Appendix 1 Signs and Symptoms of -Borne Diseases

The following is an alphabetical listing of common signs and symptoms of arthropod- borne diseases. Unfortunately, few signs and symptoms are specific to any one disease. Further differentiation by appropriate laboratory or radiologic tests may be needed. By no means should this listing be considered as a complete differential diagnosis of any of the symptoms discussed. Adenopathy: Generalized adenopathy may occur in the early stages of African trypanosomiasis – the glands of the posterior cervical triangle being most conspicuously affected (Winterbottom’s sign). Adenopathy may also be seen in the acute stage of Chagas’ disease. Anemia: Anemia may be seen in cases of malaria, , and trypanosomiasis. Anemia can be especially severe in fal- ciparum malaria. Blister: A blister may occur at arthropod bite sites. Blistering may also occur as a result from blister beetles contacting human skin. Bulls-Eye Rash (see Erythema Migrans) Chagoma: An indurated, erythematous lesion may occur on the body – often head or neck – caused by Trypanosoma cruzi infection (Chagas’disease). A chagoma may persist for 2–3 mo. Chyluria: The presence of chyle (lymphatic fluid) in the urine is often seen in lymphatic filariasis. Urine may be milky white and even contain microfilariae. Coma: Sudden coma in a person returning from a malarious area may indicate cerebral malaria. African trypanosomiasis (sleeping sickness) may also lead to coma after a long period of increasingly severe symptoms of meningoen- cephalitis. Rocky Mountain and other rickettsial infections may also lead to coma.

227 228 Appendix 1

Conjunctivitis: Chagas’ disease and onchocerciasis may lead to chronic conjunctivitis. Dermatitis: Several may directly or indirectly cause dermatitis. Chiggers and other mites may attack the skin, causing a maculopapular rash. Scabies mites may burrow under the skin’s surface making itchy trails or papules. Lice may give rise to hypersensitivity reactions with itchy papules. Chigoe burrow in the skin (especially on the feet), causing local irritation and itching. Macules or erythematous nodules may result as a secondary cutane- ous manifestation of leishmaniasis. Diarrhea: Leishmaniasis (and specifically visceral leishmaniasis – kala-azar) may lead to mucosal ulceration and diarrhea. In falciparum malaria, plugging of mucosal capillaries with parasitized red blood cells may lead to watery diarrhea. Edema: Edema may result from arthropod bites or stings. Loiasis (a nematode worm transmitted by deer flies) may also cause edema – a unilateral circumorbital edema as the adult worm passes across the eyeball or lid. Passage of the worm is brief, but inflammatory changes in the eye may last for days. Loiasis may also lead to temporary appearance of large swellings on the limbs, known as Calabar swellings at the sites where migrating adult worms occur. Unilateral edema of the eyelid, called Romaña’s sign, may occur in Chagas’ disease. African trypanosomiasis (sleeping sickness) may result in edema of the hips, legs, hands and face. Elephantiasis: Hypertrophy and thickening of tissues, leading to an “elephant leg” appearance, may result from lymphatic filariasis. Various tissues may be affected, including limbs, the scrotum, and the vulva. Eosinophilia: Helminth worms may cause eosinophilia. Atopic dis- eases, such as rhinitis, asthma, and hay fever also are characterized by eosinophilia. Eosinophilic Cerebrospinal fluid eosinophilic pleocytosis can be Cerebrospinal caused by a number of infectious diseases (including Fluid Pleocytosis: rickettsial and viral infections), but is primarily associ- ated with parasitic infections. Epididymitis: Epididymitis, with orchitis, may be an early complication of lymphatic filariasis. Appendix 1 229

Erythema Migrans: Erythema migrans may follow bites of infected with the causative agent of , Borrelia burgdor- feri. Typically the lesion consists of an annular erythema with a central clearing surrounded by a red migrating border. Although erythema migrans does not always occur, it is virtually pathognomonic for Lyme disease. Eschar: A round (generally 5–15 mm) spot of necrosis may result from boutonneuse fevers, American , (spotted fever group illnesses), or scrub . An eschar develops at the site of or chigger bite. Excoriation: Lesions produced by “self-scratching” may be a sign of imaginary insect or mite infestations (delusions of parasitosis). Fever: Fever is a common sign of many arthropod-borne dis- eases, including the rickettsioses, thyphus, dengue, yel- low fever, , the encephalitides, and others. In some cases, there are cyclical peaks of fever, such as in relaps- ing fever (tick-borne) or malaria. Falciparum malaria is notorious for causing extremely high fever (107°F or higher). Filariasis may be marked by fever, especially early in the course of infection. Hematemesis: Coffee-ground color or black vomit may be a sign of yel- low fever. Hemoglobinuria: Falciparum malaria can cause “blackwater fever.” Hydrocele: Hydrocele may result from lymphatic filariasis, develop- ing as a sequel to repeated attacks of orchitis. Kerititis: Inflammation of the cornea is sometimes a result of ocu- lar migration of Onchocerca volvulus microfilariae. It may lead to blindness. Leukopenia: Leukopenia is a prominent finding in cases of ehrlichio- sis. It may also occur (3,000–6,000/mm3) with a relative monocytosis during the afebrile periods of malaria. Lymphadenitis: Inflammation of one or more lymph nodes may be a sign of lymphatic filariasis – especially involving the femoral, inguinal, axillary, or epitrochlear nodes. : Lymphangitis can be an early symptom of lymphatic filariasis, involving the limbs, breast, or scrotum. Lymphocytosis: Lymphocytosis may occur in Chagas’ disease. Maggots: The presence of fly larvae in human tissues is termed myiasis. Various blow flies, bot flies, and other muscoid flies are usually involved. 230 Appendix 1

Meningoencephalitis: Meningoencephalitis has many causes, but may be a result of trypanosomes in the case of African trypano- somiasis (sleeping sickness) or Chagas’ disease (although generally milder). Falciparum malaria infection may be cerebral, with increasing headache and drowsiness over several days, or even sudden onset of coma. Myocarditis: Chagas’ disease may lead to myocardial infection. African trypanosomiasis may also cause myocarditis to a lesser extent. Neuritis: Neuritis may be caused by bee, ant, or wasp venom. Occasionally stings to an extremity result in weakness, numbness, tingling, and prickling sensations for days or weeks. Neuritis may also result from infection with the Lyme disease spirochete. Nodules, Onchocerciasis may present as skin nodules (see Subcutaneous: Onchocercoma). Tick bites may also result in nodules. Fly larvae in the skin (myiasis) may also present as nod- ules. Common species involved are the human botfly larva, Dermatobia hominis, the Tumbu fly, Cordylobia anthropophaga, and rodent botfly larvae, Cuterebra spp. Onchocercoma: Coiled masses of adult O. volvulus worms beneath the skin enclosed by fibrous tissues may occur in patients living in tropical countries endemic for ochocerciasis. Orchitis: Orchitis may be a symptom of lymphatic filariasis; repeated attacks may lead to hydrocele. Paralysis: Ascending flaccid paralysis may result from tick attach- ment. The paralysis is believed to be caused by a salivary toxin injected as the tick feeds. Proteinuria: Proteinuria, with hyaline and granular casts in the urine, often occurs in falciparum malaria. Puncta: A small, point-like pierce mark may mark the bite or sting site of an arthropod. Paired puncta may indicate spider bite or centipede bite. Rash: There are myriad causes of rash, but rash may accompany many arthropod-borne diseases, such as Rocky Mountain Spotted Fever, , , and African trypanosomiasis. The rash may appear to be ring-like, and expanding in the case of Lyme disease (see Erythema Migrans). An allergic urticarial rash may be seen in the case of bites or stings. Appendix 1 231

