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, babesiosis, 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 Spotted Fever and other rickettsial infections may also lead to coma.

Appendix 1Signs and Symptoms of Arthropod-Borne Diseases

227

228 Appendix 1

Conjunctivitis: Chagas’ disease and onchocerciasis may lead to chronic conjunctivitis.

Dermatitis: Several arthropods 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 fleas 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 CerebrospinalFluid Pleocytosis:

Cerebrospinal fluid eosinophilic pleocytosis can be caused by a number of infectious diseases (including 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 ticks infected with the causative agent of Lyme disease, 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 boutonneuse fever, (spotted fever group illnesses), or scrub typhus. An eschar develops at the site of tick 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, plague, 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: 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, Subcutaneous:

Onchocerciasis may present as skin nodules (see 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, ehrlichiosis, murine typhus, 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 bartonellosis. The verrugae are chronic, last-ing from several months to years, and contain large numbers of Bartonella bacilliformis bacteria.

Winterbottom’s Sign: In the early stages of African trypanosomiasis, patients may exhibit posterior cervical lymphadenitis.

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.

Appendix 2Diagnostic Tests Used in Arthropod-Borne Diseases

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 animals. 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

AAccidental myiasis, 209

contributing factors, 215treatment, 217–218

Artemisinin-based combination therapy (ACT), 44–45

Adenopathy, 227Aedes aegypti, 21, 58–61, 63

biting patterns, 58breeding, 61dengue virus, 58geographic distribution, 61illustration, 60and YF, 63

Aedes africanus, 21, 67and YF, 67

Aedes albopictus, 21, 57–61biting patterns, 58dengue virus, 58geographic distribution, 61

Aedes mosquitoes, 21, 32–35, 57–61, 67breathing, 31–33dog heartworm, 74egg laying, 34positions, 33

Aedes vexans, 33African sleeping sickness, 160–164

causative agent, 160clinical and laboratory findings, 161diagnosis, 160–161ecology, 161–162geographical distribution, 161medical significance, 160prevention and control, 163symptoms, 160treatment, 163vectors, 162

African tick bite fever (ATBF), 96African trypanosomiasis, 13, 160–164

Agglutination, 141, 233African sleeping sickness

diagnosis, 161Allergy to stings, 13Allopurinol, 159Amastigote, 148Amblyomma, 85, 93–100, 107Amblyomma americanum, 85, 93–100, 107

geographical distribution, 100illustration, 99tularemia, 107

Amblyomma hebraeum, 85, 94Amblyomma maculatum, 85, 90–94

and American boutonneuse fever, 85, 90–94

American dog tick, 85, 87–88American trypanosomiasis, 153–159Amodiaquine, 45Amoxicillin, 105

LD treatment, 105Amphotericin B

leishmaniasis treatment, 149Anaplasma marginale, 96Anaplasma phagocytophilum, 96–98Anaplasmosis (HGA), 96–98Anemia, 38, 227Anopheles darlingi, 40

geographic distribution, 42illustration, 42malaria, 40

Anopheles freeborni, 26catholic feeder, 26malaria vectors, 26, 40

Anopheles gambiae, 40geographic distribution, 41illustration, 41malaria, 40

Anopheles hermsi, 26, 40malaria vectors, 40

237

238 Index

Anopheles leucosphyrus, 40, 43geographic distribution, 43illustration, 43malaria, 40

Anopheles maculipennis, 27Anopheles mosquitoes, 21, 26–27, 31–45,

72, 74Bancroftian filariasis, 72breathing, 31breeding, 33cyclopropagative transmission, 22dog heartworm, 74egg laying, 33positions feeding, 32vector control, 44vectors, 21, 40–43

Anopheles punctipennis, 26malaria vectors, 40

Anopheles quadrimaculatus, 27, 40malaria vectors, 40

Anophelinae, 31Antibody-dependent

Enhancement (ADE), 63Antimalarial drugs, 45Antiparasitic drug

onchocerciasis treatment, 166Ants

fire ants, 195–198sting apparatus, 202stings, 195–198

Arachnids, 4–9characteristics, 4

Arborival encephalitis, 49–57Argasidae, 81–84

illustration, 82Arkansas strain

HME, 98Arthropod-borne diseases

diagnostic tests, 233–236dynamics, 19–27signs and symptoms, 227–231

Arthropodscharacteristics, 3and health, 10–17, 19–27historical medical aspects, 10and HIV, 183–184human diseases transmitted, 19–27medical importance, 10–17,

19–27class list, 4stings and bites, 201–208

Asian tiger mosquitoes, 21, 57–61dengue virus, 58

AzithromycinLD treatment, 105

BBabesia bigemina, 110Babesia canis, 110Babesia divergens, 109Babesia equi, 110Babesia gibsoni, 110Babesia microti, 109–111

life cycle, 110Babesiosis, 109–111Bacillus thuringiensis, 166Bacon therapy, 218Bacterium tularense, 105

