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Mosquitoes
 Mosquitoes are flies in the family Culicidae
 Over 3,000 known species of mosquitoes
belonging to 34 genera exist worldwide
 Adult mosquitoes are characterized by having
long, slender, needle-like mouthparts
(proboscis), antennae, and legs.
 Their narrow wings are often covered with
minute scales. Fine scales cover the mosquito
body and vary in coloration from white, silver,
or gold, to very dark.
Mosquitoes & Vector
Borne Diseases
 Despite their delicate appearance, mosquitoes are aggravating pests
of humans and other animals
 Bites from mosquitoes can cause severe discomfort.
 The resulting intense itching is due to an immunological reaction to
mosquito saliva injected into the bite wound.
 Mosquitoes are capable of transmitting disease-causing viruses,
protozoans, and filarial nematodes.
 In India Malaria, Dengue, Japanese encephalitis, Filariasis,Chikungunia
& Kala-azar are some of the vector borne diseases.
Loss of Blood
 “ It is estimated that if ten mosquitoes bite man
per night a human population of one million
would be loosing approximately 50 liters of
blood per night”
 “40 million people in India suffer from mosquito
borne diseases annually. The diseases are
malaria, dengue, filariasis Japanese
encephalitis etc”
Anopheline Sp
Culex Sp -Egg Laying
Aedes Sp
1. Egg
2. Larva
3. Pupa
4. Blood Feeding Adult
Anopheles Mosquito
ANOPHELINE LIFE CYCLE
Eggs laid singly
Female
Anopheline
mosquito
Larva
Pupa
EGGS
 These are very small and laid singly on
the water surface
 The female mosquito lays her eggs in
standing or slow moving water
 These hatch into larvae after 2-3 days
LARVAE
 The larvae feed on micro-
organisms in the water and
develop into pupae after 7-10 days
PUPA
 The pupal stage is a resting
non-feeding stage
 This is the stage that the
mosquito turns into an adult
Emerging Adult
The female mosquito needs a blood meal to develop her eggs
ADULT
 The female seeks out a host to
feed several days after
emerging, then lays eggs and
the cycle starts again
Malaria life cycle
The infected female mosquito
injects sporozoites into the host
while taking a blood meal
DISEASES TRANSMITTED BY MOSQUITOES
MOSQUITOES &DISEASES
Anopheles: Malaria,
Culex: Lymphatic Filariasis, Japanese encephalitis,Viral
Diseases
Aedes: Dengue & Chikungunya, Yellow Fever (Not in India)
Mansonia: Lymphatic Filariasis
Armegeris :- Nuisance Mosquito Breeds in Septic tanks
Anopheline
 50 species of Anophelines found in India.
 10 species of Anophilines are vectors of
malaria.
 Anopheles culicifacies, Anopheles fluviatilis,
Anopheles stephensi, Anopheles sundaicus,
Anopheles balabacensis, Anopheles
philipinensis,Anopheles annularis, Anopheles
varuna and Anopheles jeyporiensis.
Malaria
 Malaria is a potentially life threatening parasitic disease. caused
by parasites known as Plasmodium viviax (P.vivax), Plasmodium
falciparum (P.falciparum), Plasmodium malariae (P.malariae)
and Plasmodium ovale (P.ovale)
 It is transmitted by the infective bite of Anopheles mosquito
 Man develops disease after 10 to 14 days of being bitten by an
infective mosquito
 There are two types of parasites of human malaria, Plasmodium
vivax, P. falciparum, which are commonly reported from India.
 Inside the human host, the parasite undergoes a series of
changes as part of its complex life cycle. (Plasmodium is a
protozoan parasite)
 The parasite completes life cycle in liver cells (pre-erythrocytic
schizogony) and red blood cells (erythrocytic schizogony)
 Infection with P.falciparum is the most deadly form of malaria.
History of malaria in India
 Preamble
 Malaria is one of the major public health problem of the country. Around 2 million
laboratory
 confirmed cases of malaria are reported in the country annually. Out of the total
malaria cases,
 40-50% is P.falciparum. The P.falciparum species is spreading wider due to migration
of
 population from endemic to non endemic areas and vice versa has increased
tremendously.