Romaña’s Sign: A common sign early in the course of Chagas’ disease, Romaña’s sign is a unilateral palpebral edema, involving both the upper and lower eyelids. This generally occurs when a kissing bug (the vector of the Chagas’ organism) bites near the eye. Shock: Shock may occur from arthropod stings (rarely bites) as a result of hypersensitivity reactions to venom or saliva. Shock may also accompany falciparum malaria. Splenomegaly: Splenomegaly can be a result of lymphoid hyperplasia in both African and American trypanosomiasis. It may also occur in visceral leishmaniasis (kala-azar). Tachycardia: Both African and American trypanosomiasis may pro- duce tachycardia. In Chagas’ disease tachycardia may persist into the chronic stage where it may be associated with heart block. Ulcers, Cutaneous: A shallow ulcer (slow to heal) may be a sign of cutaneous leishmaniasis. In the New World, lesions from cutaneous leishmaniasis are most often found on the ear. Also, a firm, tender, raised lesion up to 2 cm or more in diameter may occur at the site of infection in African trypanosomiasis. Urticaria: Urticaria may result from an allergic or generalized sys- temic reaction to arthropod venom or (more rarely) saliva. Verruga Peruana: A benign dermal eruption (peruvian warts) is one mani- festation of . The verrugae are chronic, last- ing from several months to years, and contain large numbers of bacilliformis bacteria. Winterbottom’s Sign: In the early stages of African trypanosomiasis, patients may exhibit posterior cervical lymphadenitis. Appendix 2 Diagnostic Tests Used in Arthropod-Borne Diseases

A.2.1 Agglutination

Agglutinations are antibodies that cause clumping together (agglutination) of microorganisms, erythrocytes, and often antigenic particulates. If the serum being tested is specific, agglutinins present will cause cultured parasites or bacteria to clump when the serum is introduced.

A.2.2 Complement Fixation

In CF tests, the suspected serum is incubated with a known source of antigen, permitting the antigen-antibody interaction to bind complement and remove it from the reaction mixture. A sheep-blood indicator is then added which hemolyzes in the presence of free complement. If the sheep cells fail to hemolyze, complement is absent; its absence testifies to the prior occurrence of an antigen-antibody reaction. By varying the serum or antigen dilution, one can achieve a crude approximation of titer.

A.2.3 Direct Fluorescent Antibody

A DFA test (some texts refer to it as direct immunofluorescence or DIF) utilizes fluorescent tagging of antibodies produced against the pathogen in question. These tagged antibodies can be purchased commercially against a wide variety of organ- isms. When tagged antibodies are placed on a microscope slide containing the pathogen, the organisms fluoresce when viewed by fluorescent microscopy. DFA is a one-step procedure involving the placement of tagged antibody on a suspect smear of tissue or blood and viewing (after a brief phosphate-buffered saline [PBS] wash) with a UV light-equipped microscope.

233 234 Appendix 2

A.2.4 Enzyme-Linked Immunosorbent Assay (ELISA)

Similar, if not identical, to a test called Enzyme Immunoassay (EIA), the ELISA test may be used for quantitative determination of either antigen or antibody. The appropriate antigen or antibody is bound to (usually) plastic microtiter plates, and the specimen to be tested is then added and given time to react with the already present antigen or antibody. After a wash to remove any unbound test material, an enzyme-linked antigen or antibody is added. After a second wash, a substrate is added that will react with the remaining enzyme to produce a color change.

A.2.5 Hemagglutination Inhibition (HI)

The HI test measures the presence of hemagglutination-inhibiting antibody toward a particular organism. The suspected serum is incubated with fluid medium known to be capable of agglutinating red cells. After the incubation period, the agglutinat- ing potency is measured, and the absence of subsequent agglutination indicates the presence of specific antibodies in the serum.

A.2.6 Immunohistochemistry (IHC)

IHC is used to visualize pathogens in tissues as well as to diagnose abnormal cells such as those found in cancerous tumors. The test is performed on tissue sections and, in most cases, utilizes an antibody conjugated to an enzyme, such as peroxi- dase, that can catalyse a color-producing reaction. Alternatively, the antibody can be tagged to a fluorescent chemical such as FITC, rhodamine, or Texas Red, for reading with a fluorescent microscope.

A.2.7 Indirect Fluorescent Antibody (IFA)

The IFA test is a two-step test involving the placement of patient serum suspected of containing antibodies on a slide with fixed, known antigen. After an incubation period and PBS washing, the slide is then covered with a solution containing fluorescent-tagged antihuman antibodies. After a second incubation period and PBS washing, the slide is viewed by fluorescent microscopy. Fluorescence of antigen on the slide is considered evidence of patient antibodies toward that par- ticular organism. By serially diluting patient serum, a titer can be determined. Appendix 2 235

A.2.8 Leishmanin (Montenegro Test)

The leishmanin test (not available in the United States) is sometimes used to help diag- nose cases of cutaneous and muco-cutaneous leishmaniasis. It involves an intradermal injection of a suspension of killed promastigotes. A high percentage of Leishmania tropica and Leishmania braziliensis infections will test positive by this test.

A.2.9 Mazzotti

The Mazzotti test is used to determine if a patient has onchocerciasis. It can be dangerous and is not used in many areas. It consists of oral administration of 25 or 50 mg of diethylcarbamazine to a patient suspected of having onchocerciasis. If the patient is infected, an intense itching occurs in a few hours (as the microfilariae die within the skin). The itching is then controlled by short-term administration of corticosteroids, or will subside on its own within 2–3 d.