See also Francisella tularensisBancroftian filariasis, 68–74

biological transmission, 22geographic distribution, 69Wuchereria bancrofti, 70

Bartonella bacilliformis, 150Bartonella henselae, 140Bartonella quintana, 171Bartonellosis, 140, 150Bees, 13, 202

sting apparatus, 202stings, 204–206

Beetles, 16blister, 12larvae, 16

Benznidazole, 159Chagas’ disease treatment, 159

Biological transmissionclassification types, 20disease agents, 21

example, 22Bird-biting mosquitoes, 47, 50Bite lesions, 11, 201Bites, 11, 201

arthropods, 11, 201spiders, 5, 189, 201tick

illustration, 91Rocky Mountain Spotted Fever

(RMSF), 87Bite site

erythema migrans (EM), 101Biting flies

tularemia, 106Black death, 134Black flies, 165–166

filarial worms, 164Black rat, 134Black soldier fly, 209

illustration, 210Black widow spider, 11

venom, 11Blister, 12

Index 239

Blister beetles, 12Blow flies see Calliphoridae, 211–216

illustration, 213larvae, 213

Body lice, 170–171medical importance, 170

Boils (caused by fly larvae), 216–217

Borrelia burgdorferi, 104–105detection, 104

Borrelia hermsi, 116illustration, 115

Borrelia recurrentis, 116, 174Borrelia turicata, 116Bot fly, 212, 214Boutonneuse fever, 94Brown recluse, 187Brown widow spider

venom, 11bite effects, 11

Brugia malayi, 72, 74lymphatic filariasis treatment, 74

Brugian filariasis, 68geographic distribution, 69

Bubonic plague, 134–135Bulls-eye rash, 101Burrowing fleas, 10

CCalliphoridae, 211, 213Calliphora vicina, 211Campestral plague, 133Canine ehrlichiosis, 97Cantharidin, 12Carios rudis, 117Carrion’s disease, 150Cat fleas, 139, 141Catholic feeder

Anopheles freeborni, 26Cat-scratch disease (CSD), 140

clinical presentation, 139symptoms, 140transmission modes, 141treatment, 141

Cebidae monkeysand YF, 67

CefuroximeLD treatment, 105

Centipedes, 4, 9characterizations, 9

Central European TBE, 111Cercopithecidae monkeys

and YF, 67Cerebral malaria, 38

Chagas’ disease, 153–160clinical and laboratory findings,

153–154diagnosis, 157ecology, 157geographic distribution, 155medical significance, 153prevention and control,

159–160symptoms, 153–156transmission mode, 157treatment, 159vectors, 159

Chagoma, 227Cheese skipper, 210

illustration, 210Chiclero’s ulcer, 146Chikungunya, 56–57

outbreaks, 57symptoms, 56vectors, 57

Chigger-borne rickettsiosis, 166Chiggers, 166–169

life cycle, 169Chigoe fleas, 10Chilopoda

characteristics, 4, 9Chloramphenicol

louse-borne disease treatment, 174murine typhus treatment, 139RMSF treatment, 90scrub typhus treatment, 169tularemia treatment, 108

Chloroquineantimalarial drug, 40

Chrysomya albicepsillustration, 214

Chrysomya chloropygaillustration, 214

Chrysomya fliesillustration, 214

Chrysomya megacephalusillustration, 214

Chrysomya rufifacies, 211Chrysops discalis, 108Chyluria, 227Ciprofloxacin

CSD treatment, 141Clindamycin

human babesiosis treatment, 111Cochliomyia macellaria, 211

illustration, 213Cockroaches

mechanical transmission, 19transmission mode, 20

240 Index

Colorado tick fever (CTF), 113diagnosis and treatment, 113symptoms, 113

Coma, 38, 46, 50, 86, 112, 160, 227Commensal rats, 134Competent vectors, 12, 24–25Complement fixation, 138,

157, 233Conenose bugs, 157. See also Kissing bugs

and TriatomaConjunctivitis, 228Coquillettidia perturbans

mosquito vector, 48Cotton rats, 138Cowdria ruminantium 96CSD (cat-scratch disease),

139–141Ctenocephalides felis, 139, 141Culex mosquitoes, 21, 33–35, 46, 74

breathing, 33breeding, 35dog heartworm, 74egg laying, 35positions, 32SLE, 46, 50–52

Culex nigripalpusSLE mosquito vector, 51

Culex pipiensSLE mosquito vector, 51

Culex quinquefasciatusBancroftian filariasis, 70–71SLE mosquito vector, 51WNV mosquito vector, 54