 One of the reasons attributed to rise in P.falciparum is resistance to drug
chloroquine, which is
 being used as a first line of treatment for malaria cases. During recent years it has
been
History of malaria in India
 observed that chloroquine resistance is widely spread as per the results of the drug
sensitivity
 studies conducted in the country. This is a serious concern to the programme as this
species is
 responsible for mortality. It is observed that P.falciparum infection may lead to
complications in
 0.5% to 2% of cases. Mortality may result in about 30% of such cases if timely
treatment is not
 given. Use of an appropriate anti malaria drug is very important not only to save the
life of
 patients suffering from P.falciparum cases but also to contain the spread of this
species.
 At present the main thrust in the programme is on early diagnosis and prompt
treatment which
Diagnosis
 Malaria diagnosis is carried out by microscopic
 examination of blood films collected by active and
passive surveillance. In the new drug policy it
 has been stressed that all fever cases clinically
suspected of malaria should preferably be
 investigated for confirmation of malaria by Microscopy
or Rapid Diagnostic Kit (RDK) so as to
 ensure full therapeutic dose with appropriate drug to all
confirmed cases. Presumptive
 treatment with incomplete dose of chloroquine has
been stopped and it has been stressed to
Diagnosis
 treat patients on the basis of clinically suspected cases rather than only
fever. If a patient is
 suspected of having malaria i.e showing signs and symptoms of malaria
without any other
 obvious causes (listed in drug policy) which cannot be immediately
confirmed, full treatment with
 chloroquine should be given. Health agencies and volunteers running
Fever Treatment Depots
 like ASHAs in inaccessible areas are being provided with rapid diagnostic
kits for diagnosis of
 P.falciparum cases and to ensure full radical treatment to all confirmed
malaria cases. Further,
 the National Malaria Treatment Guidelines also recommend that
change of drug should be
 considered when treatment failure proportion exceeds 10%.
Signs & Symptoms
 Signs and symptoms of malaria
 Typical: Sudden onset of high fever with rigors and sensation of extreme
cold followed by
 feeling of burning, leading to profuse sweating and remission of fever by
crisis thereafter. The
 febrile paroxysms may occur every alternate day. Headache, body
ache, nausea, etc. may be
 the associated features.
 Atypical: In atypical cases, classical presentation as mentioned above
may not manifest.
 Hence, any fever case without any other obvious cause in the endemic
areas during
 transmission season may be considered as malaria. For ruling out other
obvious causes of
 fever, the following should be looked for:
Other Signs
 1. Cough and other signs of respiratory infection
 2. Running nose and other signs of cold
 3. Diarrhea
 4. Pelvic inflammation indicated by severe low back
ache, with or without vaginal discharge
 and urinary symptoms
 5. Skin rash suggestive of eruptive illness
 6. Burning sensation
 7. Skin infections e.g. boils, abscesses, infected
wounds
 8. Painful swelling of joints
 9. Ear discharge
Anti Malarial Drugs
 Classification of Anti malarial Drugs
 1) Schizonticidal drugs for clinical and parasitological cure
 Chloroquinea, Amodiaquine, Quinine, Quinidine,
Pyrimethamine, Trimethoprim,
 Proguanil, sulfonamides in combination with Pyrimethamine,
Mefloquine, Halofantrine,
 Artemisinine and its derivatives like Artesunate, Artemether,
Arteether.
 2) Gametocytocidal and anti-relapse drugs.
 Primaquine (8-Aminoquinolines groups)
 The main features of the National Drug Policy on malaria are given
below along with the flow
 chart. Treatment schedule followed for different drugs under the
programme is given in
 Annexure1.
Treatment
 Treatment 1 Chloroquine + Primaquine (25mg/kg over 3 days +
0.75mg/kg single dose)
 or
 Artesunate + Sulpha Pyrimethamine + Primaquine (in areas
qualified for ACT)
 4 mg/kg for 3 days + 25/1.25mg/kg single dose + 0.75mg/kg
single dose
 Treatment 2 Chloroquine + Primaquine (25mg/kg over 3 days +
0.25mg/kg for 14 days)
 Treatment 3 Chloroquine (25mg/kg over 3 days)
 Note: Primaquine is contraindicated in pregnant women, G6PD
deficiency, and infants, ACT is contraindicated in pregnant
women
 * For clinically suspected malaria cases, signs and symptoms
may be reffered
Culex
 57 species found in India
 Culex quinquefasciatus transmits filaria caused by
Wuchereria bancrofti.
 Genus Mansonia annulifera & M.indica transmit
Brugia malayi.