A.2.10 Neutralization

The neutralization test (NT) is the most specific immunologic test for the majority of viral infections. The identification of an unknown viral isolate is made by ana- lyzing the degree to which antisera of known reactivity prevent the virus from infecting tissue-culture cells, eggs, or . If neutralizing antibody is present, virus cannot attach to cells, and infectivity is blocked

A.2.11 Polymerase Chain Reaction (PCR)

PCR has dramatically changed diagnostic microbiology in recent years. PCR makes specific identification of pathogens possible, even when only a few organ- isms are present. PCR is a highly sensitive technique by which minute quantities of DNA or RNA sequences are enzymatically amplified to the extent that a sufficient quantity of material is available to reach a threshold signal for detection using a specific probe. The scientific basis of PCR is that each infectious disease agent (in fact, every living thing) possesses a unique signature sequence in its DNA or RNA by which it can be identified. In other words, there is a unique sequence of amino acids for each organism. By finding those unique sequences and constructing prim- ers to amplify those specific areas of DNA, identification of an organism can be accomplished from a blood or tissue sample, or even from an infected arthropod 236 Appendix 2 vector. PCR is carried out using a thermocycler, which produces a series of heat- cool cycles, whereby double-stranded DNA is dissociated into single strands that are in turn allowed to anneal in the presence of specific primers on cooling. Through the successive heat–cool cycles (usually about 30), the DNA sequence to be detected is amplified millions of times. The product is then visualized after sepa- ration on agarose gels by electrophoresis and appropriate staining. There are vari- ous types of PCR, such as real-time PCR which allows more samples to be processed at once, and nested PCR which is more sensitive than either real-time or direct PCR. Index

A Agglutination, 141, 233 Accidental myiasis, 209 African sleeping sickness contributing factors, 215 diagnosis, 161 treatment, 217–218 Allergy to stings, 13 Artemisinin-based combination therapy Allopurinol, 159 (ACT), 44–45 Amastigote, 148 Adenopathy, 227 , 85, 93–100, 107 Aedes aegypti, 21, 58–61, 63 , 85, 93–100, 107 biting patterns, 58 geographical distribution, 100 breeding, 61 illustration, 99 dengue virus, 58 , 107 geographic distribution, 61 Amblyomma hebraeum, 85, 94 illustration, 60 Amblyomma maculatum, 85, 90–94 and YF, 63 and American boutonneuse fever, 85, Aedes africanus, 21, 67 90–94 and YF, 67 American dog tick, 85, 87–88 Aedes albopictus, 21, 57–61 American trypanosomiasis, 153–159 biting patterns, 58 Amodiaquine, 45 dengue virus, 58 Amoxicillin, 105 geographic distribution, 61 LD treatment, 105 Aedes mosquitoes, 21, 32–35, 57–61, 67 Amphotericin B breathing, 31–33 leishmaniasis treatment, 149 dog heartworm, 74 Anaplasma marginale, 96 egg laying, 34 Anaplasma phagocytophilum, 96–98 positions, 33 (HGA), 96–98 Aedes vexans, 33 Anemia, 38, 227 African sleeping sickness, 160–164 Anopheles darlingi, 40 causative agent, 160 geographic distribution, 42 clinical and laboratory findings, 161 illustration, 42 diagnosis, 160–161 malaria, 40 ecology, 161–162 Anopheles freeborni, 26 geographical distribution, 161 catholic feeder, 26 medical significance, 160 malaria vectors, 26, 40 prevention and control, 163 Anopheles gambiae, 40 symptoms, 160 geographic distribution, 41 treatment, 163 illustration, 41 vectors, 162 malaria, 40 (ATBF), 96 Anopheles hermsi, 26, 40 African trypanosomiasis, 13, 160–164 malaria vectors, 40

237 238 Index

Anopheles leucosphyrus, 40, 43 B geographic distribution, 43 Babesia bigemina, 110 illustration, 43 Babesia canis, 110 malaria, 40 Babesia divergens, 109 Anopheles maculipennis, 27 Babesia equi, 110 Anopheles mosquitoes, 21, 26–27, 31–45, Babesia gibsoni, 110 72, 74 , 109–111 Bancroftian filariasis, 72 life cycle, 110 breathing, 31 Babesiosis, 109–111 breeding, 33 Bacillus thuringiensis, 166 cyclopropagative transmission, 22 Bacon therapy, 218 dog heartworm, 74 Bacterium tularense, 105 egg laying, 33 See also positions feeding, 32 Bancroftian filariasis, 68–74 vector control, 44 biological transmission, 22 vectors, 21, 40–43 geographic distribution, 69 Anopheles punctipennis, 26 Wuchereria bancrofti, 70 malaria vectors, 40 , 150 Anopheles quadrimaculatus, 27, 40 , 140 malaria vectors, 40 , 171 Anophelinae, 31 Bartonellosis, 140, 150 Antibody-dependent Bees, 13, 202 Enhancement (ADE), 63 sting apparatus, 202 Antimalarial drugs, 45 stings, 204–206 Antiparasitic drug Beetles, 16 onchocerciasis treatment, 166 blister, 12 Ants larvae, 16 fire ants, 195–198 Benznidazole, 159 sting apparatus, 202 Chagas’ disease treatment, 159 stings, 195–198 Biological transmission , 4–9 classification types, 20 characteristics, 4 disease agents, 21 Arborival encephalitis, 49–57 example, 22 , 81–84 Bird-biting mosquitoes, 47, 50 illustration, 82 Bite lesions, 11, 201 Arkansas strain Bites, 11, 201 HME, 98 arthropods, 11, 201 Arthropod-borne diseases spiders, 5, 189, 201 diagnostic tests, 233–236 tick dynamics, 19–27 illustration, 91 signs and symptoms, 227–231 Rocky Mountain Spotted Fever Arthropods (RMSF), 87 characteristics, 3 Bite site and health, 10–17, 19–27 erythema migrans (EM), 101 historical medical aspects, 10 Biting flies and HIV, 183–184 tularemia, 106 human diseases transmitted, 19–27 Black death, 134 medical importance, 10–17, Black flies, 165–166 19–27 filarial worms, 164 class list, 4 Black rat, 134 stings and bites, 201–208 Black soldier fly, 209 Asian tiger mosquitoes, 21, 57–61 illustration, 210 dengue virus, 58 Black widow spider, 11 Azithromycin venom, 11 LD treatment, 105 Blister, 12 Index 239