Culex tarsalisillustration, 52SLE mosquito vector, 51WEE, 54WNV, 54

Culex tritaeniorhynchusJE, 56

Culicidae mosquitoes, 31subfamilies, 31

Culicinaecharacteristics, 31

Culiseta melanuraenzootic vector, 21, 47

Cutaneous leishmaniasis, 143–144

geographic distribution, 145Cuterebra flies, 215Cyclodevelopmental transmission

disease agents, 22Cyclopropagative transmission

disease agents, 22

DDaddy longlegs, 6Dark rice field mosquitoes, 33Deer fly, 21, 105, 108

illustration, 106Deer fly fever, 106Deer mice, 133, 135Deer tick, 101–102

geographic distribution, 101illustration, 101

DEET, 48, 89, 150leishmaniasis protection, 150

Delusions of parasitosis (DOP), 221Den 1

dengue virus serotype, 58Den 2

dengue virus serotype, 58Den 3

dengue virus serotype, 58Den 4

dengue virus serotype, 58Dengue, 58–63Dengue fever, 58–63Dengue hemorrhagic fever (DHF), 61–63

risk factors, 62Dengue shock syndrome (DSS), 61–62

risk factors, 62Dengue vaccine, 63Dengue virus, 58–63

geographic distribution, 59laboratory characteristics, 61mosquito markings, 60serotypes, 58spread, 58symptoms, 58treatment, prevention and control,

62–63Dermacentor andersoni

and CTF, 113geographic distribution, 88illustration, 87interference phenomenon, 25tick vectors, 21, 87, 107, 113

tick paralysis, 120–121Dermacentor marginatus, 96Dermacentor nuttalli, 96, 107Dermacentor silvarum, 96Dermacentor ticks

tick paralysis, 120–121Dermacentor variabilis, 21, 85, 87, 99

geographic distribution, 87illustration, 88tick paralysis, 120–121tick vectors, 87, 99, 107

Index 241

Dermatitis, 15, 101, 103, 165, 191, 223, 228Diagnostic tests

arthropod-borne diseases, 233Diarrhea, 228Diethylcarbamazine (DEC)

lymphatic filariasis treatment, 74onchocerciasis treatment, 166

Diplopoda, 4, 9characteristics, 9

Dip-Sticksmalaria diagnosis, 38scrub typhus diagnosis, 167

Direct fluorescent antibody, 233Dirofilaria immitis, 74Dirofilaria repens, 74Dirofilariasis, 74Dirofilaria tenuis, 74Dirofilaria ursi, 74Disease agents

biological transmission, 20mechanical transmission, 19

Diseasestransmitted by arthropods, 21

Disease transmissiondirect effects, 11indirect effects, 12

Dog antiparalysis serumtick paralysis treatment, 123

Dog heartworm, 74Dog tapeworm

transmission mode, 20Dog tick, 85, 87, 99Domestic rats, 134DOP, 221Doxycyline

ABF treatment, 94CSD treatment, 141ehrlichiosis treatment, 100LD treatment, 105murine typhus treatment, 139RMSF treatment, 90scrub typhus treatment, 169TBRF treatment, 117

Dust mites, 14

EEastern equine encephalitis (EEE), 46–49

control, 48differential diagnosis, 48ecology, 47geographic distribution, 47life cycle, 48onset of symptoms, 46

East Side agent, 25Edema, 228Ehrlichia, 96–100Ehrlichia canis, 97Ehrlichia chaffeensis, 97–98Ehrlichia ewingii, 98–100Ehrlichia phagocytophila, see Anaplasma

phagocytophilum, 98–100Ehrlichia ruminantium, 96Ehrlichiosis, 96–100EIA. See ELISA, 234Ekbom’s Syndrome, 221Elephantiasis, 68ELISA. See Enzyme-linked immunosorbent

assay, 234Encephalitides group, 46–56Encephalitis viruses

mosquito-transmitted, 46–56Envenomation, 11, 201Envenomization, 11, 201Enzootic cycle, 47Enzootic vector

Culiseta melanura, 47Enzyme immunoassay (EIA),

see ELISA, 234in scrub typhus diagnosis, 167

Enzyme-linked immunosorbent assay (ELISA), 234

African sleeping sickness diagnosis, 161Borrelia burgdorferi detection, 104Chagas’ disease diagnosis, 157leishmaniasis diagnosis, 147microfilariae identification, 70plague diagnosis, 136tick-borne encephalitis diagnosis, 113

Eosinophilia, 228Eosinophilic cerebrospinal fluid pleocytosis,

228Epidemic typhus, 21, 170–171Epididymitis, 228Epizootic cycle, 22, 47, 97Epizootic hosts

fleas, 135Eristalis tenax, 210

illustration, 211Erythema migrans,

bite site, 103Erythromycin,

CSD treatment, 141Eschar, 92–94

tick bite, 93–94Excoriation, 222Extrinsic factors

vector competence, 24

242 Index

FFacultative myiasis, 211

contributing factors, 215treatment, 217–218

Falciparum malaria, 38, 46, 50, 53, 56, 86, 96, 97, 100, 106, 112, 114, 229

Febrile anemia, 150Fever, 38Fiddle back spider, venom of, 11Field’s stain

microfilariae identification, 70Filarial worms, 22

biological transmission, 22life cycle, 73

Fire ants, 195–198attacks, 198venom, 196

Flea-borne diseases, 138–140Fleas, 131

biology, 131burrowing, 10cat, 139, 141chigoe, 10epizootic hosts, 135labeled diagram structure, 132larvae, 131mouthparts, 132Oriental rat flea, 135–138

