Tag Archives: vector borne disease

That last one was our 100th Post!

LET US GIVE THANKS TO ST. BRIGITTE, OUR PATRON SAINT

Even though this is a public health site, it seems that more people have been led here by the formerly freakishly thin-waisted,

Head, thorax, abdomen..

animal-loving,

buck-toothed,

In her defense, she did say: "Apart from my husband—who maybe will cross over one day as well—I am entirely surrounded by homos. For years, they have been my support, my friends, my adopted children, my confidants."

and proud  hate-speech spewer (several times arrested and fined)

WE KNOW that it would be mean-spirited and even provincially gringoish to disparage a great cultural icon and source of pride to the Gallic heart. We just want to give our readers more of what they want, with the ulterior motive of promoting public health.

With that in mind, we provide this link to an article on the movement to address Neglected Tropical Diseases.

Assassin Bugs on the Beach

And now, …

What we talk about when we talk about lice: Lice story, Part II

A LITTLE  LOUSE CAN DO LOT OF DAMAGE

So can a big one, if it's a body louse and not a head louse.

There are few very important things to know about lice.

First of all, lice are very species specific. Cattle lice (there are 4 common kinds in the United States) do not infect sheep. Sheep lice do not infect hogs. And what ever Rick Santorum’s current anxieties are, no species of animal lice infects people. I am sure that he will sleep better knowing this.

Secondly, lice are often quite specific to an area of the body. Human head lice (Pediculis capitis humanus) stay on the head. They do not like moving towards the torso. They like to lay their eggs on hair.

Picture from Wikimedia Commons

Body lice–Pediculus humanus humanus, or sometimes Pediculus humanis corporis–are indistinguishable from head lice, yet except in the laboratory, they will not breed with head lice. They prefer to lay eggs in clothing, especially along the seams. (Bad infestations, therefore, can be prevented by avoiding clothing.)

Thirdly, there is an  important distinction between head lice and body lice from an epidemiological point of view. Head lice really don’t cause any serious problems. Kids get sent home from school, squeamish parents lose it and stay up all night itching–even though they are not infested–and the washing machine and vacuum cleaner do overtime. However, other than the chaos and the irrational panic, there is little to worry about.

Body lice, on the other hand, are the vector for some rather serious diseases.

Epidemic typhus

Spread in the feces of lice (like Chagas’ Disease), epidemic typhus is caused by infection with the bacteria Rickettsia prowazekii. Typhus is one of the reasons that, at least until our last couple of wars, more death to soldiers and civilians during conflicts has been caused  by germs and disease than by bullets, cannonballs, spears, arrows, bayonets, bombs…..

Trench Fever

Caused by the bacteria Bartonella quintana, trench fever is described as a “moderately serious” disease, and though rarely lethal, was responsible for yet another of the epidemics that plagued soldiers during the War to End All Wars. It is not to be confused with Trench Mouth or Trench Foot, both of which also plagued soldiers in the First World War.

Louse-Borne Relapsing Fever

Caused by Borrelia recurrentis, relapsing fever occurs epidemically in areas of poverty and deprivation. It is currently prevalent in Sudan. If left untreated, mortality rates can reach 30%-70%

Take home message: Head lice don’t cause disease, and war, poverty, and deprivation are bad for your health.

Keep Smiling!

Tonight we revel

 

One of the reasons we watched Monty Python: Carol Cleveland

 

BECAUSE THE BUGS ARE COMING BACK TOMORROW

You'll see me tomorrow (Asian Tiger Mosquito)

It was time.

Proper footwear can protect against a variety of vector-borne diseases.

Did Darwin Die of Chagas’ Disease?

From The Voyage of the Beagle:

We crossed the Luxan, which is a river of considerable size, though its course towards the sea-coast is very imperfectly known: it is even doubtful whether, in passing over the plains, it is not evaporated and lost. We slept in the village of Luxan, which is a small place surrounded by gardens, and forms the most southern cultivated district in the Province of Mendoza; it is five leagues south of the capital. At night I experienced an attack (for it deserves no less a name) of the Benchuca, a species of Reduvius, the great black bug of the Pampas. It is most disgusting to feel soft wingless insects, about an inch long, crawling over one’s body. Before sucking they are quite thin, but afterwards they become round and bloated with blood, and in this state are easily crushed. One which I caught at Iquique (for they are found in Chile and Peru) was very empty. When placed on a table, and though surrounded by people, if a finger was presented, the bold insect would immediately protrude its sucker, make a charge, and if allowed, draw blood. No pain was caused by the wound. It was curious to watch its body during the act of sucking, as in less than ten minutes it changed from being as flat as a wafer to a globular form. This one feast, for which the benchuca was indebted to one of the officers, kept it fat during four whole months; but, after the first fortnight, it was quite ready to have another suck.

My dog has Ehrlichiosis!! Anaplasmosis!! Lyme Disease!!

Or does it?

