Medical Entomology
Medical Entomology
Medical Entomology
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Introduction
A study of the arthropods of medical
importance is known as medical entomology
Arthropod borne diseases constitute a major
health problem in India, accounting for about
50% of total deaths in the country.
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The distinguishing feature of arthropods is
the presence of a jointed skeletal covering
composed of chitin. This nonliving
exoskeleton is secreted by the underlying
epidermis (which corresponds to the skin
of other animals).
The body is usually segmented
About one million arthropod species have
been described, of which most are insects.
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Amber
Burmese Canadian
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Classification
Class :INSECTA
1. Mosquitoes: Anopheles
Culex
Aedes
Mansonia
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2. Flies: House flies
Sandflies
Tse Tse flies
Black flies
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3. Human Lice: Head & body lice
Crab lice
4. Fleas: Rat fleas
Sand fleas
5. Bugs: Bed bugs
Reduvid bugs
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Class: ARACHNIDA
Ticks: Hard ticks
Soft ticks
Mites: Trombuculid mite
Itch mite
Class: CRUSTACEA
Cyclops
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Distinctive characteristics
Characteristics Insecta Arachnida Crustacea
1 Body division Head, thorax & Cephalo Cephalo
abdomen thorax & thorax &
abdomen abdomen
2 Legs 3 pairs 4 pairs 5 pairs
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Arthropod borne diseases
Arthropod Diseases transmitted
1 Mosquito Malaria, Filaria, JE, Yellow Fever etc.
2 Housefly Typhoid and paratyphoid, Cholera, Poliomyelitis,
Trachoma, Amebiasis etc.
3 Sand fly Kala azar, Oriental sore etc.
4 Tse Tse fly Sleeping sickness
5 Black fly Onchocerciasis
6 Louse Epidemic typhus, Relapsing fever, pediculosis,etc.
7 Rat flea Bubonic plague, Endemic typhus, etc.
8 Reduviid bug Chagas disease
9 Tick KFD, Tick typhus, Hemorrhagic fever, Relapsing
fever etc.
10 Mite Scrub typhus, Scabies
11 Cyclops Guinea worm disease, Fish tape worm
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Modes of transmission
1. Direct contact:
Arthropods are directly transmitted from man to man
through close physical contact
Ex. Pediculosis, Scabies
2. Mechanical transmission:
The disease agent is just mechanically carried by the
Arthropod
Ex. Typhoid, Cholera, Dysentery etc. by houseflies
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3. Biological transmission:
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Cyclo-developmental:
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Vector :
“Arthropod or other invertebrate which transmits infection
by inoculation into or through the skin or mucous
membrane by biting or by deposit of infective materials on
the skin or on food or other objects”
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Definite host :
“Host in which sexual cycle of the agent occurs”
Intermediate host :
“The host in which the asexual cycle of the agent
occurs”
Infestation:
“The lodgement, development and reproduction of
arthropods on the surface of the body or in the
clothing”
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Trans ovarian transmission: The disease agent is passed
onto the next generation through the eggs of the insect.
Ex. Scrub typhus in thrombuculid mite
Trans stadial transmission:
The disease agent is passed from one stage of life cycle to
another and then transmit the disease to man.
Ex. Typhoid in housefly
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General principles of arthropod control
Protective measures:
1. Physical barriers: Mosquito nets, screening of
building against houseflies etc.
2. Chemical barriers: Application of repellent cream
to body and clothing. Ex. Use of odomos against
mosquitoes
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Aggressive Measures
1. Environmental Control:
• Elimination of breeding places(Source Reduction )
• Filling and drainage operation
• Carefully planned water management
• Provision of piped water supply
• Proper disposal of refuse and other waste
• Cleanliness in and around houses
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2. Chemical control – By use of insecticides which are classified
as Larvicides: against Larvae.
Imagicides: against adults.
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Contact insecticides
Space sprays (knock down agents)
e.g. Pyrethrum
Residual sprays
Organochlorine : e.g. DDT
Organophosphorous :e.g. Parathion
Carbamates e.g. Carbaryl, etc.
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3. Biological Control –
e.g. use of Gambusia Affinis and Lebister reticulatus(Guppy
fishes) to eat anopheles larvae
4. Genetic Control –
Sterile male technique
E.g. use of (irradiated) sterile male Culex in control of filariasis.
