ARTHROPODS OF MEDICAL IMPORTANCE Introduction Phylum Arthropoda is one of the most important. 85% of all animals are arthropods.

s. These are bilaterally symmetrical invertebrate animals o with segmented bodies o Jointed appendages o Hard outer coverings or exoskeletons. Arthropods are found everywhere, whether it be in mountains, cities, swamps, deserts, countrysides. 2 Classes: o Insecta Flies, mosquitoes, bees, bugs, etc. Considered the largest Most important from medical viewpoint o Arachnida Arthropods as Vectors of Disease Vectors Arthropods which are capable of acquiring and transmitting pathogens that cause diseases. 2 types: o Biological vectors: Undergo multiplication, propagation and development inside the arthropods body. Acquire pathogenic agents in the act of blood feeding. o Mechanical vectors Transmit pathogens by way of their oral secretions and the contaminated external surfaces of their body. Serve as mere contaminators Pathogens do not undergo multiplication or development inside their bodies. Most arthropods classified as vectors belong to Class Insecta, subclass Pterygota o (winged insects such as mosquitoes, flies and cockroaches)

List of arthropod-associated diseases and corresponding agents and vectors Disease Agent Vector
Malaria Filariasis Dengue/DHF Japanese encephalitis Scrub typhus Babasiosis Paragonimias Diphyllobothriasis Dracunculiasis Hymenolepiasis Dipylidiasis Amebiasis Plasmodium Wucherera/Brugia Dengue virus JE virus Rickettsia Babesia Paragonimus Diphyllobothrium Dracunculus Hymenolepis Dipylidium Entamoeba Mosquito Mosquito Mosquito Mosquito Chigger mite Tick Crab Copepod Copepod Flea Flea Flies & cockroach

Mosquitoes 2 important divisions or tribes of mosquito vectors o Anopheline mosquitoes Vectors of human malaria and human filariasis o Culicine mosquitoes Vectors of dengue, Japanese encephalitis and human filariasis Only female mosquitoes bite and suck blood thereby transmitting the disease. Both sexes feed on plant juices and nectar. Differentiation based on types of antennae: o Plumose or bushy for the males o Pinnose or less bushy for the females. Undergo a complete type of metamorphosis. Fertilized eggs go through 4 larval stages, develop into comma-shaped pupa, then emerge as adults. Immature stages require an aquatic environment. Adult, an aerial and terrestial one. Egg Anophelines lay their boat-shaped eggs individually over the surface of water, each having lateral air floats to keep it bouyant. Culex lay eggs in rafts. Mansonia under leaves of aquatic plants. Aedes eggs are laid individually, often in artificial containers and dry hollows which become flooded after the rain. o Retain viability for long periods without water. Larva Eggs generally hatch after 2 to 3 days of contact with water. Larva casts its skin 4 times. Instars stages between molts. Spiracles 2 openings used by larva to breathe. o (Anopheline) located on the 8th abdominal segment o (Culicines) situated at the end of a tubular organ (siphon) extending from the 8th abdominal segment. Hangs down from the water surface by the siphon tip. Pupa Nonfeeding stage Found on the water sources. Mobile and able to dive rapidly when disturbed. Breathes through a pair of respiratory trumpets. Culicine pupae have longer trumpets than anophelines. Adult Generally, the wings of anophelines have dark and pale areas, whereas culicines have unpatterned wings. At rest, the body of an anopheline mosquito forms an angle nearly vertical with the surface. The culicine lies almost parallel to the surface (sometimes appearing as hump-backed). Abdominal tip is pointed in the female Aedes Blunt in Culex. Mansonia has speckled legs with asymmetrical brown, yellow and gold scales. Palpi - appendages provided with hairs used to feel, smell and taste food.