 Culex triateniorhynchus & Culex vishnui group
transmit Japanese encephalitis.
 Aedes is represented by several species in India.
 Aedes aegypti is the vector of dengue
haemorhagic fever.
Filariasis & Dengue
 Latest official estimate in India showed that 304
million people are reported to be exposed to
the risk of infection with an estimated 22 million
microfilarial carriers and 16 million chronic
filarial cases.
 Approximately about 1 million people in India
are said to suffer from Dengue diseases
annually.
Aedes aegypti
Dengue
 Viral fever caused by Flavivirus.
 It is: Family:Flaviviridae;Genus:Flavivirus;Species:Dengue virus.
 Spread by the bite of Aedes aegypti.
 Two fifth of the world population at risk(2500 Million).
 Worldwide 50 million cases reported every year.
 Disease is in more than 100 countries.
 Dengue virus comes in 4 forms-as 1,2,3 &4.
 Dengue Heamorrhagic Fever (DHF)infection causes death.2.5% die
& mostly children.
 Symptoms are high fever, chills, headache, enlargement of liver, in
severe cases circulatory failure.
 In DHF plasma leakage lead to hypovolaemic shock(Dengue Shock
Syndrome)
Dengue Fever
 DF may be asymptomatic or may lead to undifferentiated fever.
 Fever 2-7 days duration.
 The clinical features of DF : Headache, Retro-orbital
oain,Myalgia,arthralgia,rash,heamorrhagic manifestations.
 Older Children & adults may have either a mild fever or with high
fever of abrupt onset ,sometimes with 2 peaks(saddle –backed),
severe headache, pain behind the eyes, muscle and bone or
joint pains, nausea and vomiting,& rash.
 In some epidemics DF may cause bleeding complications, such
as epistaxis,gingival bleeding, gastrointestinal
bleeding,haematuria and elevated haemotocrit (i.e.
haemoconcentration),a serous effusion or hypoprotinaemia.
DHF-Clinical Features
 Acute viral infection.
 Children with DHF sudden rise of fever &accompanied
by facial flush & other non-specific constitutional
symptoms resembling DF.
 Some complain of sore throat and an infected pharynx,
rhinitis & cough are infrequent. Also generalized
abdominal pain are common. Bleeding from mucosa &
intestinal tract.
 High fever last for 2-7 days.
 Fever rises to 103 to 105 F.
 This acute phase of High temperature lasts 2-7 days.
 Febrile convulsions occur, particularly in infants.
Management of Cases
-No specific treatment for viral fevers.
-Usually the illness is self limiting. Symptoms based treatment to be given.
-Only method of controlling or preventing Dengue & DHF is to combat the vector
mosquitoes.
-Containers to be emptied periodically in and around houses. (Peridomestic).
-Environmental management, source reduction, chemical methods & space spray to
be undertaken.
-Improved water storage practices, including covering containers to prevent egg
laying to be strictly adhered to by thorough supervision by municipal authorities.
-Larval habitats to be sprayed with Bti fortnightly or with Temephos weekly.
-Space spray with Pyrethrum extract 2% twice in a week during Dawn & Dusk to be
done during initial stages & then to weekly once.
- Use mosquito repellents like Coil,mat,Liquidator,Cream & also mosquito nets during
day time also.
- To wear full sleeve shirts &pants
Transmission
 Caused by day biting Aedes aegypti.
 Also causes Chikungunya Fever.
 Day biting Mosquito. Also called as “Tiger
mosquito". Has got white dots on body.
 Bites are painful & it causes allergic eruptions.
 Breeds in domestic & peri domestic containers.
 Clean water structures like cement tank,
coolers, containers,Waterplants vases, plastic
containers, metal drums& earthen pots, Fish
tanks,unused tyres thrown out, coconut shells &
lot many small water holding structures.
Measures to control
 Breeding places to be emptied ones in a week.
 Drinking water to be covered very tightly.
 Empty the coolers & clean them weekly.
 Use mosquito repellents during day time also.
 Mosquito repellent Creams to be applied on to the
exposed body parts.
 Children sleeping during morning time to be kept
under mosquito nets.
 To wear full sleeve shirts & pants.
Mosquito Control By
Municipal Agencies.
 Periodic Fogging with Natural Pyrethrum Extract
2%.This to be done during Dawn & Dusk.