Cytoplasmic incompatibility
Chromosomal translocations
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Integrated vector control
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Mosquito
• In India, mosquitoes constitute the most important
group of insects of public health importance.
• Four important groups in India are :
Anopheles
Culex
Aedes
Mansonia
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Structure and Life History
Morphology: The body of a mosquito is divided into
head, thorax and abdomen.
Head: Semiglobular and bears a pair of
- compound eyes
- a pair of antennae or feelers
- a pair of palpi, a four jointed structure,
situated on either side of proboscis
- a central piercile proboscis.
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Thorax: Large and rounded
- a pair of wings dorsally
- 3 pairs of legs ventrally.
Abdomen:
- Long and narrow
- 10 segments and the last 2
fused to form genitals.
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Life History: has 4 stages – egg,
larva, pupa and adult.
The eggs are laid only in water
and hence presence of water is
essential for the existence of all
mosquitoes.
The metamorphosis is complete,
the egg and pupal stages are the
resting stages while the
alternating larval and adult stages
are highly active.
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The Life Cycle is normally of about 2 weeks duration (Egg: 1-
3 days, Larva: 7-10 days, Pupa: 1-3 days. Adult life span
about 2 weeks-1 month).
Only the females are blood sucking and males live on plant
juices.
Normally the mosquitoes (except Aedes) have a flight range
of up to 2 miles, and this is an important factor which
determines the extent of the area to be included under
mosquito-borne disease control operation.
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Differentiation of Mosquitoes
Tribe Genus Important Area of
Species Distribution
Anophelini Anopheles Culicifacies Plains
Philippinensis
Fluviatelis
minimus Foothills
Sundaicus
Stepnesi Coastal areas
Aedes Aegypti
Mansonoides Annulifera
Uniformis
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Anopheles Vs. Culex
Stage of Life Anopheles Culex
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Culex
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Aedes (Stegomyia)
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Outline of Mosquito-Borne Diseases
Mosquito Disease Extrinsic Mode of Causative Reservoir of the
transmitted Incubation Transmission Agent Agent
Period
Anopheles Malaria Not less than 10- Bite of infective Plasmodium: Man suffering
15 days female mosquito vivax, falciparum, from Malaria
malariae & ovale
Culex
fatigans Urban filariasis 10-14 days Deposition of Wuchereria Man harboring
infective larva at bancrofti microfilaria
the site of bite by
female mosquito
tritaeniorrh- Japanese Some short time Bite of infected J.E. virus Infected pig
ynchus encephalitis after the bite of female mosquito
infected pig
Aedes Yellow fever 4-8 days Bite of infected Virus Infected man
aegypti female mosquito
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Aggressive Measures:
◦ Anti-larval measures:
◦ Environmental Control:
◦ It involves chiefly the water management. If Anopheles are
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◦ Chemical Control:
The commonly used larvicides are:
◦ Mineral oil (Malariol) acting as asphyxiant applied at the rate
of 40-90 litres/hectare;
◦ Paris green (copper acetoarsenite) acting as a stomach poison
is applied as a 2% dust at 1 kg/hectacre;
◦ Synthetic insecticides baytex (Fenthion) 1000 applies as
emulsion at 150-500 litres/hectare
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◦ Anti-adult measures:
◦ Insecticides: As space sprays – use of Pyrethrum extract (1
oz/1000 cu.ft. space); ULV (ultra low volume) fogging of
malathion or fenthion in outdoors in control of Aedes (a day
biter).
Residual sprays for indoors, lindane (0.5 g/m2), DDT (1 or 2
g/m2), malathion (2 g/m2), etc.
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Aedes aegypti index :
Ratio of number of houses with breeding to total houses
examined in that area.
Kept zero at all ports.
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Flies
Non-Biting: Housefly
Biting:
◦ Sandfly
◦ Tsetse Fly
◦ Blackfly
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Housefly (Musca domestica)
The presence of housefly is an index of poor sanitation.
Structure:
The body is divided into head, thorax and abdomen.