Proboscis stout sheath formed by the labium (a mouthpart)

Mosquito Binomics Deal with the relationship between a species and its environment. An understanding of bionomics is important in the epidemiology of mosquito-borne diseases and in planning methods of mosquito control. Mating Usually occurs within 24-48 hours after emergence. In some species, the male forms a swarm, usually at dawn or in the evening. Females entering the swarm are seized and the resulting pairs drop out of the swarm. Insemination then follows. Dispersal The male is a much weaker flyer than the female. Most fly within a range of 1 to 2 km. Strong winds carry mosquitoes along greater distances. Biting habits Host seeking and feeding generally take place in a warm, humid environment. Biting hours vary. Culex , Mansonia and Anopheles prefer to bite at night. Aedes during daytime. Endophagic Feed while inside human dwellings Exophagic Feed outdoors. Resting Habits Endophily Rest inside dwellings after feeding. Exophily Rest outdoors Host preference Anthrophilic Feed on humans Zoophilic Feed on animals Seasonal Prevalence In the Philippines, rainfall is the most important factor affecting the mosquito population. Seasonal fluctuation (rise and fall of the mosquito density) dependent on the availability of suitable aquatic environments, which can support the multiplication of the mosquito. The climate in which the mosquito lives dictates its capability for disease transmission. The climate influences the rate of development of the parasite within the vector, and the longevity of the mosquito. Extrinsic incubation period The period between the mosquitos infected blood meal and its transmission of the infective agent in a subsequent feeding.

Varies in length in response to the temperature of the host mosquitos environment, Example: development of malaria parasite (Plasmodium) is retarded at 19C down to 15 C but completed at 20 C to 30 C . Example: growth of Wuchereria in Culex quinquefasciatus is inhibited at mean temperatures below 24 C and above 34 C . Temperature and humidity affect the survival of mosquitoes. At extremely high or low humidities, mosquitoes are unable to regulate their water loss. They thrive best at 70% to 80% relative humidity and at a temperature of 20 C to 30 C.

Major Mosquito-Borne Diseases 1. Malaria The vectors of malaria in the Philippines include: o Anopheles flavirostris The primary vector of malaria Found in the entire national territory except in areas with elevations of more than 4000 feet. Anopheles flavirostris Most important vector of malaria in the Philippines. A small to medium-sized mosquito measuring 2-6 mm in length. Has a proboscis with a pale golden patch that is usually confined to its apical half. Basal third of its costal vein is usually dark or has a single pale spot. Usually breeds in slow-flowing, clear, partially-shaded streams with vegetation. Also breeds in foothills and in wells. During rainy season, it is possible to collect larvae from the ricefields and trapped waters. Anopheles litoralis This small- to medium-sized mosquito is a secondary vector (supplementary role in transmission but would be unable to maintain an epidemic in the absence of primary vector) of malaria. Prefer to breed in water with a salinity of 2.5-3.0%. Anopheles balabacensis Also a secondary vector of malaria. Breeds in clear ponds and pools in deep forests and jungles.

2. Filariasis Vectors for Bancroftian filariasis in the Philippines include Aedes poecilus (in abaca-raising areas) and Anopheles flavirostris (in clear mountain streams). Malayan filariasis in the Phili: Mansonia bonneae and Mansonia uniformis which breed in swampy and forested areas. Aedes poecilus Has been reported in the Bicol region, Masbate, areas of Mindanao, Mindoro, Quezon and Sulu. (Anopheles flavirostris for Filariasis in Mt. Province, Palawan and Sulu. Mansonia in Agusan del Sur, Eastern Samar, Palawan and Sulu.) Associated with Bancroftian filariasis. Breeds in the axils of plants like abaca, banana, pandanus, gabi, biga. A nocturnal feeder however, possible to find it seeking a blood meal during the day. Highly anthrophilic but may feed on animals (birds, bovids and dogs). Highest density of these mosquitoes is observed from 10 pm to 12 am which coincides with W. bancrofti periodicity. The density of these mosquitoes is also related to rainfall patterns in endemic areas. This mosquito is endophilic and partially exophilic. Mansonia A vector of the Brugian type of filariasis Mansonia bonneae is a forest swamp mosquito. Prefers fresh water swamps with an extensive growth of giant pandanus. Ma. uniformis also breeds in swamps containing other aquatic plants. Are exophagic and exophilic. Peak of biting observed at 1 am to 2 am. The population density of Aedes mosquitoes and Mansonia is related to rainfall patterns. Adult Mansonia A medium-sized robust-built mosquito, usually light to dark brown, or light yellow to golden in color. Legs have many pale markings Wings have white and dark broad scales, many of which are assymetrical.