Blister beetles, 12 Chagas’ disease, 153–160 Blow flies see Calliphoridae, 211–216 clinical and laboratory findings, illustration, 213 153–154 larvae, 213 diagnosis, 157 Body lice, 170–171 ecology, 157 medical importance, 170 geographic distribution, 155 (caused by fly larvae), medical significance, 153 216–217 prevention and control, Borrelia burgdorferi, 104–105 159–160 detection, 104 symptoms, 153–156 Borrelia hermsi, 116 transmission mode, 157 illustration, 115 treatment, 159 Borrelia recurrentis, 116, 174 vectors, 159 Borrelia turicata, 116 Chagoma, 227 Bot fly, 212, 214 Cheese skipper, 210 Boutonneuse fever, 94 illustration, 210 Brown recluse, 187 Chiclero’s ulcer, 146 Brown widow spider Chikungunya, 56–57 venom, 11 outbreaks, 57 bite effects, 11 symptoms, 56 Brugia malayi, 72, 74 vectors, 57 lymphatic filariasis treatment, 74 Chigger-borne , 166 Brugian filariasis, 68 Chiggers, 166–169 geographic distribution, 69 life cycle, 169 , 134–135 Chigoe fleas, 10 Bulls-eye rash, 101 Chilopoda Burrowing fleas, 10 characteristics, 4, 9 Chloramphenicol louse-borne disease treatment, 174 C murine typhus treatment, 139 Calliphoridae, 211, 213 RMSF treatment, 90 Calliphora vicina, 211 treatment, 169 Campestral plague, 133 tularemia treatment, 108 Canine ehrlichiosis, 97 Chloroquine Cantharidin, 12 antimalarial drug, 40 Carios rudis, 117 Chrysomya albiceps Carrion’s disease, 150 illustration, 214 Cat fleas, 139, 141 Chrysomya chloropyga Catholic feeder illustration, 214 Anopheles freeborni, 26 Chrysomya flies Cat-scratch disease (CSD), 140 illustration, 214 clinical presentation, 139 Chrysomya megacephalus symptoms, 140 illustration, 214 transmission modes, 141 Chrysomya rufifacies, 211 treatment, 141 Chrysops discalis, 108 Cebidae monkeys Chyluria, 227 and YF, 67 Ciprofloxacin Cefuroxime CSD treatment, 141 LD treatment, 105 Clindamycin Centipedes, 4, 9 human babesiosis treatment, 111 characterizations, 9 Cochliomyia macellaria, 211 Central European TBE, 111 illustration, 213 Cercopithecidae monkeys Cockroaches and YF, 67 mechanical transmission, 19 Cerebral malaria, 38 transmission mode, 20 240 Index

Colorado tick fever (CTF), 113 D diagnosis and treatment, 113 Daddy longlegs, 6 symptoms, 113 Dark rice field mosquitoes, 33 Coma, 38, 46, 50, 86, 112, 160, 227 Deer fly, 21, 105, 108 Commensal rats, 134 illustration, 106 Competent vectors, 12, 24–25 Deer fly fever, 106 Complement fixation, 138, Deer mice, 133, 135 157, 233 Deer tick, 101–102 Conenose bugs, 157. See also Kissing bugs geographic distribution, 101 and Triatoma illustration, 101 Conjunctivitis, 228 DEET, 48, 89, 150 Coquillettidia perturbans leishmaniasis protection, 150 mosquito vector, 48 Delusions of parasitosis (DOP), 221 Cotton rats, 138 Den 1 Cowdria ruminantium 96 dengue virus serotype, 58 CSD (cat-scratch disease), Den 2 139–141 dengue virus serotype, 58 Ctenocephalides felis, 139, 141 Den 3 Culex mosquitoes, 21, 33–35, 46, 74 dengue virus serotype, 58 breathing, 33 Den 4 breeding, 35 dengue virus serotype, 58 dog heartworm, 74 Dengue, 58–63 egg laying, 35 Dengue fever, 58–63 positions, 32 Dengue hemorrhagic fever (DHF), 61–63 SLE, 46, 50–52 risk factors, 62 Culex nigripalpus Dengue shock syndrome (DSS), 61–62 SLE mosquito vector, 51 risk factors, 62 Culex pipiens Dengue vaccine, 63 SLE mosquito vector, 51 Dengue virus, 58–63 Culex quinquefasciatus geographic distribution, 59 Bancroftian filariasis, 70–71 laboratory characteristics, 61 SLE mosquito vector, 51 mosquito markings, 60 WNV mosquito vector, 54 serotypes, 58 Culex tarsalis spread, 58 illustration, 52 symptoms, 58 SLE mosquito vector, 51 treatment, prevention and control, WEE, 54 62–63 WNV, 54 andersoni Culex tritaeniorhynchus and CTF, 113 JE, 56 geographic distribution, 88 Culicidae mosquitoes, 31 illustration, 87 subfamilies, 31 interference phenomenon, 25 Culicinae tick vectors, 21, 87, 107, 113 characteristics, 31 , 120–121 Culiseta melanura Dermacentor marginatus, 96 enzootic vector, 21, 47 Dermacentor nuttalli, 96, 107 Cutaneous leishmaniasis, Dermacentor silvarum, 96 143–144 Dermacentor ticks geographic distribution, 145 tick paralysis, 120–121 Cuterebra flies, 215 , 21, 85, 87, 99 Cyclodevelopmental transmission geographic distribution, 87 disease agents, 22 illustration, 88 Cyclopropagative transmission tick paralysis, 120–121 disease agents, 22 tick vectors, 87, 99, 107 Index 241

Dermatitis, 15, 101, 103, 165, 191, 223, 228 East Side agent, 25 Diagnostic tests Edema, 228 arthropod-borne diseases, 233 Ehrlichia, 96–100 Diarrhea, 228 Ehrlichia canis, 97 Diethylcarbamazine (DEC) , 97–98 lymphatic filariasis treatment, 74 , 98–100 onchocerciasis treatment, 166 Ehrlichia phagocytophila, see Anaplasma Diplopoda, 4, 9 phagocytophilum, 98–100 characteristics, 9 Ehrlichia ruminantium, 96 Dip-Sticks Ehrlichiosis, 96–100 malaria diagnosis, 38 EIA. See ELISA, 234 scrub typhus diagnosis, 167 Ekbom’s Syndrome, 221 Direct fluorescent antibody, 233 Elephantiasis, 68 Dirofilaria immitis, 74 ELISA. See Enzyme-linked immunosorbent Dirofilaria repens, 74 assay, 234 Dirofilariasis, 74 Encephalitides group, 46–56 Dirofilaria tenuis, 74 Encephalitis viruses Dirofilaria ursi, 74 mosquito-transmitted, 46–56 Disease agents Envenomation, 11, 201 biological transmission, 20 Envenomization, 11, 201 mechanical transmission, 19 Enzootic cycle, 47 Diseases Enzootic vector transmitted by arthropods, 21 Culiseta melanura, 47 Disease transmission Enzyme immunoassay (EIA), direct effects, 11 see ELISA, 234 indirect effects, 12 in scrub typhus diagnosis, 167 Dog antiparalysis serum Enzyme-linked immunosorbent assay tick paralysis treatment, 123 (ELISA), 234 Dog heartworm, 74 African sleeping sickness diagnosis, 161 Dog tapeworm Borrelia burgdorferi detection, 104 transmission mode, 20 Chagas’ disease diagnosis, 157 Dog tick, 85, 87, 99 leishmaniasis diagnosis, 147 Domestic rats, 134 microfilariae identification, 70 DOP, 221 plague diagnosis, 136 Doxycyline tick-borne encephalitis diagnosis, 113 ABF treatment, 94 Eosinophilia, 228 CSD treatment, 141 Eosinophilic cerebrospinal fluid pleocytosis, ehrlichiosis treatment, 100 228 LD treatment, 105 , 21, 170–171 murine typhus treatment, 139 Epididymitis, 228 RMSF treatment, 90 Epizootic cycle, 22, 47, 97 scrub typhus treatment, 169 Epizootic hosts TBRF treatment, 117 fleas, 135 Dust mites, 14 Eristalis tenax, 210 illustration, 211 Erythema migrans, E bite site, 103 Eastern equine encephalitis (EEE), 46–49 Erythromycin, control, 48 CSD treatment, 141 differential diagnosis, 48 Eschar, 92–94 ecology, 47 tick bite, 93–94 geographic distribution, 47 Excoriation, 222 life cycle, 48 Extrinsic factors onset of symptoms, 46 vector competence, 24 242 Index