 Larval breeding sources to be treated with
Biolarvicide like Bti & this to be taken up once in a
fortnight.
 Incase if opt for chemical larvicide then to go far
weekly application of Temephos.
Dengue-Precaution
 Transovarial transmission proved & established .
 The transmission season is normally after monsoon
i.e. from July to November.
 The eggs laid hatch out from containers & other
breeding sources during next monsoon & from these
eggs also virus can come out & transmission can
start.
 Since the breeding takes place in & around houses
it is more a community problem & hence in
cooperation with governmental efforts community
should participate to control outbreaks.
Chikungunya
ARBOVIRAL DISEASE TRANSMITTED BY DAY BITING
MOSQUITO AEDES AEGYPTI
Chikungunya
 Rare form of viral fever caused by Alpha virus.
 Spread by the bite of Aedes aegypti.
 “Swahili” word meaning stooped posture or bent
back.
 Symptoms are fever, chills, headache, nausea,
vomiting, joint pain with or without swelling, low
back pain.
Chikungunya-History
 First isolated n Tanganyika (Tanzania) in 1953.
 Between 1960’s & 1980’s the virus isolated from
numerous countries in Central & Southern Africa as
well as in Senegal & Nigeria in Western Africa.
 During this period the Virus was also identified in
Asia.
 Since 1953,Chik Virus has caused numerous
outbreaks in Africa & South Eastern Asia.
 It is a Group IV virus belonging to family Togaviridae
with genus Alpha virus & species Chukungunya.
 It involves wild primates in sylvatic cycle in forested
areas.This has been found in African countries.
Chikungunya-Clinical Features
 Acute viral infection.
 Heralded by fever & severe arthralgia.
 Last for 1-7 days.
 Incubation period is 2-3 days.
 Fever rises to 103 to 105 C.
 This acute phase lasts 2-3 days.
 The temperature result in “Saddle back" fever curve.
 Swelling occurs on lower limbs. Pain on movements is
worse in the morning.
 During acute disease , most patients will have headache.
Transmission
 Caused by day biting Aedes aegypti.
 Also causes Dengue Fever.
 Day biting Mosquito. Also called as “Tiger
mosquito". Has got white dots on body.
 Bites are painful & it causes allergic eruptions.
 Breeds in domestic & peri domestic containers.
 Clean water structures like cement tank,
coolers, containers,Waterplants containers, Fish
tanks,unused tyres thrown out & lot many
holding structures.
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Mosquito biology & life cycle

  • 1.
  • 2. Mosquitoes  Mosquitoes are flies in the family Culicidae  Over 3,000 known species of mosquitoes belonging to 34 genera exist worldwide  Adult mosquitoes are characterized by having long, slender, needle-like mouthparts (proboscis), antennae, and legs.  Their narrow wings are often covered with minute scales. Fine scales cover the mosquito body and vary in coloration from white, silver, or gold, to very dark.
  • 3. Mosquitoes & Vector Borne Diseases  Despite their delicate appearance, mosquitoes are aggravating pests of humans and other animals  Bites from mosquitoes can cause severe discomfort.  The resulting intense itching is due to an immunological reaction to mosquito saliva injected into the bite wound.  Mosquitoes are capable of transmitting disease-causing viruses, protozoans, and filarial nematodes.  In India Malaria, Dengue, Japanese encephalitis, Filariasis,Chikungunia & Kala-azar are some of the vector borne diseases.