illustration, 136transmission mode, 135

Flesh flies, 211illustration, 213

Fliesbiting

tularemia, 106black flies, 164–166

filarial worms, 164black soldier fly, 210blow flies, 210–211

illustration, 213larvae, 213

bot fly, 212Chrysomya

illustration, 214Cuterebra, 215deer fly, 21, 106, 108

illustration, 106flesh flies, 215

illustration, 213house flies

disease transmission, 20life cycle, 19–20

hump-backed, 212larvae, 212

mechanical transmission, 19–20, 179, 183–184

Megaselia, 211Musca, 211Muscina, 211Sarcophaga, 211

illustration, 213sand, 21, 143–151

biology, 143sand fly fever, 150Sarcophaga, 211screwworm, 212

illustration, 214Simulium, 21, 164–165soldier fly, 210

illustration, 210tsetse, 21, 160–165

illustration, 160tularemia, 21, 106, 108

Fomite houseand YF, 66

Francisella tularensis, 105

GGamma-interferon

leishmaniasis treatment, 149Gentamicin

CSD treatment, 141tularemia treatment, 109

Geographic distributionAedes aegypti, 61Aedes albopictus, 61African sleeping sickness, 161Amblyomma americanum, 100Anopheles darlingi, 42Anopheles gambiae, 41Anopheles leucosphyrus, 43Brugian filariasis, 70Chagas’ disease, 155deer tick, 101dengue virus, 59Dermacentor andersoni, 88Dermacentor variabilis, 88eastern equine encephalitis (EEE), 47HGE/HGA, 97Ixodes holocylus, 122Ixodes scapularis, 101Japanese encephalitis (JE), 57LaCrosse encephalitis (LAC), 56LBRF, 173leishmaniasis, 145lone star tick (LST), 100louse-borne typhus, 172

Index 243

malaria, 37Ornithodoros ticks, 118plague, 133scrub typhus, 167St. Louis encephalitis, 51tick-borne relapsing fever (TBRF), 118western equine encephalitis (WEE), 55yellow fever (YF), 64

Giant centipede, 9Giemsa stain

babesiosis diagnosis, 110leishmaniasis diagnosis, 148microfilariae identification, 70

Giemsa Wayson stainplague diagnosis, 136

Glossina, 161–164Glossina fuscipes, 162Glossina morsitans, 162Glossina pallidipes, 162Glossina palpalis, 162Glossina swynnertoni, 162Glossina tachinoides, 162Glucantime

leishmaniasis treatment, 149Grasshoppers, 3Gulf coast tick, 85, 90–94

HHaemagogus mosquitoes

sylvatic cycle, 67Haemaphysalis

tick vectors, 21, 96Haemaphysalis concinna, 96Haemaphysalis flava, 85

tick vectors, 85Hard ticks, 81–82

characteristics, 81Harvestmen, 6HE, 98HME, 97–98Head lice

life cycle, 5Health

arthropods direct effects, 11arthropods indirect effects, 12

Hemagglutination inhibition (HI), 234Hematemesis, 229Hemipteran insects, 153Hemoglobinuria, 229Hemolymph test, 25Hemolytic anemia, 38, 187Hermetia illucens, 210

illustration, 210

Hetrazanlymphatic filariasis treatment, 74

HGA/HGE. See also Human granulocytic ehrlichiosis (HE), 96–98

HIV transmissionand mosquitoes, 183–184

HME. See Human monocytic ehrlichiosis (HME), 96–98

House centipede, 9House flies, 4

larvae, 5life cycle, 5

House mosquitoBancroftian filariasis, 72

Howler monkeysand YF, 67

Human babesiosis, 109–111clinical and laboratory findings, 109ecology, 110medical significance, 109treatment and control, 111

Human bot fly, 212–216Human diseases transmitted

arthropods, 21Human ehrlichiosis, 96–98Human granulocytic ehrlichiosis (HGE),

96–98ecology, 99tick vectors, 99

Human immunodeficiency virus (HIV), 183–184

Human monocytic ehrlichiosis (HME), 96–98

Hump-backed flies, 212Hyalomma, 85

tick vectors, 85Hyalomma iongicornis, 85

tick vectors, 85Hydrocele, 229Hymenoptera

sting apparatus, 204Hypereosinophilia, 70

IIFA. See Indirect fluorescent antibody (IFA),

70Imaginary insect and mite infestation, 221

contributing factors, 222differential diagnosis, 223treatment strategies, 224

Immunoglobulin Mand LD, 103

Indigenous leishmaniasis, 148

244 Index

Indirect fluorescent antibody (IFA), 70African sleeping sickness diagnosis,

161babesiosis diagnosis, 110Chagas’ disease diagnosis, 157ehrlichiosis diagnosis, 99leishmanisasis diagnosis, 147microfilariae identification, 70murine typhus, 138plague diagnosis, 136RMSF diagnosis, 86scrub typhus diagnosis, 167