3. Dengue/Dengue Hemorrhagic Fever Vectors include: o Aedes aegypti (associated with urban dengue) o Aedes albopictus (associated with rural dengue). o There is a widespread distribution of these vectors in the Philippines. Aedes aegypti tiger mosquito Black in color, small to medium in size. Has characteristic lyre-shaped, silvery markings on its mesonotum. Fore- and mid-pairs of legs have white narrow bands at the base of the tarsi. tiger mosquito because of hind pairs of legs with five broad white bands. Breeds in clear water collecting in indoor and outdoor containers such as old tires, vases, jars and bottles. Aedes albopictus Most important diagnostic characteristic is presence of a single, longitudinal, silvery stripe on the mesonotum. (part of mesothorax) The mosquito breeds in clear water collecting in indoor and outdoor containers such as bamboo stumps, empty coconut shells, some artificial containers and tree holes. 4. Japanese Encephalitis The proven vector in the Philippines is Culex tritaeniorynchus. Potential vectors: o Culex vishnui o Vulex gelidus o Culex fuscocephalus Widely distributed in ricefields. Most cases from Luzon (Nueva Ecija). Culex tritaeniorhynchus A small mosquito. The mesonotum is uniformly covered with dense, very small, brown to dark brown scales, which are curved and narrow. Proboscis has a pale band. Usually associated with ricefields. Activity is greatest from 6 pm to 7pm. Feeds on man and animals, specifically pigs. Pigs serve as amplifying gosts.

ECTOPARASITES Order Anoplura Wingless permanent ectoparasites of mammals. Lice are strictly host-specific. Head lice and genital lice, for example are seen only in humans. Do not infest domestic household pets and other animals. Order Anoplura: Head louse Genus Pediculus humanus capitis is also called the head louse. 2 to 3 mm (males), 3-4 mm (females) Head is small compared to its body size. It is narrow and pointed in front, and has antennae with 4 to 5 segments. Legs are of the clinging type and are of equal size. Found in the scalp. Head lice infestation is very common in the Philippines. Children most commonly affected. Very much associated with warm weather, as the lice require this for further development. Severe infestations may result in the hair become matted with eggs. Itching attributed to injection of the saliva and may also be a reaction to lice feces. Order Anoplura: Genital louse Pubic/crab louse Has carb-like body. Nearly as broad as it is long. (1.5-2 mm) Middle and hind legs are stouter than the first pair. Found on axillary hair, eyelashes, eyebrow and other parts of the body, where the hair is coarser and more widely spaced, as compared to the hair of the head. Pubic lice infestation is more common in adults rather than in children. Transmission from intimate contact. Ordinarily, the pubic louse confines its activities to pubic hairs, but it may also be found in axillary hairs, eyebrows or eyelashes. Lice All lice have similar life histories in that the adult lay eggs, which are called nits. These appear as white or gray oval bodies which are glued to the hair by the head, or by the gonopod, as seen in pubic lice. Young resembles the adults, except in size. They require at least one week for complete development.

Order Siphonaptera (Fleas) Wingless insects measuring less than 4 mm (usually 1.4-2 mm in length.) The body is laterally compressed and covered with spines which enable them to move freely. Antennae are short, three-segmented, club-shaped and embedded in a deep groove. Legs are adapted for jumping. Both sexes feed on blood. Most common species: Ctenocephalides canis (dog flea) C. felis (cat flea) Pulex irritans (human flea) Xenopsylla cheopis (rat flea) Also Ctenocephalides preferably feed on dogs and cats, they can also bite humans when their preferred hosts are not around. Fleas remain on their hosts less constantly than lice do. Female fleas after blood feeding, lay their eggs on the fur of the hosts, in the dusts, on debris, in floor cracks and under rugs and carpets. The larvae feed on organic debris. They usually avoid light. Bites appear as small punctures, which represent areas probed by the fleas. Initially the flea explores the exposed skin area completely, frequently stopping to probe the surface without necessarily feeding at each probe site. Once a suitable site is selected, the flea bites and remains attached until hunger is appeased. It then moves along, biting and feeding in a grouped but irregular pattern, resulting in multiple lesions. Appearing immediately around the probe site is a wheal with or without accompanying erythema. Order Hemiptera (Bedbugs) Cimex hemipterus is common in tropical climates. Very irritating and itchy bites. Erythematous wheals of uniform size with a central red puncta. The lesions are multiple and persist for many days. Generally nocturnal feeders. The bug uses its beak-like proboscis, with its mandibles and maxillae, to pierce or puncture the skin of the host. It feeds directly on the capillaries. The combination of initial skin piercing and the subsequent probing for blood, results in swelling and irritation.

