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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

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    1. MEDICAL ENTOMOLOGY Subjects : 1. Medical Entomology (Introduction) 2. Mosquitoes and flies 3. Mites

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

    3. 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

    4. Introduction Medical entomology • Study of vector, vector borne diseases and abnormalities caused by insects

    5. 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

    6. 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

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

    8. Metamorphosis Metamorphosis • Morphological changes and development in the life cycle of Arthropods Two type metamorphosis • Complete metamorphosis • Incomplete metamorphosis

    9. 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

    10. ROLE OF ARTHROPODS Role as vector Insects may act as • Vector/transmitter of disease agents • As direct cause/etiology of disease or injury

    11. ROLE OF ARTHROPODS Mode of transmission Two modes of transmission • As mechanical vector • As biological vector

    12. 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

    13. ROLE AS BIOLOGICAL VECTOR - Disease agents develop or multiply inside the vector • Example :Plasmodiumsp. at Anopheles sp. • Transmission occurs through the proboscis

    14. Aedes aegypti , vector of dengue hemorrhagic fever ROLE OF ARTHROPODS Role as vector Anopheles , vector of malaria

    15. 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

    16. 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

    17. 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

    18. Spider Scorpion Role of Arthropods Insect as cause of injury and disease

    19. (1) (2) (3) Bedbugs: (1) female; (2) male; (3) bloodsucking activity Centipedes

    20. 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

    21. 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.

    22. 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.

    23. 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

    24. Medical importance Aedes aegypti , vector of dengue fever

    25. 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

    26. 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

    27. 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 :

    28. 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

    29. Adults Culicoides sp. Source : Color Atlas of Medicine and parasitesology. 1977 W. Peters & H.M. Gillers Flies Culicoides sp.

    30. Flies Glossina sp. Medical importance • vector Arfiican sleeping disease • Trypanosoma gambiense, vector is Glossina palpalis • Trypanosoma rhodesiense, vector is Glossina morsitans

    31. 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.

    32. 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

    33. Stomoxys sp.

    34. 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

    35. 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

    36. 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

    37. Musca domestica (House flies ) Flies Musca domestica

    38. 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

    39. Myiasis Larvae in necrotic tissue

    40. 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.

    41. 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.

    42. MITES Introduction • Classified under ordo Acarina • Causing acariasis • Medically most important mites : • Family Sarcoptidae (Scabies mite) • Family Trombiculidae

    43. 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)

    44. 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

    45. 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

    46. Predilection sites of Scabies in man Source : Basic Clinical Parasitology. 1994. Neva F.A. & Brown H.W. Scabies Mites

    47. 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.

    48. 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

    49. Thank you …………………. Thank you …………………. Thank you ………………….