VECTOR-BORNE DISEASES IT'S IMPORTANCE IN PUBLIC

HEALTH
Dr.Kedar Karki

From the perspective of infectious diseases, vectors are the

transmitters of disease-causing organisms that carry the pathogens
from one host to another. By common usage, vectors are considered
to be invertebrate animals, usually arthropods. Technically, however,
vertebrates can also act as vectors, including foxes, raccoons, and
skunks, which can all transmit the rabies virus to humans via a bite.
Arthropods account for over 85 percent of all known animal species,
and they are the most important disease vectors. Arthropods may
affect human health either directly by bites, stings, or infestation of
tissues, or indirectly through disease transmission. Several genera of
arthropods play a role in human disease, but mosquitoes and ticks
are the most notable disease vectors. The most significant mode of
vector-borne disease transmission is by biological transmission by
blood-feeding arthropods. The pathogen multiplies within the
arthropod vector, and the pathogen is transmitted when the arthropod
takes a blood meal. Mechanical transmission of disease agents may
also occur when arthropods physically carry pathogens from one
place or host to another, usually on body parts. The transmission of
vector-borne diseases to humans depends on three different factors:
the pathologic agent; the arthropod vector; and the human host .The
majority of vector-borne diseases survive in nature by utilizing
animals as their vertebrate hosts, and are therefore zoonoses. For a
small number of zoonoses, such as malaria and dengue, humans are
the major host, with no significant animal reservoirs. Intermediary
animal hosts often serve as a reservoir for the pathogens until
susceptible human populations are exposed. The vector receives the
pathogen from an infected host and transmits it either to an
intermediary host or directly to the human host. The different stages
of the pathogen's life cycle occur during this process and are
intimately dependent upon the availability of suitable vectors and
hosts. Key components that determine the occurrence of vector-
borne diseases include:

(1) the abundance of vectors and intermediate and reservoir hosts;

(2) the prevalence of disease-causing pathogens suitably adapted to
the vectors and the human or animal host; (3) the local environmental
conditions, especially temperature and humidity; and (4) the
resilience behavior and immune status of the human population.

Vector-borne diseases are prevalent in the tropics and subtropics and

are relatively rare in temperate zones, although climate change could
create conditions suitable for outbreaks of diseases such as Lyme
disease, Rocky Mountain spotted fever, malaria, dengue fever, and
viral encephalitis in temperate regions. There are different patterns of
vector-borne disease occurrence. Parasitic and bacterial diseases,
such as malaria and Lyme disease, tend to produce a high disease
incidence but do not cause major epidemics. An exception to this rule
is plague, a bacterial disease that does cause outbreaks. In contrast,
many vector viral diseases, such as Yellow fever, dengue, and
Japanese encephalitis, commonly cause major epidemics.

There has been a worldwide resurgence of vector-borne diseases

since the 1970s including malaria, dengue, Yellow fever, louse-borne
typhus, plague, leishmaniasis, sleeping sickness, West Nile
encephalitis, Lyme disease, Japanese encephalitis, Rift Valley fever,
and Crimean-Congo hemorrhagic fever. Reasons for the emergence
or resurgence of vector-borne diseases include the development of
insecticide and drug resistance; decreased resources for
surveillance, prevention and control of vectorborne diseases;
deterioration of the public health infrastructure required to deal with
these diseases; unprecedented population growth; uncontrolled
urbanization; changes in agricultural practices; deforestation; and
increased travel. Changes have been documented in the distribution
of important arthropod disease vectors. The yellow fever mosquito,
Aedes aegypti has reestablished in parts of the Americas where it
had been presumed to have been eradicated; the Asian tiger
mosquito, Aedes albopictus, was introduced into the Americas in the
1980s and has spread to Central and South America; and the
blacklegged tick, Ixodes scapularis, an important transmitter of Lyme
disease and other pathogens, has gradually expanded its range in
parts of eastern and central North America.

Control measures for vector-borne diseases are important because

most are zoonoses that are maintained in nature in cycles involving
wild animals and are not amenable to eradication. Therefore, control
methods generally focus on targeting the arthropod vector. These
include undertaking personal protective measures by establishing
physical barriers such as house screens and bed nets; wearing
appropriate clothing (boots, apparel that overlap the upper garments,
head nets, etc.); and using insect repellents. Environmental
modification to eliminate specific breeding areas, or chemical
biological control measures to kill arthropod larvae or adults may also
be undertaken. Areas such as ports and airports should be rigidly
monitored, with control measures utilized to prevent important
arthropod disease vectors from entering the country. Some efforts to
control vectorborne diseases focus on the pathogen. For example,
there are vaccines available for diseases such as Yellow fever, tick-
borne encephalitis, Japanese encephalitis, tularemia, and plague.
The vertebrate host and/or reservoir may also be the target for control
measures. For example, vaccination of fox against rabies in Europe
and Canada is an effective means to reduce the threat of rabies. In
addition, reduction of host reservoirs, such as rodents and birds, from
areas of human habitation may lessen the risk for contracting certain
vector borne diseases such as plague and St. Louis encephalitis,
Japanese encephalitis

It is clear that people will always have to live with vector-borne

diseases, but maintenance of a strong public health infrastructure and
undertaking research activities directed at improved means of control
—possibly utilizing biological and genetic-based strategies, combined
with the development of new or improved vaccines for diseases such
as malaria, Japanese encephalitis, dengue and Lyme disease—
should lessen the threat to human health.