Infective sporozoitesmalaria, 38

Inland floodwater mosquitoes, 33Insect

characterizations, 3–4forms of development, 3–4and HIV, 183–184pathogen pick up, 19–21

Insectacharacteristics, 3–4

Insect infestationimaginary, 221

Insect mouthpartsdescription, 202illustration, 202list, 201–202

Insect pupae, activity of vs. mosquito pupae, 31

Insect stings or bites, 201–207diagnosis, 206infectious complications, 205medical significance, 201pathogenesis, 201recognition, 206

Interference phenomenon, 25Intrinsic factors

vector competence, 24Itraconazole, 159Ivermectin

lymphatic filariasis treatment, 74onchocerciasis treatment, 166

Ixodes cookie, 112Ixodes cornuatus, 121Ixodes dammini, 102Ixodes holocyclus, 14, 96, 121

geographic distribution, 122illustration, 122tick vectors, 85

Ixodes ovatus, 85tick vectors, 85

Ixodes pacificus, 104Ixodes persulcatus, 112

Ixodes ricinus, 107illustration, 108

Ixodes scapularis, 21–22, 102, 124geographic distribution, 101illustration, 101

Ixodidae, 81–83

JJapanese encephalitis (JE), 56

geographic distribution, 57Japanese spotted fever, 85Jungle YF cycles, 67

KKerititis, 229Kissing bugs, 20, 21, 153–160

beak, 158illustration, 158transmission mode, 20

Kyasanur forest disease, 111

LLaCrosse encephalitis (LAC),

46, 54geographic distribution, 56vectors, 46, 54

Larvaemosquitoes, 31

Latex agglutination (LA) tests, 138Leishmania aethiopia, 144Leishmania braziliensis, 146Leishmania chagasi, 147Leishmania donovani, 146Leishmania guyanensis, 146Leishmania infantum, 146Leishmania major, 144Leishmania mexicana, 146Leishmania panamensis, 146Leishmania tropica, 144Leishmania parasites, 143Leishmaniasis, 143–145

clinical manifestations, 143–144diagnosis, 147ecology, 148forms, 146geographic distribution, 145life cycle, 149medical significance, 143–145treatment and control, 149

Leishmanin test, 147Leptopsylla segnis, 138

Index 245

Leptotrombidium akamushiST vector species, 169

Leptotrombidium arenicolaST vector species, 169

Leptotrombidium delienseST vector species, 169

Leptotrombidium fletcheriST vector species, 169

Leptotrombidium mites, 168–169Leptotrombidium pallidum

ST vector species, 169Leptotrombidium pavlovsky

ST vector species, 169Leptotrombidium scutellaris

ST vector species, 169Leptotrombidium species, 168–169Lesions

bite, 11, 205Leukopenia, 229Lice, 5, 170–173

headlife cycle, 5

Liponyssoides sanguineus, 85Loiasis, 74, 228Lone star tick (LST), 99–100

geographic distribution, 100illustration, 99

Louping ill, 111Louse-borne diseases

treatment, control, and prevention, 174

Louse-borne infectionsmedical importance, 170

Louse-borne relapsing fever (LBRF), 174

geographic distribution, 173Louse-borne typhus, 171

geographic distribution, 173Lucilia sericata, 211, 215Lutzomyia, 21, 148–150Lutzomyia anthophora, 148Lutzomyia colombiana, 150Lutzomyia mexicana, 146Lutzomyia verrucarum, 150Lyme disease (LD), 21

clinical and laboratory findings, 103ecology, 104history, 102symptoms, 100–101tick bite, 104treatment, 105vectors, 22

Lymphadenopathy, 229Lymphangitis, 229

Lymphatic filariasisclinical and laboratory findings, 68ecology, 70–71medical significance, 68symptoms, 68treatment, 74

Lymphocytosis, 229

MMaggot infestation, 218Maggots, 209–220Malaria, 13, 35–45

causative agent, 38deaths, 13diagnosis, 38epidemiology, 35geographic distribution, 36–37history, 35incidence, 13life cycle, 39mosquitoes, 40mosquito vectors and behavior, 40symptoms, 38transmission mode, 20treatment and control, 44

Malaria organism vectorsmosquitoes, 40

Malaria plasmodiacyclopropagative transmission, 22

Malaria vaccine, 44Malaria vectors

Anopheles mosquitoes, 40Malayan filariasis, 68Mansonella ozzardi, 74Mansonella perstans, 74 Mansonella streptocerca, 74Mansonia, 72Mazzotti test, 65, 235

onchocerciasis diagnosis, 165Mechanical transmission

disease agents, 20Mectizan

lymphatic filariasis treatment, 74onchocerciasis treatment, 165

Mediterranean spotted fever, 94Mefloquine, 45Megaselia flies, 211Melarsoprol

African sleeping sickness treatment, 163Mel-B7

African sleeping sickness treatment, 163Meningoencephalitis, 48, 112, 156,

160, 227, 236

246 Index

Merozoitesmalaria, 40

Microfilaramia, 68Microfilariae identification

microscopic view, 70–71sheath showing, 70

Millipedes, 4, 9characterizations, 4,9stains on skin, 12

Mite infestationimaginary, 221

Mite islands, 166Mites

characterizations, 8Leptotromidium, 168pathogen pick up, 169trombiculid, 168

Montenegro test, 235Morulae (illustration), 97Mosquito biology, 31Mosquito-borne diseases, 35–77Mosquito-borne encephalitis, 45–56Mosquitoes, 31–77