Head : - Bears a pair of antennae
- a pair of large compound eyes
- retractile proboscis
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Thorax :
- Marked with 2 to 4 dark longitudinal stripes
- has 3 pairs of legs and 1 pair of wings.
- The legs and body are covered with numerous short and
stiff hairs, called the tenent hairs, which contain a sticky
substance.
- Each leg has a pair of foot pads which help the fly to walk
on highly polished surfaces.
Abdomen :
- Segmented and show light and dark markings
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Life History
The female lays eggs in moist decaying organic matter like
human & animal excreta, manure heaps & garbage.
The eggs are white, 1 mm size and just visible to naked eye
(resembling polished rice grain).
The eggs hatch larvae (maggots) which are creamy white,
segmented & footless, active and eat voraciously & grow up to 1
cm. They resent light and bury themselves under manure
heaps.
When about to pupate, they migrate to outer dry regions. The
pupa measures ½ cm and is dark brown and barrel-shaped.
From the pupa, adult fly comes out and the life cycle is
completed in 1-3 weeks.
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Mode of Disease Transmission:
- They carry the pathogens (mechanically) on their feet and
hairy legs.
- In addition, the flies frequently vomit (vomit drop) and
defecate which also contain ingested pathogens in viable
state.
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Diseases Transmitted
Bacterial: Typhoid & Paratyphoid, Cholera, Bacillary
dysentery, Gastroenteritis, Yaws, Anthrax
Viral: Trachoma, Viral conjunctivitis, Poliomyelitis,
Infective hepatitis
Parasitic – Amoebiasis, Giardiasis, Ascariasis
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Fly Control Measures
Environmental control:
Safe and sanitary disposal of;
- Human excreta (sanitary latrines)
- Animal excreta (manure pits with earth cover or by
composting)
- Garbage & refuse (refuse bins with tight lids,
composting, etc.).
A clean house with a clean surrounding is the best
solution.
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Protective measures:
Use of fly-proof meshes (14/inch) for windows and even doors
(provided with springs to keep always closed)
By use of sticky fly papers, fly traps, etc.
Insecticidal control :
Larvicides: Use of DDT, 0.5% Diazinon, etc. for fly breeding
sources
Imagicides: Use of baits (Baigon-2% propuxur) and
occasionally space sprays (Pyrethrum/Malathion)
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Breeding habits :
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Diseases Transmitted
Sandfly Species Disease Agent
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Control Measures
By locating cattle sheds, poultries and stables 50 yards away
from house
By tight cement plastering of cracks and crevices in the
walls & floors
By use of insecticides like DDT spraying (1-2 g/sq. m.) of
cattle sheds and other resting places
Use of insect repellants
Sandfly net: 45 mesh/inch may be used to protect against
bite
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Tsetse Flies (Glossinae)
These are blood sucking insects found in Africa and attack
man and animals during daytime.
Tsetse flies are vectors of Trypanosomiasis or sleeping
sickness, affecting man, domestic animals and wild game.
They breed in woodland vegetation and females give birth
to larvae (no egg laying).
Control measures include aerial spraying of insecticides of
large areas for woodland vegetation.
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Lice
The Lice which infest man (pediculosis) are:
◦ Head Louse: Pediculus capitis
◦ Body Louse: Pediculus corporis
◦ Pubic Louse: Pthirus pubis
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Head & Body Lice
They differ very little in structure except in their habitat.
Morphology:
-The body is flattened dorso-ventrally and divided into head , thorax
and abdomen
Head : Pointed in front and has a pair of 5 jointed antennae.
Thorax : Shaped like a square, has 3 pairs of legs with strong terminal
claws which help to cling to the clothing.
Abdomen : Has 9 segment and last one is pointed in males and
bilobed in females.
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Life History
The eggs (Nits) are glued to individual hairs near the root
(head lice)/glued to the cloth especially along seams and in
folds (body lice).
The next is a two-stage Nymph which resembles adult
except in size.
The life cycle is completed in 15 days-1 month.
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Pubic (Crab) Lice
Are normally found in the hair of pubic region.
Pubic louse has a small square body, head impacted on
thorax and first pair of leg being smaller than the other two.
Pubic louse infestation is considered under sexually
transmitted diseases (STD).
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Pthirus pubis
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Louse-Borne Diseases
Both nymph and adult are blood sucking ectoparasites of
man.
