: entomology • Science that study insects (Entomon = Insecta) and other species belonging to Phylum Arthropoda, in relation to health, and its control
Introduction Medical entomology • Study of vector, vector borne diseases and abnormalities caused by insects
Introduction entomology Medik (Kedokteran) • Ilmu yang mempelajari tentang vector, disease dan kelainan yang disebabkan oleh insects Vector • Vector are mostly insects which carry and transmit disease agents from patient to healthy person; or from disease sources to uninfected food or drinks
ARTHROPODA - Divided into 5 classes I. Class Insecta --- Medically important insect : * Order Diptera * Order Anoplura * Order Hemiptera * Order Siphonaptera II. Class Arachnida III. Class Crustacea IV. Class Chilopoda V. Class Diplopoda
Characteristic Phylum Arthropoda • Multicellular animal (metazoa) • Symmetric, bilateral • Segmented body • Possess an exoskeleton • Appendages : antennae, palpa etc.
Metamorphosis Metamorphosis • Morphological changes and development in the life cycle of Arthropods Two type metamorphosis • Complete metamorphosis • Incomplete metamorphosis
Metamorphosis Complete Metamorphosis • Marked changes and development in the morphology and biology (natural habitat, types of food, etc) • Eggs - Larva - Nymphs - Adults Incomplete Metamorphosis • Eggs/ova - (Larva) - Pupa - Adults
ROLE OF ARTHROPODS Role as vector Insects may act as • Vector/transmitter of disease agents • As direct cause/etiology of disease or injury
ROLE OF ARTHROPODS Mode of transmission Two modes of transmission • As mechanical vector • As biological vector
House flies Role as mechanical vector • disease agents do not develop or multiply inside the vector • Example : gastroenteritis agents in flies and cockroach • Transmission occurs through the proboscis, legs, body, wings
ROLE AS BIOLOGICAL VECTOR - Disease agents develop or multiply inside the vector • Example :Plasmodiumsp. at Anopheles sp. • Transmission occurs through the proboscis
Aedes aegypti , vector of dengue hemorrhagic fever ROLE OF ARTHROPODS Role as vector Anopheles , vector of malaria
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 cause • Bites - sting - piercing and bloodsucking - larval movement • Arthropods may act as : • Endoparasites : larva of flies causing myiasis • Ectoparasites: headlouse • Permanent parasites : fleas • Intermittent parasites: mosquito
Injection of Toxic substance • Poison enters through : • Direct contact (caterpillars), bites (spider), sting (scorpion), piercing (mosquito) • Common symptoms : • Itching, swelling, urticaria (mosquito, caterpillars) • Hemolysis (scorpion) • bleeding (bees) • Nerve damage (scorpion) Allergies • Dyspnea /asthma : caterpillar, butterflies Psychosis • Entomophobia A boy with allergy from mosquito bite
Spider Scorpion Role of Arthropods Insect as cause of injury and disease
(1) (2) (3) Bedbugs: (1) female; (2) male; (3) bloodsucking activity Centipedes
Mosquito Life cycle • 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
Medical importance Mosquito bites may cause urticaria, and dermatitis 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.
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.
Medical importance • vector of disease : Example 4 & 5 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
Medical importance Aedes aegypti , vector of dengue fever
1 Family Psychodidae Genus Phlebotomus = Sandflies Family Simuliidae Genus Simulium = black fly = buffalo gnats 2 Family Ceratopogonidae/Heleidae Genus Culicoides = midges = no-see-um = punkies 3 Flies Bloodsucking Flies
Sub ordo Brachycera Family Tabanidae Genus Tabanus = horse fly Genus Chrysops = deer fly Genus Hybomitra 4 Sub ordo Athericera = Cyclorrapha Family Muscidae Genus Glossina = TsetseFlies Genus Stomoxys = Stable Flies 5 Flies BloodsuckingFlies
Kala azar • By Leishmania donovani Oriental sore • By Leishmania tropica American Leishmaniasis • By Leishmania braziliensis Phlebotomus fever = demam papataci • Disebabkan virus • Terdapat di laut Tengah, Arab, Asia selatan • vectornya Phlebotomus papataci Bartonellosis • Disebabkan Bartonella baciliformis • Terdapat di Pegunungan Andes • vectornya Phlebotomus verrucosum Flies Phlebotomus sp. Medical importance • The bites may cause dermal papules, intense pain, itching, nausea, fever, malaise • As vector of the following diseases :
Flies Culicoides 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 asvector of Dipetalonema streptocerca • Culicoides furens and C. paraensis as vector of Mansonella ozzardi
Adults Culicoides sp. Source : Color Atlas of Medicine and parasitesology. 1977 W. Peters & H.M. Gillers Flies Culicoides sp.
Flies Glossina sp. Medical importance • vector Arfiican sleeping disease • Trypanosoma gambiense, vector is Glossina palpalis • Trypanosoma rhodesiense, vector is Glossina morsitans
Source :A Colour Atlas of Clinical parasitesology. Tomio Yamaguchi Alih Bahasa : Lesmana Padmasutra, dkk. Source : Atlas parasitesologi Kedokteran. 1994Juni Prianto, Tjahaya P.U., Darwanto Glossina sp.
Flies Stomoxys sp. Medical importance • Painful bites; mostly on cattle and horses which may cause anemia • Mechanical vector of : Trypanosoma evansi – which causesa disease in animals called surra - Example: Stomoxys calcitrans
1 Family Muscidae • Musca domestica = House flies Family Sarcophagidae • Meat flies • Characteristic : viviparous • Lay its larva on meat • Example : • Genus Sarcophaga : myiasis semi-systemic and accidental • Genus Wohlfahrtia : specific • myiasis 2 Flies Non-biting Flies
Family Calliphoridae • Blow flies • Example : Chrysomyia bezziana • Specific Myiasis on open wound, nostril, ear holes (myiasis of the skin and atrial openings) 3 Family Drosophilidae • Species: Drosophila melanogaster • Also called fruit flies, may cause accidental intestinal myiasis 4 Flies Non-biting Flies
Flies Musca domestica 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
Musca domestica (House flies ) Flies Musca domestica
MYIASIS 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 the hospes
Myiasis Larvae in necrotic tissue
TRANSMISSION • Infestations occur when the insects put their eggs on the injury skin or open abscess. • Species that cause myasis, for example Passeromyia longicomis larvae. • Species that cause myasis dermal only, for example Cordylobia anthropophage and Cordylobia hominis.
Diagnosis • For Ophtalmomyasis, irrigation of lacrimal gland until the parasite come out. • One drop of cocaine for paralyzing the movement, then lifted by using tweezer ( forceps ). Same as dermal myasis. • Myasis intestinal : feces examination.
MITES Introduction • Classified under ordo Acarina • Causing acariasis • Medically most important mites : • Family Sarcoptidae (Scabies mite) • Family Trombiculidae
MITES Source :A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi. Translation : Lesmana Padmasutra, dkk. 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
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
Predilection sites of Scabies in man Source : Basic Clinical Parasitology. 1994. Neva F.A. & Brown H.W. Scabies Mites
Scabies of labia majora and the surrounding areas • Chronic Scabies of the scrotum Scabies Mites Source :A Colour Atlas of Clinical Parasitology. Tomio Yamaguchi.. Translation : Lesmana Padmasutra, dkk.
Scabies Mites Diagnosis • Clinical D/ • By finding specific skin infection in the area of predilections • Observing 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
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