Aedes, 32–35, 57–61, 67breathing, 33dog heartworm, 74egg laying, 34positions, 32–33

Anopheles, 32–33, 38, 40–43Bancroftian filariasis, 70breathing, 33breeding, 33dog heartworm, 74egg laying, 33positions, 33vectors, 40

Asian tigerdengue virus, 58

bird-biting, 47, 50, 53Culex, 21, 33–35, 46, 54, 56

breathing, 31, 33breeding, 33, 35dog heartworm, 74egg laying, 35positions, 32and SLE, 50and WNV, 53–54

Culicidae, 31subfamilies, 33

dark rice field, 33dengue virus mosquito markings,

60filarial worms, 74forest scrub

and YF, 67Haemagogussylvatic cycle, 67

head and mouthparts, 34HIV transmission, 183–184House, 21, 72

and Bancroftian filariasis, 72illustration, 32inland floodwater, 33larvae, 32malaria, 13, 35–45malaria organism vectors, 40Plasmodium

malaria, 38vectors, 40

Psorophora, 33–34biting patterns, 34egg laying, 33–34VEE, 55

pupae, 31–32Salt marsh, 33tree canopy YF and, 67tree hole, 21, 33–34, 67, 143

LAC, 54tularemia, 105tumblers, 31–32wigglers, 31–32yellow fever, 63–66

Mosquito houseand YF, 66

Mosquito pupae, 31activity, 31

insect pupae, 31Mosquito-transmitted encephalitis

viruses, 46–56Mosquito vectors, 21, 26, 40

dengue, 58malaria, 40and SLE, 50–51and WNV, 46, 54

Moths, 3, 16larvae, 3, 16

Mucocutaneous leishmaniasis, 143, 146geographic distribution, 145illustration, 146

Murine typhus, 136clinical and laboratory findings, 138ecology, 138medical significance, 136–137vs. Rocky Mountain spotted fever

(RMSF), 138symptoms, 138treatment, 139

Musca flies, 211

Index 247

Muscina flies, 211Myiasis, 11, 209–218

contributing factors, 215in clinical practice, 216prevention, treatment, and

control, 217Myocarditis, 230

NNeuritis, 230Neutralization, 235Nifurtimox

Chagas’ disease treatment, 159Nodules, subcutaneous, 230North Asian tick typhus, 85Norway rat, 139Nosopsyllus fasciatus, 138

OObligate myiasis, 209–218

contributing factors, 216treatment, 217–218

Obstructive filariasis, 70Ochlerotatus (formerly Aedes) mosquitoes,

31, 35Ochlerotatus sollicitans, 34, 46, 48Ochlerotatus taeniorhynchus, 48Ochlerotatus triseriatus, 33, 46

and LAC, 54Oculoglandular tularemia, 106Omsk hemorrhagic fever, 111Onchocerca volvulus, 164Onchocerciasis, 164–166

clinical and laboratory findings, 165diagnosis, 165ecology, 165medical significance, 164treatment, prevention, and control, 166vectors, 165

Opiliones, 6Orbivirus, 113Orchitis, 228Oriental rat flea, 135–137

illustration, 136Orientia tsutsugamushi, 22, 166Ornithodoros, 21, 116–117Ornithodoros erraticus

geographic distribution, 117Ornithodoros hermsi

geographic distribution, 117Ornithodoros moubata

geographic distribution, 117

Ornithodoros parkerigeographic distribution, 117

Ornithodoros porcinusgeographic distribution, 119

Ornithodoros rudisgeographic distribution, 117

Ornithodoros tholozanigeographic distribution, 119

Ornithodoros turicatageographic distribution, 117illustration, 118

Oropharyngeal tularemia, 106Oroya fever, 150Otobius megnini

illustration, 82

PPanstrongylus megistus

Chagas’ disease vectors, 159Papatasi fever, 150Paralysis, 119–123, 230Parasite transmission

modes, 20Parinaud’s oculoglandular syndrome,

140Pathogen transmission

mechanical vs. biological, 19–20

modes, 20PCR. See Polymerase chain reaction (PCR),

235Pediculus, 21, 170Pediculus humanus corporis, 170Pentavalent antimonials

leishmaniasis treatment, 149Pentostam

leishmaniasis treatment, 149Permanone, 90Permanone Repel, 90Permethrin products, 90Peromyscus leucopus, 110Peruvian warts, 150Phaenicia (Lucilia) sericata, 211Phlebotominae, 148Phlebotomus, 21, 151Phlebotomus papatasi, 151Phormia regina, 211Pian bois, 146Pimozide

imaginary insect and mite infestation treatment, 223–224

Piophilia casei, 210illustration, 210

248 Index

Plague, 133–136clinical presentation, 133diagnosis, 136ecology, 135geographic distribution, 133

state by state, 135history, 134life cycle, 135transmission mode, 135treatment, 136