  • 4. Loss of Blood  “ It is estimated that if ten mosquitoes bite man per night a human population of one million would be loosing approximately 50 liters of blood per night”  “40 million people in India suffer from mosquito borne diseases annually. The diseases are malaria, dengue, filariasis Japanese encephalitis etc”
  • 6. Culex Sp -Egg Laying
  • 8. 1. Egg 2. Larva 3. Pupa 4. Blood Feeding Adult Anopheles Mosquito
  • 9. ANOPHELINE LIFE CYCLE Eggs laid singly Female Anopheline mosquito Larva Pupa
  • 10. EGGS  These are very small and laid singly on the water surface  The female mosquito lays her eggs in standing or slow moving water  These hatch into larvae after 2-3 days
  • 11. LARVAE  The larvae feed on micro- organisms in the water and develop into pupae after 7-10 days
  • 12. PUPA  The pupal stage is a resting non-feeding stage  This is the stage that the mosquito turns into an adult
  • 14. The female mosquito needs a blood meal to develop her eggs
  • 15. ADULT  The female seeks out a host to feed several days after emerging, then lays eggs and the cycle starts again
  • 16. Malaria life cycle The infected female mosquito injects sporozoites into the host while taking a blood meal
  • 17. DISEASES TRANSMITTED BY MOSQUITOES MOSQUITOES &DISEASES Anopheles: Malaria, Culex: Lymphatic Filariasis, Japanese encephalitis,Viral Diseases Aedes: Dengue & Chikungunya, Yellow Fever (Not in India) Mansonia: Lymphatic Filariasis Armegeris :- Nuisance Mosquito Breeds in Septic tanks
  • 18. Anopheline  50 species of Anophelines found in India.  10 species of Anophilines are vectors of malaria.  Anopheles culicifacies, Anopheles fluviatilis, Anopheles stephensi, Anopheles sundaicus, Anopheles balabacensis, Anopheles philipinensis,Anopheles annularis, Anopheles varuna and Anopheles jeyporiensis.
  • 19. Malaria  Malaria is a potentially life threatening parasitic disease. caused by parasites known as Plasmodium viviax (P.vivax), Plasmodium falciparum (P.falciparum), Plasmodium malariae (P.malariae) and Plasmodium ovale (P.ovale)  It is transmitted by the infective bite of Anopheles mosquito  Man develops disease after 10 to 14 days of being bitten by an infective mosquito  There are two types of parasites of human malaria, Plasmodium vivax, P. falciparum, which are commonly reported from India.  Inside the human host, the parasite undergoes a series of changes as part of its complex life cycle. (Plasmodium is a protozoan parasite)  The parasite completes life cycle in liver cells (pre-erythrocytic schizogony) and red blood cells (erythrocytic schizogony)  Infection with P.falciparum is the most deadly form of malaria.
  • 20. History of malaria in India  Preamble  Malaria is one of the major public health problem of the country. Around 2 million laboratory  confirmed cases of malaria are reported in the country annually. Out of the total malaria cases,  40-50% is P.falciparum. The P.falciparum species is spreading wider due to migration of  population from endemic to non endemic areas and vice versa has increased tremendously.  One of the reasons attributed to rise in P.falciparum is resistance to drug chloroquine, which is  being used as a first line of treatment for malaria cases. During recent years it has been
  • 21. History of malaria in India  observed that chloroquine resistance is widely spread as per the results of the drug sensitivity  studies conducted in the country. This is a serious concern to the programme as this species is  responsible for mortality. It is observed that P.falciparum infection may lead to complications in  0.5% to 2% of cases. Mortality may result in about 30% of such cases if timely treatment is not  given. Use of an appropriate anti malaria drug is very important not only to save the life of  patients suffering from P.falciparum cases but also to contain the spread of this species.  At present the main thrust in the programme is on early diagnosis and prompt treatment which
  • 22. Diagnosis  Malaria diagnosis is carried out by microscopic  examination of blood films collected by active and passive surveillance. In the new drug policy it  has been stressed that all fever cases clinically suspected of malaria should preferably be  investigated for confirmation of malaria by Microscopy or Rapid Diagnostic Kit (RDK) so as to  ensure full therapeutic dose with appropriate drug to all confirmed cases. Presumptive  treatment with incomplete dose of chloroquine has been stopped and it has been stressed to
  • 23. Diagnosis  treat patients on the basis of clinically suspected cases rather than only fever. If a patient is  suspected of having malaria i.e showing signs and symptoms of malaria without any other  obvious causes (listed in drug policy) which cannot be immediately confirmed, full treatment with  chloroquine should be given. Health agencies and volunteers running Fever Treatment Depots  like ASHAs in inaccessible areas are being provided with rapid diagnostic kits for diagnosis of  P.falciparum cases and to ensure full radical treatment to all confirmed malaria cases. Further,  the National Malaria Treatment Guidelines also recommend that change of drug should be  considered when treatment failure proportion exceeds 10%.