Disease Agent
Epidemic typhus Rickettsia prowazeki
Relapsing fever Borrelia recurrentis (Spirochete)
Trench fever Rickettsia quintana
Dermatitis (Vagabond’s Directly caused due to irritation,
disease) scratching and secondary infection
resulting in rough, thickened and
deeply pigmented skin
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Lice Control
Head Lice:
-0.5% malathion to be applied thoroughly over whole
scalp, particularly to be rubbed along the roots of hairs.
-After 12 to 24 hours, hairs to be washed by shampooing
and another application repeated.
-Simultaneously, combs are cleaned in hot water and
bed linen washed in soap and hot water.
- Carbaryl dusting is also effective
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Body Lice:
- 1% malathion lotion is applied all over the body below neck.
- After 24 hours, a bath is taken, and another application
repeated after 7 days.
- All used clothes, towels and bed linen of the infected individual
to be boiled separately
- Carbaryl dusting is also effective
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Mass Delousing: By use of hand operated dusters,
50 g of insecticides (DDT 10%) per person and a
second application after a week (to kill late
hatching lice) will usually eradicate lice.
Concurrent boiling or autoclaving and hot ironing
of clothes is essential.
A daily bath with soap and water and washing of
clothes with soap will prevent lice infestation.
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Fleas
The fleas of public health importance are Rat fleas (tropical
and temperate), Human fleas, cat and dog fleas and sand
fleas.
The fleas found on one particular animal host usually do not
seek another type of animal host unless compelled by
necessity.
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Rat Fleas (Tropical or Oriental)
These include Xenopsylla cheopis, X. astia and X. braziliensis.
All 3 are found on domestic rats.
Fleas are small, bilaterally compressed, wingless insects with
a hard chitinous exoskeleton and covered with backwardly
directed strong bristles.
Both sexes are blood sucking and usually jump vertically 6”
height.
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Morphology:
Body divided into head , thorax and abdomen
Head : Head is conical and attached to thorax without a neck
Head bears a small piercing mouth part and project downwards
from the head
Thorax :
Composed of three segments- prothorax, mesothorax & metathorax
3 pairs of strong legs
No wings.
Abdomen :
Consists of 10 segments
Female flea has a short stumpy structure called spermatheca
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Life History
The eggs are oval, laid in dark places of rat holes.
The larva is a caterpillar-like maggot and feeds on the
bloody excreta of adult fleas.
The larva spins a cocoon and pupates.
The adult comes out of cocoon. The life cycle is
completed in 1 month-1 year.
Habits : burrows of wild rodents
Cracks and crevices, under carpets
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Diseases Transmitted
Disease Agent Mode of
Transmission
Bubonic plague Y. pestis Bite of infected
rat flea
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Flea indices
General flea index
Specific flea index
Percentage incidence of flea spices
Rodent infestation rate
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Blocked fleas –
fleas which ingest plague bacilli become blocked
due to multiplication of plague bacilli in their
proventriculus or stomach.
Plays great role in spread of plague
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Flea Control
1. Insecticidal control :
- 10% DDT or 5% Malathion or carbaryl 2% or diazinon 2% as
dust is applied along rat runs
- Applied up to a height of about 1 ft.
- Insecticidal dust should also be blown into rodent burrows
with the help of dust-blowers (30 g/burrow)
2. Use of repellants by man – diethyltoluamide, benzyl
benzoate
3. Rodent control
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Bugs
Bed Bugs (Cimex):
◦ Small, brown, wingless insects which harbor in cracks
and crevices of wooden furniture, cots, etc., used by
man
◦ They are not known to transmit any human diseases.
But their bites are irritating and cause sleeplessness.
◦ The control includes spraying 1% Fenitrothion or 2%
Fenthion of all sources of breeding and concurrent
boiling (steam disinfection) of all clothes.
are vectors of Chagas disease
Reduvid (cone nose) Bugs:
(Trypanosoma cruzii) in Central and South America.
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Ticks
The ticks are blood sucking ectoparasites.
Two kinds :
1.Hard ticks (Ixodidae )
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The ticks essentially transmit viruses, spirochaetes,
rickettsiae and bacteriae from wild animal reservoirs
(rabbits, monkeys, cattles,etc. ) to man.