F mechanical transmission, 19–20, 179, Facultative myiasis, 211 183–184 contributing factors, 215 Megaselia, 211 treatment, 217–218 Musca, 211 Falciparum malaria, 38, 46, 50, 53, 56, 86, 96, Muscina, 211 97, 100, 106, 112, 114, 229 Sarcophaga, 211 Febrile anemia, 150 illustration, 213 Fever, 38 sand, 21, 143–151 Fiddle back spider, venom of, 11 biology, 143 Field’s stain sand fly fever, 150 microfilariae identification, 70 Sarcophaga, 211 Filarial worms, 22 screwworm, 212 biological transmission, 22 illustration, 214 life cycle, 73 Simulium, 21, 164–165 Fire ants, 195–198 soldier fly, 210 attacks, 198 illustration, 210 venom, 196 tsetse, 21, 160–165 -borne diseases, 138–140 illustration, 160 Fleas, 131 tularemia, 21, 106, 108 biology, 131 Fomite house burrowing, 10 and YF, 66 cat, 139, 141 Francisella tularensis, 105 chigoe, 10 epizootic hosts, 135 labeled diagram structure, 132 G larvae, 131 Gamma-interferon mouthparts, 132 leishmaniasis treatment, 149 Oriental rat flea, 135–138 Gentamicin illustration, 136 CSD treatment, 141 transmission mode, 135 tularemia treatment, 109 Flesh flies, 211 Geographic distribution illustration, 213 Aedes aegypti, 61 Flies Aedes albopictus, 61 biting African sleeping sickness, 161 tularemia, 106 Amblyomma americanum, 100 black flies, 164–166 Anopheles darlingi, 42 filarial worms, 164 Anopheles gambiae, 41 black soldier fly, 210 Anopheles leucosphyrus, 43 blow flies, 210–211 Brugian filariasis, 70 illustration, 213 Chagas’ disease, 155 larvae, 213 deer tick, 101 bot fly, 212 dengue virus, 59 Chrysomya , 88 illustration, 214 Dermacentor variabilis, 88 Cuterebra, 215 eastern equine encephalitis (EEE), 47 deer fly, 21, 106, 108 HGE/HGA, 97 illustration, 106 holocylus, 122 flesh flies, 215 , 101 illustration, 213 Japanese encephalitis (JE), 57 house flies LaCrosse encephalitis (LAC), 56 disease transmission, 20 LBRF, 173 life cycle, 19–20 leishmaniasis, 145 hump-backed, 212 lone star tick (LST), 100 larvae, 212 louse-borne typhus, 172 Index 243

malaria, 37 Hetrazan ticks, 118 lymphatic filariasis treatment, 74 plague, 133 HGA/HGE. See also Human granulocytic scrub typhus, 167 ehrlichiosis (HE), 96–98 St. Louis encephalitis, 51 HIV transmission tick-borne (TBRF), 118 and mosquitoes, 183–184 western equine encephalitis (WEE), 55 HME. See Human monocytic ehrlichiosis yellow fever (YF), 64 (HME), 96–98 Giant centipede, 9 House centipede, 9 Giemsa stain House flies, 4 babesiosis diagnosis, 110 larvae, 5 leishmaniasis diagnosis, 148 life cycle, 5 microfilariae identification, 70 House mosquito Giemsa Wayson stain Bancroftian filariasis, 72 plague diagnosis, 136 Howler monkeys Glossina, 161–164 and YF, 67 Glossina fuscipes, 162 Human babesiosis, 109–111 Glossina morsitans, 162 clinical and laboratory findings, 109 Glossina pallidipes, 162 ecology, 110 Glossina palpalis, 162 medical significance, 109 Glossina swynnertoni, 162 treatment and control, 111 Glossina tachinoides, 162 Human bot fly, 212–216 Glucantime Human diseases transmitted leishmaniasis treatment, 149 arthropods, 21 Grasshoppers, 3 Human ehrlichiosis, 96–98 Gulf coast tick, 85, 90–94 Human granulocytic ehrlichiosis (HGE), 96–98 ecology, 99 H tick vectors, 99 Haemagogus mosquitoes Human immunodeficiency virus (HIV), sylvatic cycle, 67 183–184 Haemaphysalis Human monocytic ehrlichiosis (HME), tick vectors, 21, 96 96–98 Haemaphysalis concinna, 96 Hump-backed flies, 212 Haemaphysalis flava, 85 Hyalomma, 85 tick vectors, 85 tick vectors, 85 Hard ticks, 81–82 Hyalomma iongicornis, 85 characteristics, 81 tick vectors, 85 Harvestmen, 6 Hydrocele, 229 HE, 98 Hymenoptera HME, 97–98 sting apparatus, 204 Head lice Hypereosinophilia, 70 life cycle, 5 Health arthropods direct effects, 11 I arthropods indirect effects, 12 IFA. See Indirect fluorescent antibody (IFA), Hemagglutination inhibition (HI), 234 70 Hematemesis, 229 Imaginary insect and mite infestation, 221 Hemipteran insects, 153 contributing factors, 222 Hemoglobinuria, 229 differential diagnosis, 223 Hemolymph test, 25 treatment strategies, 224 Hemolytic anemia, 38, 187 Immunoglobulin M Hermetia illucens, 210 and LD, 103 illustration, 210 Indigenous leishmaniasis, 148 244 Index