  • 24. Signs & Symptoms  Signs and symptoms of malaria  Typical: Sudden onset of high fever with rigors and sensation of extreme cold followed by  feeling of burning, leading to profuse sweating and remission of fever by crisis thereafter. The  febrile paroxysms may occur every alternate day. Headache, body ache, nausea, etc. may be  the associated features.  Atypical: In atypical cases, classical presentation as mentioned above may not manifest.  Hence, any fever case without any other obvious cause in the endemic areas during  transmission season may be considered as malaria. For ruling out other obvious causes of  fever, the following should be looked for:
  • 25. Other Signs  1. Cough and other signs of respiratory infection  2. Running nose and other signs of cold  3. Diarrhea  4. Pelvic inflammation indicated by severe low back ache, with or without vaginal discharge  and urinary symptoms  5. Skin rash suggestive of eruptive illness  6. Burning sensation  7. Skin infections e.g. boils, abscesses, infected wounds  8. Painful swelling of joints  9. Ear discharge
  • 26. Anti Malarial Drugs  Classification of Anti malarial Drugs  1) Schizonticidal drugs for clinical and parasitological cure  Chloroquinea, Amodiaquine, Quinine, Quinidine, Pyrimethamine, Trimethoprim,  Proguanil, sulfonamides in combination with Pyrimethamine, Mefloquine, Halofantrine,  Artemisinine and its derivatives like Artesunate, Artemether, Arteether.  2) Gametocytocidal and anti-relapse drugs.  Primaquine (8-Aminoquinolines groups)  The main features of the National Drug Policy on malaria are given below along with the flow  chart. Treatment schedule followed for different drugs under the programme is given in  Annexure1.
  • 27. Treatment  Treatment 1 Chloroquine + Primaquine (25mg/kg over 3 days + 0.75mg/kg single dose)  or  Artesunate + Sulpha Pyrimethamine + Primaquine (in areas qualified for ACT)  4 mg/kg for 3 days + 25/1.25mg/kg single dose + 0.75mg/kg single dose  Treatment 2 Chloroquine + Primaquine (25mg/kg over 3 days + 0.25mg/kg for 14 days)  Treatment 3 Chloroquine (25mg/kg over 3 days)  Note: Primaquine is contraindicated in pregnant women, G6PD deficiency, and infants, ACT is contraindicated in pregnant women  * For clinically suspected malaria cases, signs and symptoms may be reffered
  • 28. Culex  57 species found in India  Culex quinquefasciatus transmits filaria caused by Wuchereria bancrofti.  Genus Mansonia annulifera & M.indica transmit Brugia malayi.  Culex triateniorhynchus & Culex vishnui group transmit Japanese encephalitis.  Aedes is represented by several species in India.  Aedes aegypti is the vector of dengue haemorhagic fever.
  • 29. Filariasis & Dengue  Latest official estimate in India showed that 304 million people are reported to be exposed to the risk of infection with an estimated 22 million microfilarial carriers and 16 million chronic filarial cases.  Approximately about 1 million people in India are said to suffer from Dengue diseases annually.
  • 31. Dengue  Viral fever caused by Flavivirus.  It is: Family:Flaviviridae;Genus:Flavivirus;Species:Dengue virus.  Spread by the bite of Aedes aegypti.  Two fifth of the world population at risk(2500 Million).  Worldwide 50 million cases reported every year.  Disease is in more than 100 countries.  Dengue virus comes in 4 forms-as 1,2,3 &4.  Dengue Heamorrhagic Fever (DHF)infection causes death.2.5% die & mostly children.  Symptoms are high fever, chills, headache, enlargement of liver, in severe cases circulatory failure.  In DHF plasma leakage lead to hypovolaemic shock(Dengue Shock Syndrome)
  • 32. Dengue Fever  DF may be asymptomatic or may lead to undifferentiated fever.  Fever 2-7 days duration.  The clinical features of DF : Headache, Retro-orbital oain,Myalgia,arthralgia,rash,heamorrhagic manifestations.  Older Children & adults may have either a mild fever or with high fever of abrupt onset ,sometimes with 2 peaks(saddle –backed), severe headache, pain behind the eyes, muscle and bone or joint pains, nausea and vomiting,& rash.  In some epidemics DF may cause bleeding complications, such as epistaxis,gingival bleeding, gastrointestinal bleeding,haematuria and elevated haemotocrit (i.e. haemoconcentration),a serous effusion or hypoprotinaemia.
  • 33. DHF-Clinical Features  Acute viral infection.  Children with DHF sudden rise of fever &accompanied by facial flush & other non-specific constitutional symptoms resembling DF.  Some complain of sore throat and an infected pharynx, rhinitis & cough are infrequent. Also generalized abdominal pain are common. Bleeding from mucosa & intestinal tract.  High fever last for 2-7 days.  Fever rises to 103 to 105 F.  This acute phase of High temperature lasts 2-7 days.  Febrile convulsions occur, particularly in infants.