Plague of Justinian, 134Plasmodium falciparum, 38, 110Plasmodium malariae, 38Plasmodium mosquitoes

malaria, 40vectors, 40

Plasmodium ovale, 38Plasmodium species, 38Plasmodium vivax, 38Pleomorphic coccobacilli, 96Pneumonic

plague form, 24Polymerase chain reaction (PCR),

235Borrelia burgdorferi detection,Chagas’ disease diagnosis, 157CSD detection, 138ehrlichiosis diagnosis, 98RMSF diagnosis, 86tularemia diagnosis, 105

Powassan encephalitis (POW), 111Promastigotes, 144, 147Propagative transmission

disease agents, 22Prophylaxis, 45Proteinuria, 230Pseudomyiasis, 209Psorophora columbiae, 33Psorophora mosquitoes

biting patterns, 35egg laying, 33and VEE, 46, 55

Psychodidae, 148Puncta, 205, 230Pupae, 3, 31

mosquitoes, 31Pyrimethamine

antimalarial drug, 45

QQueensland tick typhus (QTT), 96Quinidine

antimalarial drug, 45

Quinineantimalarial drug, 45

Quinine sulfatehuman babesiosis treatment, 111

RRabbit fever, 105Radio-immunoassay (RIA)

Chagas’ disease diagnosis, 157Rapid diagnostic tests

malaria diagnosis, 38Rash, 14, 61, 86, 92, 94, 96, 98, 105, 113, 115,

138, 165, 171, 201, 227Rats, 133, 148Rat-tailed maggot, 210

illustration, 211Rattus norvegicus, 138Rattus rattus, 23, 135, 138Red-tailed monkeys

and YF, 67Reduviidae, 153Relapsing fever, 21, 114

louse-borne vs. tick borne, 116Rhipicephalus

tick vectors, 85, 87, 94Rhipicephalus appendiculatus, 94Rhipicephalus sanguineus, 85, 87Rhodnius, 159Rhodnius prolixus

Chagas’ disease vectors, 159Rice culture, 27Rice rats, 138Rickettsia africae, 85Rickettsia akari,22, 85Rickettsia australis, 85Rickettsiaceae, 84Rickettsia conori, 85Rickettsiae, 84Rickettsia honei, 85Rickettsia japonica, 85Rickettsial disease, 21–22, 84Rickettsial pox, 22Rickettsia montana, 25Rickettsia parkeri, 85Rickettsia peacocki, 25Rickettsia prowazekii, 21Rickettsia rhipicepahali, 25Rickettsia rickettsii, 22, 25, 85Rickettsia siberica, 85Rickettsia typhi, 138

murine typhus, 138Rifampin

CSD treatment, 141

Index 249

Riparian habitat, 26–27River blindness, 164Rochalimaea henselae, 140Rochalimaea quintana, 171Rocky Mountain spotted fever

(RMSF), 84characteristics, 84clinical and laboratory aspects, 85ecology, 87infected tick bite, 87prevention, 87symptoms, 84

Rocky Mountain wood tick, 87–88Romana’s sign, 156Roof rat, 139Russian spring-summer encephalitis (RSSE),

111–112

SSarcophaga flies, 211

illustration, 213Salivary excretions

arthropods, 11, 153, 205, 208Salt marsh mosquitoes, 33, 34, 48Salt marsh mosquitoes

biting patterns, 35epizootic vector species, 48

Sand flies, 10, 142, 148, 150biology, 148

Sand fly fever, 150Sand fly-transmitted diseases, 150Sarcophaga flies, 211Sarcophaga haemorrhoidalis, 213Scorpion

stinging position, 8venom, 11

Scorpions, 3, 4, 8, 13characterizations, 4, 9

Screwworm flies, 11, 212, 214, 216, 218illustration, 214

Scrub typhus, 166–169clinical and laboratory findings, 167diagnosis, 167ecology, 168geographic distribution, 167medical significance, 166treatment, prevention, and control, 168vectors, 169

Sensu latu, 26Septicemic plague, 133Shock, 62, 231Siberian tick typhus (STT), 84–85Simulium, 21, 164–165

Simulium damnosum, 165Simulium flies, 21, 165Simulium metallicum, 166Simulium neavei, 165Simulium ochraceum, 166Skin biopsies

onchocerciasis diagnosis, 165Sleeping sickness, 160–164Social insects, 11Soft ticks, 81, 83, 116

characteristics, 81illustration, 82

Soldier fly, 209, 210, 216illustration, 210

Spider monkeys, YF and, 67Spiders, 3–7, 11, 187–192

bites, 187black widow

venom, 11brown widow

venom, 11characterizations, 4–5daddy longlegs, 6fiddle back

venom, 187venom, 11, 187

Splenomegaly, 146Sporozoites (malaria), 40Spotted fever group, 25, 84–85

epidemiologic information, 84–85Spotted fever rickettsioses, 84St. Louis encephalitis, 46, 49–52

control, 52ecology, 50–51geographic distribution, 51life cycle, 50symptoms, 50vectors, 50–51