ECTOPARASITES Order Acarina (Mites and ticks) Parameter Mites

Body Hypostome Size Body texture Pedipalps chelicerae With long hair Hidden and unarmed Usually small(microscopic) Membranous in appearance Almost lacking of segmentation Reduced to blades and rods

Ticks
With short hair or maybe bare Exposed with teeth Large(macroscopic) Leathery in appearance Prominent and distinctly segmented Heavily chitinized, bearing teeth at their distal end

Mites - a. Scabies (galis-aso) Caused by Sarcoptes scabiei A contagious skin infection. Seen in all age groups. Very common in crowded dwellings. Usual transfer is by direct contact. Causes intense pruritus and may persist for some time. a. Scabies Female mite is 0.3-0.45 mm in length. Whitish, disc-shaped and flattened ventrally. Mite is covered with membranous, small peg-like protuberances, has a few bristles both dorsally and ventrally. Striated appearance. Female mite favors places on the body where skin is wrinkled such as wrists, elbows, feet, penis, scrotum, breasts, axillae and in between fingers. Mite digs and eats its way through the surface of the stratum corneum. Buries itself, excavates and creates a tunnel then feeds on liquids oozing from dermal cells. During the mites progress along the tunnel, it lays about 4-6 eggs and sometimes defecates while feeding. Final diagnosis by demonstration of the female mite. Physical exam reveals mite burrows. In chronic cases, the skin becomes eczematoid.

Ticks Two types biting humans o Argasid (soft) o Ixodid (hard) Hard ticks o Difficult to remove o More frequently encountered Readily distinguished from insects by their strongly fused thorax and abdomen. Body is ovoidal and capable of great expansion (particularly in females). Bigger than mites and are usually more than 1 mm in length. Generally, ticks pass through the egg, larval, nymphal and adult stages over months or years. Eggs are usually laid on the ground in batches of 100 to 18,000. The larvae emerge and climb up any available object. Ticks of some species remain on the same host until they reach maturity but others find two or more hosts for their blood meal. Females take prolonged blood meals lasting 8 to 10 days. Males, however remain attached to the host only for a few hours in order to mate with females. Once the tick comes in contact with a host, the hypostome and chelicerae are inserted into the skin. Using their recurved teeth, a firm hold is maintained, reinforced by a cement-like secretion. The tick can detach quickly once it is fully engorged without the host noticing it. Forceful removal of the tick may result in granuloma formation. A granuloma can persist for days or even months after the bite. Granuloma may be due to either a reaction to mouthparts or to injected salivary secretions. Granuloma measures 0.5 to 2 cm.
CESTODE SHAPE TAPE-LIKE, SEGMENTED NOT SEPARATE (MONOECIOUS) SUCKERS OFTEN WITH SUCKERS TREMATODE LEAF-LIKE, UNSEGMENTED NOT SEPARATE EXCEPT SCHISTOSOMES SUCKERS NO HOOKS NEMATODE ELONGATED, CYLINDRICAL, UNSGEMENTED SEPARATE (DIECIOUS) NO SUCKER & HOOKS, WELLDEVELOPED BUCCAL CAPSULE PRESENT AND COMPLETE, ANUS PRESENT PRESENT

SEXES

HEAD END

ALIMENTARY

ABSENT

INCOMPLETE, NO ANUS ABSENT

BODY CAVITY

ABSENT