Indirect fluorescent antibody (IFA), 70 , 107 African sleeping sickness diagnosis, illustration, 108 161 Ixodes scapularis, 21–22, 102, 124 babesiosis diagnosis, 110 geographic distribution, 101 Chagas’ disease diagnosis, 157 illustration, 101 ehrlichiosis diagnosis, 99 , 81–83 leishmanisasis diagnosis, 147 microfilariae identification, 70 murine typhus, 138 J plague diagnosis, 136 Japanese encephalitis (JE), 56 RMSF diagnosis, 86 geographic distribution, 57 scrub typhus diagnosis, 167 , 85 Infective sporozoites Jungle YF cycles, 67 malaria, 38 Inland floodwater mosquitoes, 33 Insect K characterizations, 3–4 Kerititis, 229 forms of development, 3–4 Kissing bugs, 20, 21, 153–160 and HIV, 183–184 beak, 158 pathogen pick up, 19–21 illustration, 158 Insecta transmission mode, 20 characteristics, 3–4 , 111 Insect infestation imaginary, 221 Insect mouthparts L description, 202 LaCrosse encephalitis (LAC), illustration, 202 46, 54 list, 201–202 geographic distribution, 56 Insect pupae, activity of vs. mosquito pupae, vectors, 46, 54 31 Larvae Insect stings or bites, 201–207 mosquitoes, 31 diagnosis, 206 Latex agglutination (LA) tests, 138 infectious complications, 205 Leishmania aethiopia, 144 medical significance, 201 Leishmania braziliensis, 146 pathogenesis, 201 Leishmania chagasi, 147 recognition, 206 Leishmania donovani, 146 Interference phenomenon, 25 Leishmania guyanensis, 146 Intrinsic factors Leishmania infantum, 146 vector competence, 24 Leishmania major, 144 Itraconazole, 159 Leishmania mexicana, 146 Ivermectin Leishmania panamensis, 146 lymphatic filariasis treatment, 74 Leishmania tropica, 144 onchocerciasis treatment, 166 Leishmania parasites, 143 Ixodes cookie, 112 Leishmaniasis, 143–145 , 121 clinical manifestations, 143–144 Ixodes dammini, 102 diagnosis, 147 , 14, 96, 121 ecology, 148 geographic distribution, 122 forms, 146 illustration, 122 geographic distribution, 145 tick vectors, 85 life cycle, 149 Ixodes ovatus, 85 medical significance, 143–145 tick vectors, 85 treatment and control, 149 , 104 Leishmanin test, 147 , 112 Leptopsylla segnis, 138 Index 245

Leptotrombidium akamushi Lymphatic filariasis ST vector species, 169 clinical and laboratory findings, 68 Leptotrombidium arenicola ecology, 70–71 ST vector species, 169 medical significance, 68 Leptotrombidium deliense symptoms, 68 ST vector species, 169 treatment, 74 Leptotrombidium fletcheri Lymphocytosis, 229 ST vector species, 169 Leptotrombidium mites, 168–169 Leptotrombidium pallidum M ST vector species, 169 Maggot infestation, 218 Leptotrombidium pavlovsky Maggots, 209–220 ST vector species, 169 Malaria, 13, 35–45 Leptotrombidium scutellaris causative agent, 38 ST vector species, 169 deaths, 13 Leptotrombidium species, 168–169 diagnosis, 38 Lesions epidemiology, 35 bite, 11, 205 geographic distribution, 36–37 Leukopenia, 229 history, 35 Lice, 5, 170–173 incidence, 13 head life cycle, 39 life cycle, 5 mosquitoes, 40 Liponyssoides sanguineus, 85 mosquito vectors and behavior, 40 Loiasis, 74, 228 symptoms, 38 Lone star tick (LST), 99–100 transmission mode, 20 geographic distribution, 100 treatment and control, 44 illustration, 99 Malaria organism vectors Louping ill, 111 mosquitoes, 40 Louse-borne diseases Malaria plasmodia treatment, control, and prevention, cyclopropagative transmission, 22 174 Malaria vaccine, 44 Louse-borne infections Malaria vectors medical importance, 170 Anopheles mosquitoes, 40 Louse-borne relapsing fever Malayan filariasis, 68 (LBRF), 174 Mansonella ozzardi, 74 geographic distribution, 173 Mansonella perstans, 74 Louse-borne typhus, 171 Mansonella streptocerca, 74 geographic distribution, 173 Mansonia, 72 Lucilia sericata, 211, 215 Mazzotti test, 65, 235 Lutzomyia, 21, 148–150 onchocerciasis diagnosis, 165 Lutzomyia anthophora, 148 Mechanical transmission Lutzomyia colombiana, 150 disease agents, 20 Lutzomyia mexicana, 146 Mectizan Lutzomyia verrucarum, 150 lymphatic filariasis treatment, 74 Lyme disease (LD), 21 onchocerciasis treatment, 165 clinical and laboratory findings, 103 Mediterranean spotted fever, 94 ecology, 104 Mefloquine, 45 history, 102 Megaselia flies, 211 symptoms, 100–101 Melarsoprol tick bite, 104 African sleeping sickness treatment, 163 treatment, 105 Mel-B7 vectors, 22 African sleeping sickness treatment, 163 , 229 Meningoencephalitis, 48, 112, 156, Lymphangitis, 229 160, 227, 236 246 Index

Merozoites and YF, 67 malaria, 40 Haemagogus Microfilaramia, 68 sylvatic cycle, 67 Microfilariae identification head and mouthparts, 34 microscopic view, 70–71 HIV transmission, 183–184 sheath showing, 70 House, 21, 72 Millipedes, 4, 9 and Bancroftian filariasis, 72 characterizations, 4,9 illustration, 32 stains on skin, 12 inland floodwater, 33 Mite infestation larvae, 32 imaginary, 221 malaria, 13, 35–45 Mite islands, 166 malaria organism vectors, 40 Mites Plasmodium characterizations, 8 malaria, 38 Leptotromidium, 168 vectors, 40 pathogen pick up, 169 Psorophora, 33–34 trombiculid, 168 biting patterns, 34 Montenegro test, 235 egg laying, 33–34 Morulae (illustration), 97 VEE, 55 Mosquito biology, 31 pupae, 31–32 Mosquito-borne diseases, 35–77 Salt marsh, 33 Mosquito-borne encephalitis, 45–56 tree canopy YF and, 67 Mosquitoes, 31–77 tree hole, 21, 33–34, 67, 143 Aedes, 32–35, 57–61, 67 LAC, 54 breathing, 33 tularemia, 105 dog heartworm, 74 tumblers, 31–32 egg laying, 34 wigglers, 31–32 positions, 32–33 yellow fever, 63–66 Anopheles, 32–33, 38, 40–43 Mosquito house Bancroftian filariasis, 70 and YF, 66 breathing, 33 Mosquito pupae, 31 breeding, 33 activity, 31 dog heartworm, 74 insect pupae, 31 egg laying, 33 Mosquito-transmitted encephalitis positions, 33 viruses, 46–56 vectors, 40 Mosquito vectors, 21, 26, 40 Asian tiger dengue, 58 dengue virus, 58 malaria, 40 bird-biting, 47, 50, 53 and SLE, 50–51 Culex, 21, 33–35, 46, 54, 56 and WNV, 46, 54 breathing, 31, 33 Moths, 3, 16 breeding, 33, 35 larvae, 3, 16 dog heartworm, 74 Mucocutaneous leishmaniasis, 143, 146 egg laying, 35 geographic distribution, 145 positions, 32 illustration, 146 and SLE, 50 Murine typhus, 136 and WNV, 53–54 clinical and laboratory findings, 138 Culicidae, 31 ecology, 138 subfamilies, 33 medical significance, 136–137 dark rice field, 33 vs. Rocky Mountain spotted fever dengue virus mosquito markings, (RMSF), 138 60 symptoms, 138 filarial worms, 74 treatment, 139 forest scrub Musca flies, 211 Index 247

