Other Tick Borne Illnesses Illnesses Colorado Tick Fever Babesiosis Tularemia Ehrlichiosis

Disclosures Common Bites and Stings • None David Hartnett, MD Assistant Professor Department of Emergency Medicine The Ohio State University Wexner Medical Center Learning Objectives Impact of bites and stings • Discuss the incidence of bites and stings in the US • 1.5 million ED visits per year • Review management of clinically relevant species • Insects • Mammals • Arachnids • Reptiles • Describe indications and methods of rabies prophylaxis 1 Hymenoptera • Bees, vespids, fire ants • Symptomatic control Insects - 50% • Localized, systemic, and anaphylactic Source: Alvesgaspar - Own work CC BY-SA 3.0, reactions • Stinger removal • Killer Bees Source: James Heilman, MD Own work, CC BY-SA 3.0, Africanized Killer Bees LD50 (mg/kg) Venom (µg) European Honey Bee 2.8 148 Africanized Honey Bee 2.8 156 Cape Honey Bee 3.0 187 LD50 for a 110 lb person Rule of Thumb Honey Bees – 890 Stings 6 stings/lb – survival Yellow Jackets – 3600 stings 8 stings/lb – LD50 Source: James Heilman, MD - Own work CC BY-SA 3.0, Paper wasps – 850 stings 10 stings/lb – Death Source: James Heilman, MD Own work, CC BY-SA 3.0, 2 Bed bugs Mosquito borne illnesses • Behavior • Travel medicine • Chikungunya • Transmission • Dengue • Incidence • Japanese Encephalitis • Malaria • Prevention • Yellow Fever • Zika • Symptom control • Infestation treatment • Endemic to United States Source: CDC • Eastern Equine Encephalitis • St Louis Encephalitis • La Crosse Encephalitis • West Nile La Crosse Virus Encephalitis – West Nile Virus – incidence by Incidence per 100,000 state per 100,000 3 Arachnids - 16% Source: CDC Lyme Disease Rocky Mountain Spotted Fever • Progression • Clinical • Prophylactic Diagnosis Treatment • Doxycycline • Symptomatic Treatment • STARI Source: CDC Source: CDC Source: CDC Source: CDC 4 Other Tick Borne Other Tick Borne Illnesses Illnesses Colorado Tick Fever Babesiosis Tularemia Ehrlichiosis Source: CDC Source: CDC Source: CDC Source: CDC Black Widow Brown Recluse • Localized • Necrotic Reactions Arachnidism- • Systemic hemotoxin Neurotoxin • Local wound care • Treatment – Photograph by Mark • NOT RECLUSE Analgesics, BZD, Chappell of University of antihypertensives California, Riverside. CC BY-SA 2.5 • Antivenin? • Failed Therapies Source: CDC Source: CDC Source: CDC 5 Brown Recluse Centruroides – Arizona bark scorpion • Neurotoxin • Treatment – supportive care Source: CDC • Centruroides immune Fab – Anascorp By Rosa Pineda - Own work, CC BY-SA 3.0, Source: Musides at English Wikipedia, CC BY-SA 3.0, Canine - 26% • Incidence • Infection Risk • Antibiotics Others • Closure 6 Canine Bites Other Mammals - 7% • Humans • Cat Bites • Bats • Raccoons • Possums Rabies Reptiles - 1% • Pre – exposure vaccination Crotalidae Elapidae • Post – exposure treatment • Rattle snakes, • Coral Snake copperheads, • Rabies vaccine – • Neurotoxin cottonmouths 0,3,7,14 days • Coralmyn • Human rabies • Local necrosis and Source: CDC systemic hemotoxin immunoglobulin • CroFab • Previously Vaccinated • Waking up with a bat Source: Norman.benton - Own work CC BY-SA 3.0, Source: Glenn Bartolotti - Own work, CC BY-SA 4.0, Source: CDC 7.

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Joint Statement on Insect Repellents by EPA And
Joint Statement on Insect Repellents from the Environmental Protection Agency and the Centers for Disease Control and Prevention July 17, 2014 The Environmental Protection Agency (EPA) and Centers for Disease Control and Prevention (CDC) are recommending that the public use insect repellents and take other precautions to avoid biting insects that carry serious diseases. The incidence of these diseases is on the rise. This joint statement discusses diseases that are transmitted by ticks and mosquitoes, the role of government in vector control and disease prevention, the history of repellents, how to use repellents as part of an integrated control program, and how to select and use a repellent. Introduction and Purpose CDC and EPA developed this joint statement to promote awareness of repellents and to highlight the effectiveness of repellents in preventing mosquito and tick bites. The agencies believe that promoting the use of repellents may reduce the impact of diseases and nuisance effects caused by these pests. Vector-borne diseases, such as those transmitted by mosquitoes and ticks, are among the world's leading causes of illness and death today. A wide variety of arthropods, including mosquitoes, ticks, fleas, black flies, sand flies, horse flies, stable flies, kissing bugs, lice and mites, feed on human blood. Among these, mosquitoes and ticks transmit some of the most serious vector- borne diseases both globally and within the United States. Diseases Transmitted by Mosquitoes and Ticks Mosquito-transmitted West Nile virus caused over 36,000 disease cases and 1,500 deaths in the United States between 1999 and 2012 (CDC, 2012). Mosquitoes also transmit other viruses that cause severe disease in the United States, including La Crosse encephalitis, eastern equine encephalitis and dengue.
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Mosquitoborne Diseases of Minnesota
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Orthobunyaviruses: from Virus Binding to Penetration Into Mammalian Host Cells
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City of Powell Minutes of 06.21.2016 Exhibit 1
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