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The hard ticks feed both day and night and are
invariably found always attached by their mouth
parts to a host and they can not withstand
starvation.
However, the soft ticks can withstand starvation for
several months and are found in the tracks and
crevices during day time and emerge in the nights
(i.e. nocturnal ) to feed on the host.
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Morphology
The body is oval and one fused mass, with 4 pairs of
legs and no wings and no antennae.
Hard tick Soft tick
1 Scutum In males, covers the Absent
(hard entire back
chitinous In females, covers only
shield on a small portion in the
dorsum ) front.
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Tick borne diseases
Hard tick
Haemophysalis Kyasanur forest Arbovirus
spiniegera disease Neurotoxin
Turturis Tick paralysis
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Mites
1. Itch mite
2. Trombiculid mite
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Itch mite
Itch mite (Sarcoptes scabiei or Acarus Scabiei)
Morphology :
- It is 0.4mm in size and is just visible to naked eye
- Body shows no demarcation into cephalothorax or abdomen
- The body is tortoise shaped with two pairs of legs-anteriorly and 2
pairs posteriorly.
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Life history
The pregnant itch mite burrows into the Stratum
corneum of the skin and unless scratched out remains
in her burrow for the rest of her life.
The eggs are laid in the burrow.
The larvae leave the burrow and enter the hair
follicles
They moult to form nymph which grow to become
adult.
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Mode of spread:
◦ Close physical contact, Indirect
Site of lesions:
◦ The disease classically affects the hands and wrists(63%)
◦ Extensor aspect of elbows(10.9%)
◦ buttocks, axilla , lower abdomen, feet, ankles ,in women
breast, genitals in men, palms in infants.
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Diagnosis :
1. Itching worse at night
2. Presence of follicular lesions at the affected site
3. Secondary infection leading to crusted papules and
pustules
4. Usually, the other members of the family are also affected
5. Presence of the parasites in the skin scrapings under
microscope.
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Control of scabies:
It is essential to treat all members of the affected
household simultaneously to prevent reinfestation.
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Treatment
A. 25% benzyl benzoate emulsion –Ascabiol 50ml (for
children ) and
B. 125ml (for adults )
C. (infants –dilute wth 3 parts of water,
D. young children – dilute with 2 parts of water ) or
E. 1% gamma BHC lotion (Emscab -55ml,110ml).
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First a bath is taken with hot water and soap with fine
scrubbing (to open up the burrows ) then the emulsion
is applied on the whole body below the neck and more
on the body folds (groin, armpits, fingerwebs etc. ) . In
case of infants head also must be treated
The application to be repeated after 12hours and after
further 12hours a hot water bath taken.
All the underclothes , clothes and sheets boiled and
washed with soap.
Another application may be repeated after 1 week.
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B. If the patient is found to have secondary infection, a
course of antibiotics is given (if severe injection
Strepto-penicillin for 5-7 days ) scabozon 4% sulphur
and 15% benzyl benzoate as cream to be applied on
the affected areas.
Once the secondary infection is cured application of
Ascabiol is advised.
C. Simultaneously for some days Tetmosol soap may be
used for bath.
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Thrombuculi
d mite
These are spider like
arthropods which
transmit scrub typhus
(transovarian
transmission ).
The life cycle includes
egg, larvae, nymph and
adult.
The larval stage is
infective and attacks
men.
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Cyclops
Water flea is a crustacean present in most collections of
fresh water
Morphology :
- Measures about 1mm.
- The body is pear shaped, semi transparent
- Single small pigmented eye
- 2 pairs of antennae
- 5 pairs of legs
- a forked tail
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It swims in water with jerky movements.
Cyclops is the intermediate host of
- guinea worm disease(dracunculiasis)
- fish tape worm( diphyllobothrium latum)
(rare in India).
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Control measures
1. Physical :
Straining of water through a piece of fine clean cloth
Boiling of water
2. Chemical :
Chlorination upto 5ppm followed by dechlorination kills
larvae and adult
Lime – 4gm/gallon, Abate – 1mg/litre
3. Biological :
Use of gambusia and barbal fish
4. Others : Abolition/conversion of step wells into draw wells.
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