Muscina flies, 211 Ornithodoros parkeri Myiasis, 11, 209–218 geographic distribution, 117 contributing factors, 215 Ornithodoros porcinus in clinical practice, 216 geographic distribution, 119 prevention, treatment, and Ornithodoros rudis control, 217 geographic distribution, 117 Myocarditis, 230 Ornithodoros tholozani geographic distribution, 119 Ornithodoros turicata N geographic distribution, 117 Neuritis, 230 illustration, 118 Neutralization, 235 Oropharyngeal tularemia, 106 Nifurtimox Oroya fever, 150 Chagas’ disease treatment, 159 Otobius megnini Nodules, subcutaneous, 230 illustration, 82 , 85 Norway rat, 139 Nosopsyllus fasciatus, 138 P Panstrongylus megistus Chagas’ disease vectors, 159 O Papatasi fever, 150 Obligate myiasis, 209–218 Paralysis, 119–123, 230 contributing factors, 216 Parasite transmission treatment, 217–218 modes, 20 Obstructive filariasis, 70 Parinaud’s oculoglandular syndrome, Ochlerotatus (formerly Aedes) mosquitoes, 140 31, 35 Pathogen transmission Ochlerotatus sollicitans, 34, 46, 48 mechanical vs. biological, Ochlerotatus taeniorhynchus, 48 19–20 Ochlerotatus triseriatus, 33, 46 modes, 20 and LAC, 54 PCR. See Polymerase chain reaction (PCR), Oculoglandular tularemia, 106 235 , 111 Pediculus, 21, 170 Onchocerca volvulus, 164 Pediculus humanus corporis, 170 Onchocerciasis, 164–166 Pentavalent antimonials clinical and laboratory findings, 165 leishmaniasis treatment, 149 diagnosis, 165 Pentostam ecology, 165 leishmaniasis treatment, 149 medical significance, 164 Permanone, 90 treatment, prevention, and control, 166 Permanone Repel, 90 vectors, 165 Permethrin products, 90 Opiliones, 6 Peromyscus leucopus, 110 Orbivirus, 113 Peruvian warts, 150 Orchitis, 228 Phaenicia (Lucilia) sericata, 211 Oriental rat flea, 135–137 Phlebotominae, 148 illustration, 136 Phlebotomus, 21, 151 , 22, 166 Phlebotomus papatasi, 151 Ornithodoros, 21, 116–117 Phormia regina, 211 Ornithodoros erraticus Pian bois, 146 geographic distribution, 117 Pimozide Ornithodoros hermsi imaginary insect and mite infestation geographic distribution, 117 treatment, 223–224 Piophilia casei, 210 geographic distribution, 117 illustration, 210 248 Index

Plague, 133–136 Quinine clinical presentation, 133 antimalarial drug, 45 diagnosis, 136 Quinine sulfate ecology, 135 human babesiosis treatment, 111 geographic distribution, 133 state by state, 135 history, 134 R life cycle, 135 Rabbit fever, 105 transmission mode, 135 Radio-immunoassay (RIA) treatment, 136 Chagas’ disease diagnosis, 157 Plague of Justinian, 134 Rapid diagnostic tests Plasmodium falciparum, 38, 110 malaria diagnosis, 38 Plasmodium malariae, 38 Rash, 14, 61, 86, 92, 94, 96, 98, 105, 113, 115, Plasmodium mosquitoes 138, 165, 171, 201, 227 malaria, 40 Rats, 133, 148 vectors, 40 Rat-tailed maggot, 210 Plasmodium ovale, 38 illustration, 211 Plasmodium species, 38 Rattus norvegicus, 138 Plasmodium vivax, 38 Rattus rattus, 23, 135, 138 Pleomorphic coccobacilli, 96 Red-tailed monkeys Pneumonic and YF, 67 plague form, 24 Reduviidae, 153 Polymerase chain reaction (PCR), Relapsing fever, 21, 114 235 louse-borne vs. tick borne, 116 Borrelia burgdorferi detection, Rhipicephalus Chagas’ disease diagnosis, 157 tick vectors, 85, 87, 94 CSD detection, 138 Rhipicephalus appendiculatus, 94 ehrlichiosis diagnosis, 98 , 85, 87 RMSF diagnosis, 86 Rhodnius, 159 tularemia diagnosis, 105 Rhodnius prolixus (POW), 111 Chagas’ disease vectors, 159 Promastigotes, 144, 147 Rice culture, 27 Propagative transmission Rice rats, 138 disease agents, 22 africae, 85 Prophylaxis, 45 ,22, 85 Proteinuria, 230 , 85 Pseudomyiasis, 209 , 84 Psorophora columbiae, 33 Rickettsia conori, 85 Psorophora mosquitoes Rickettsiae, 84 biting patterns, 35 , 85 egg laying, 33 , 85 and VEE, 46, 55 Rickettsial disease, 21–22, 84 Psychodidae, 148 Rickettsial pox, 22 Puncta, 205, 230 Rickettsia montana, 25 Pupae, 3, 31 , 85 mosquitoes, 31 Rickettsia peacocki, 25 Pyrimethamine , 21 antimalarial drug, 45 Rickettsia rhipicepahali, 25 , 22, 25, 85 Rickettsia siberica, 85 Q , 138 Queensland tick typhus (QTT), 96 murine typhus, 138 Quinidine Rifampin antimalarial drug, 45 CSD treatment, 141 Index 249