  • 34. Management of Cases -No specific treatment for viral fevers. -Usually the illness is self limiting. Symptoms based treatment to be given. -Only method of controlling or preventing Dengue & DHF is to combat the vector mosquitoes. -Containers to be emptied periodically in and around houses. (Peridomestic). -Environmental management, source reduction, chemical methods & space spray to be undertaken. -Improved water storage practices, including covering containers to prevent egg laying to be strictly adhered to by thorough supervision by municipal authorities. -Larval habitats to be sprayed with Bti fortnightly or with Temephos weekly. -Space spray with Pyrethrum extract 2% twice in a week during Dawn & Dusk to be done during initial stages & then to weekly once. - Use mosquito repellents like Coil,mat,Liquidator,Cream & also mosquito nets during day time also. - To wear full sleeve shirts &pants
  • 35. Transmission  Caused by day biting Aedes aegypti.  Also causes Chikungunya Fever.  Day biting Mosquito. Also called as “Tiger mosquito". Has got white dots on body.  Bites are painful & it causes allergic eruptions.  Breeds in domestic & peri domestic containers.  Clean water structures like cement tank, coolers, containers,Waterplants vases, plastic containers, metal drums& earthen pots, Fish tanks,unused tyres thrown out, coconut shells & lot many small water holding structures.
  • 36. Measures to control  Breeding places to be emptied ones in a week.  Drinking water to be covered very tightly.  Empty the coolers & clean them weekly.  Use mosquito repellents during day time also.  Mosquito repellent Creams to be applied on to the exposed body parts.  Children sleeping during morning time to be kept under mosquito nets.  To wear full sleeve shirts & pants.
  • 37. Mosquito Control By Municipal Agencies.  Periodic Fogging with Natural Pyrethrum Extract 2%.This to be done during Dawn & Dusk.  Larval breeding sources to be treated with Biolarvicide like Bti & this to be taken up once in a fortnight.  Incase if opt for chemical larvicide then to go far weekly application of Temephos.
  • 38. Dengue-Precaution  Transovarial transmission proved & established .  The transmission season is normally after monsoon i.e. from July to November.  The eggs laid hatch out from containers & other breeding sources during next monsoon & from these eggs also virus can come out & transmission can start.  Since the breeding takes place in & around houses it is more a community problem & hence in cooperation with governmental efforts community should participate to control outbreaks.
  • 39. Chikungunya ARBOVIRAL DISEASE TRANSMITTED BY DAY BITING MOSQUITO AEDES AEGYPTI
  • 40. Chikungunya  Rare form of viral fever caused by Alpha virus.  Spread by the bite of Aedes aegypti.  “Swahili” word meaning stooped posture or bent back.  Symptoms are fever, chills, headache, nausea, vomiting, joint pain with or without swelling, low back pain.
  • 41. Chikungunya-History  First isolated n Tanganyika (Tanzania) in 1953.  Between 1960’s & 1980’s the virus isolated from numerous countries in Central & Southern Africa as well as in Senegal & Nigeria in Western Africa.  During this period the Virus was also identified in Asia.  Since 1953,Chik Virus has caused numerous outbreaks in Africa & South Eastern Asia.  It is a Group IV virus belonging to family Togaviridae with genus Alpha virus & species Chukungunya.  It involves wild primates in sylvatic cycle in forested areas.This has been found in African countries.
  • 42. Chikungunya-Clinical Features  Acute viral infection.  Heralded by fever & severe arthralgia.  Last for 1-7 days.  Incubation period is 2-3 days.  Fever rises to 103 to 105 C.  This acute phase lasts 2-3 days.  The temperature result in “Saddle back" fever curve.  Swelling occurs on lower limbs. Pain on movements is worse in the morning.  During acute disease , most patients will have headache.
  • 43. Transmission  Caused by day biting Aedes aegypti.  Also causes Dengue Fever.  Day biting Mosquito. Also called as “Tiger mosquito". Has got white dots on body.  Bites are painful & it causes allergic eruptions.  Breeds in domestic & peri domestic containers.  Clean water structures like cement tank, coolers, containers,Waterplants containers, Fish tanks,unused tyres thrown out & lot many holding structures.
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