The American Dog Tick (only infects American dogs)

When I was a practicing vet, I saw how the medicine of fear works to beef up the wallets of practicing vets. As much as I like a meaty wallet, I found that hucksterism just isn’t my cup of suet. Am I being hyperbolic? Using too many high-cholesterol food metaphors? Probably. Also, working now in public health, I find that one of main jobs is to instill the proper amount of fear in the population at large.

What’s an appropriate amount of fear?

Why, what we in public health decide is appropriate!

Anyway, if you have a dog, or if you worry about the above vector-borne diseases, or if you have an interest in how medicine can be practiced when it’s just consumer and provider and no third-party payer, read my article from The Bark.

Why I Don’t Think Ms. Kelly is Going to Get Chagas’ Disease

I received this question from Asia Kelly the other day:

Dr. Lerner, thank you for the informative post about Chagas disease. I am a biology student at the University of Texas Pan American in the Rio Grande Valley, South Texas. Last night I believe that I saw an “assassin bug” last night outside of my home near my front door. I am a little worried because I frequently sit outside at night on my porch and I get bitten by what I assumed to be ants or mosquitoes. I’m concerned that I may have been bitten by this insect. I’m wondering if the bite from that bug would cause a rash, swelling, or any sign that it has bitten me. I’m actually very concerned. Also, TV personality Dr. Oz said in a recent show that there is no cure or treatment and that most people will die from chagas in about 20 years. I’m interested in your opinion about this and I’d like to know of any information you might know about the prevelance of this disease in my area. I looked for your email on this site, but cannot find it. Thank you so much.

Ms. Kelly:

You would have to be extremely unlucky to get Chagas’ Disease in the United States. Although Trypanosoma cruzi, the parasite responsible for Chagas’ Disease does exist within our borders, there have only been 7 autochthonous cases, meaning cases acquired here. Admittedly, at least three of those cases were in Texas, but all of those cases were infants, which points out another reason why I don’t think that you are going to get Chagas’: Assassin (kissing) bugs are big bugs, around 2 cm in length. If one gets on you or bites you, you are likely to know it. You can get bitten in your sleep, but we have to remember that it is unlikely that the bugs are in your house. Typically, they live in the cracks in the walls of mud houses, between the bricks of unplastered walls, or in the fronds or thatch that are used for roofing. Some species live outside (like the  North American species of triatomines), but these species–judging by the lack of autochthonous cases in the US–don’t seem to pose much danger.

Furthermore, remember that the infectious material is not the insect’s saliva, as it is with tick-borne or mosquito-borne diseases (like ehrlichiosis and West Nile Virus). The parasites are found in the feces of the assassin bugs. That means that if the insect doesn’t defecate while it bites you, it can’t infect. Apparently, the triatomines that we have here in the US don’t have that behavior.

So, while history has shown that it is possible to acquire Chagas’ disease in the US, it has also shown that it is extremely unlikely. Perhaps this will change, either to due to global warming, evolution, or the introduction of a competent vector–either inadvertently or intentionally–into the United States.

As far as vector -borne disease in the Rio Grande Valley go, I’d be more worried about those transmitted by mosquitoes. Dengue, for one,  has reared its ugly head along this area, and will probably do so again.

Bartonella henselae

otherwise known as cat-scratch fever....

Gratuitous post? No alerting astute readers to the upcoming series of posts on some truly serious diseases related to cat-scratch fever.

“…and I feel this thing under my shirt, taking a stroll along my collar bone…”

Know your external parasites

and I reach in a pull off the first tick of the season. I marked it on my calendar, and planned my annual The-Ticks-Have-Returned-It-Must-Be-Spring celebration. I placed the tick in a plastic cup with some 91% alcohol so I could identify it when I’m not busy writing these (insert adjective or expletive) grant proposals. But then the hyper-efficient nanny threw it out when she came in, before I even had a chance to play with it.

Bottom line: The ticks are back. Be aware!

A Chagas’ Disease Primer: Part 6

Chronic Chagas’ Disease

This is where the problem is.
Most people won’t get signs of acute infection, so they won’t know that they are infected.
In 70% of cases, that’s fine. As far as we know, nothing will come of that.

But the other 30%, anywhere from 10 -30 years later, will go on to develop chronic Chagas’ Disease.

Let’s review. We have our  assassin bug,

Triatoma dimidiata, important vector in Mexico

which transmits the single-celled protozoan parasite, Trypanosoma cruzi (in its feces)

A T. cruzi parasite, among red blood cells on a slide

The bug poop gets rubbed into a mucous membrane (like the conjunctiva around the eye) or the bite made by the bug.
Let’s look at the life cycle again:

For those of you who care, the trypomastigote is the infective stage, that is the stage that can be passed from bug to mammal and mammal to bug. The amastigote is the stage that multiplies in tissue.

Don’t get hung up on the names. It’s just to see that different stages do different things–one goes around to infect different cells, the other works inside the cells.

Detail of above diagram

Trypomastigotes have flagella, whip-like structures that allow them to move around, amastigotes don’t. On a blood smear you can see the trypomastigotes squiggling around among the blood cells.

Amastigotes seem to like replicating in the cells of the heart’s muscle.

That is not a good thing.