Riparian habitat, 26–27 Simulium damnosum, 165 River blindness, 164 Simulium flies, 21, 165 Rochalimaea henselae, 140 Simulium metallicum, 166 Rochalimaea quintana, 171 Simulium neavei, 165 Rocky Mountain spotted fever Simulium ochraceum, 166 (RMSF), 84 Skin biopsies characteristics, 84 onchocerciasis diagnosis, 165 clinical and laboratory aspects, 85 Sleeping sickness, 160–164 ecology, 87 Social insects, 11 infected tick bite, 87 Soft ticks, 81, 83, 116 prevention, 87 characteristics, 81 symptoms, 84 illustration, 82 Rocky Mountain wood tick, 87–88 Soldier fly, 209, 210, 216 Romana’s sign, 156 illustration, 210 Roof rat, 139 Spider monkeys, YF and, 67 Russian spring-summer encephalitis (RSSE), Spiders, 3–7, 11, 187–192 111–112 bites, 187 black widow venom, 11 S brown widow Sarcophaga flies, 211 venom, 11 illustration, 213 characterizations, 4–5 Salivary excretions daddy longlegs, 6 arthropods, 11, 153, 205, 208 fiddle back Salt marsh mosquitoes, 33, 34, 48 venom, 187 Salt marsh mosquitoes venom, 11, 187 biting patterns, 35 Splenomegaly, 146 epizootic vector species, 48 Sporozoites (malaria), 40 Sand flies, 10, 142, 148, 150 Spotted fever group, 25, 84–85 biology, 148 epidemiologic information, 84–85 Sand fly fever, 150 Spotted fever rickettsioses, 84 Sand fly-transmitted diseases, 150 St. Louis encephalitis, 46, 49–52 Sarcophaga flies, 211 control, 52 Sarcophaga haemorrhoidalis, 213 ecology, 50–51 Scorpion geographic distribution, 51 stinging position, 8 life cycle, 50 venom, 11 symptoms, 50 Scorpions, 3, 4, 8, 13 vectors, 50–51 characterizations, 4, 9 Sting apparatus, 204 Screwworm flies, 11, 212, 214, 216, 218 Stings, 10, 11, 14, 195–198 illustration, 214 arthropods, 11 Scrub typhus, 166–169 Streptomycin clinical and laboratory findings, 167 plague treatment, 136 diagnosis, 167 tularemia treatment, 108 ecology, 168 Sulfonamides geographic distribution, 167 antimalarial drug, 45 medical significance, 166 Suramin treatment, prevention, and control, 168 African sleeping sickness treatment, vectors, 169 163 Sensu latu, 26 onchocerciasis treatment, 164 Septicemic plague, 133 Sylvatic plague, 133 Shock, 62, 231 Sylvatic YF, 67 Siberian tick typhus (STT), 84–85 Symbiotic rickettsial organism, 122 Simulium, 21, 164–165 Systemic tick-borne illness, 100 250 Index

T illustration, 82 Tachycardia, 231 interference phenomenon, 25 Tapeworm Ixodes, 85, 96, 99, 102, 104, 107, 112, 121 transmission mode, 20 illustration, 101 Tarantula, 7 life cycle, 83 Tests lone star tick (LST), 21, 93, 99 arthropod-borne diseases, 233 geographic distribution, 100 Tetracycline illustration, 99 antimalarial drug, 45 removal, 91 ehrlichiosis treatment, 100 Rocky Mountain wood tick, 87–88 louse-borne disease treatment, 174 soft, 81, 83, 116 murine typhus treatment, 139 characteristics, 81 plague treatment,136 illustration, 82 RMSF treatment, 86 tularemia, 107 TBRF treatment, 117 western black-legged, 110 tularemia treatment, 108 Timorian filariasis, 68 Theileria, 110 TMP-SMX Three-day fever, 150 CSD treatment, 141 Tick-borne encephalitis, 111–113 Toxorhynchitinae, 31 diagnosis and treatment, 113 characteristics, 31 Tick-borne relapsing fever (TBRF), 114 Transmission of pathogens clinical and laboratory findings, 114 mechanical vs. biological, 19–20 diagnosis, 115 Tree canopy mosquitoes ecology, 116 and YF, 67 geographic distribution, 118 Tree hole mosquitoes, 33, 46 vs. louse-borne, 116 and LAC, 46, 54 medical significance, 119 , 171 symptoms, 114–115 Triatoma brasiliensis treatment and control, 117 Chagas’ disease vectors, 159 Tick paralysis, 119 Triatoma bugs, 157 clinical features, 119–120 Triatoma dimidiata mechanisms, 121 Chagas’ disease vectors, 159 medical significance, 119 Triatoma infestans prevention and treatment, 123 Chagas’ disease vectors, 159 Tick removal Triatoma protracta method, 91 Chagas’ disease vectors, 154 Ticks allergy to bites, 154 American dog, 21, 22, 87, 99, 107, 121 Triatoma sanguisuga biology, 81 Chagas’ disease vectors, 154 bite, 86–87, 90, 94, 96 Triatominae, 153 eschar, 94–95 Trombiculid mites, 168 Lyme disease, 102 True bugs, 153 Rocky Mountain Spotted Fever Trypanosoma brucei gambiense, 160 (RMSF), 87 Trypanosoma brucei rhodesiensei, 160 characterizations, 8 Trypanosoma cruzi, 158–159 deer, 102 Trypanosoma rangeli, 157 geographic distribution, 101 Trypomastigote, 157 illustration, 101 Tsetse flies, 21, 160 Dermacentor, 22, 25, 85, 87, 96, 99, 123 illustration, 166 Gulf coast Tularemia, 105 diseases associated with, 92–93 arthropod transmission, 107 dog, 21, 22, 87, 99, 107 clinical and laboratory findings, 106 hard, 81 medical significance, 105 characteristics, 81 treatment, 108 Index 251

Tumblers Wasps, 3, 11, 13, 14, 202 mosquitoes, 31 sting apparatus, 204 Typhus island, 166 stings, 203–205 Weil-Felix reactions, 86 West Nile virus, 46 U life cycle, 53 Ulceroglandular, 106 control, 54 Ulcers, cutaneous, 122 vectors, 46 Urban YF cycles, 67 Western black-legged tick, 104 Urine tests Western equine encephalitis, 46 onchocerciasis diagnosis, 165 geographic distribution, 55 Urticaria, 14–15, 201, 206, 230 vectors, 46 Uta, 10 White-footed mouse, 110 Wigglers mosquitoes, 31 V Wild rats, 138 Vector-borne diseases, 10, 12, 13, 24, 153 Winterbottom’s sign, 161 Vector competence, 24 Wood rats, 138, 148 Vector mosquitoes Wright’s stain sylvatic cycle plague diagnosis, 136 Haemagogus mosquitoes, 67 Wuchereria bancrofti, 70 Vectors Bancroftian filariasis, 70–72 African sleeping sickness, 161–162 life cycle, 73 Anopheles mosquitoes, 40 lymphatic filariasis treatment, 74 Chagas’ disease, 157 competent, 24 incrimination, 25 X onchocerciasis, 164 Xenopsylla, 135–138 Plasmodium mosquitoes, 40 Xenopsylla cheopis, 135, 137–138 scrub typhus, 168 illustration, 136 Venezuelan equine encephalitis, 46, 55 Vectors, 55 Venom, 11, 205 Y black widow spider, 11 Yellow fever mosquitoes, 65 brown widow spider, 11 Yellow fever (YF), 63–68 fiddle back spider, 205 geographic distribution, 64 fire ants, 11, 196 history, 65–66 scorpion, 11 jungle vs. urban, 67 spiders, 11, 205 medical significance, 63 Verruga peruana, 150 treatment and prevention, 67 Viral encephalitis, 56, 111 Yellowjacket Viruses sting apparatus, 204 tick transmission, 111 illustration, 204 Visceral leishmaniasis, 144–146 , 133 geographic distribution, 145

Z W Zoonoses Wayson stain, 136 encephalitis, 45