Sting apparatus, 204Stings, 10, 11, 14, 195–198

arthropods, 11Streptomycin

plague treatment, 136tularemia treatment, 108

Sulfonamidesantimalarial drug, 45

SuraminAfrican sleeping sickness treatment,

163onchocerciasis treatment, 164

Sylvatic plague, 133Sylvatic YF, 67Symbiotic rickettsial organism, 122Systemic tick-borne illness, 100

250 Index

TTachycardia, 231Tapeworm

transmission mode, 20Tarantula, 7Tests

arthropod-borne diseases, 233Tetracycline

antimalarial drug, 45ehrlichiosis treatment, 100louse-borne disease treatment, 174murine typhus treatment, 139plague treatment,136RMSF treatment, 86TBRF treatment, 117tularemia treatment, 108

Theileria, 110Three-day fever, 150Tick-borne encephalitis, 111–113

diagnosis and treatment, 113Tick-borne relapsing fever (TBRF), 114

clinical and laboratory findings, 114diagnosis, 115ecology, 116geographic distribution, 118vs. louse-borne, 116medical significance, 119symptoms, 114–115treatment and control, 117

Tick paralysis, 119clinical features, 119–120mechanisms, 121medical significance, 119prevention and treatment, 123

Tick removalmethod, 91

TicksAmerican dog, 21, 22, 87, 99, 107, 121biology, 81bite, 86–87, 90, 94, 96

eschar, 94–95Lyme disease, 102Rocky Mountain Spotted Fever

(RMSF), 87characterizations, 8deer, 102

geographic distribution, 101illustration, 101

Dermacentor, 22, 25, 85, 87, 96, 99, 123Gulf coast

diseases associated with, 92–93dog, 21, 22, 87, 99, 107hard, 81

characteristics, 81

illustration, 82interference phenomenon, 25Ixodes, 85, 96, 99, 102, 104, 107, 112, 121

illustration, 101life cycle, 83lone star tick (LST), 21, 93, 99

geographic distribution, 100illustration, 99

removal, 91Rocky Mountain wood tick, 87–88soft, 81, 83, 116

characteristics, 81illustration, 82

tularemia, 107western black-legged, 110

Timorian filariasis, 68TMP-SMX

CSD treatment, 141Toxorhynchitinae, 31

characteristics, 31Transmission of pathogens

mechanical vs. biological, 19–20Tree canopy mosquitoes

and YF, 67Tree hole mosquitoes, 33, 46

and LAC, 46, 54Trench fever, 171Triatoma brasiliensis

Chagas’ disease vectors, 159Triatoma bugs, 157Triatoma dimidiata

Chagas’ disease vectors, 159Triatoma infestans

Chagas’ disease vectors, 159Triatoma protracta

Chagas’ disease vectors, 154allergy to bites, 154

Triatoma sanguisugaChagas’ disease vectors, 154

Triatominae, 153Trombiculid mites, 168True bugs, 153Trypanosoma brucei gambiense, 160Trypanosoma brucei rhodesiensei, 160Trypanosoma cruzi, 158–159Trypanosoma rangeli, 157Trypomastigote, 157Tsetse flies, 21, 160

illustration, 166Tularemia, 105

arthropod transmission, 107clinical and laboratory findings, 106medical significance, 105treatment, 108

Index 251

Tumblersmosquitoes, 31

Typhus island, 166

UUlceroglandular, 106Ulcers, cutaneous, 122Urban YF cycles, 67Urine tests

onchocerciasis diagnosis, 165Urticaria, 14–15, 201, 206, 230Uta, 10

VVector-borne diseases, 10, 12, 13, 24, 153Vector competence, 24Vector mosquitoes

sylvatic cycleHaemagogus mosquitoes, 67

VectorsAfrican sleeping sickness, 161–162Anopheles mosquitoes, 40Chagas’ disease, 157competent, 24incrimination, 25onchocerciasis, 164Plasmodium mosquitoes, 40scrub typhus, 168

Venezuelan equine encephalitis, 46, 55Vectors, 55

Venom, 11, 205black widow spider, 11brown widow spider, 11fiddle back spider, 205fire ants, 11, 196scorpion, 11spiders, 11, 205

Verruga peruana, 150Viral encephalitis, 56, 111Viruses

tick transmission, 111Visceral leishmaniasis, 144–146

geographic distribution, 145

WWayson stain, 136

Wasps, 3, 11, 13, 14, 202sting apparatus, 204stings, 203–205

Weil-Felix reactions, 86West Nile virus, 46

life cycle, 53control, 54vectors, 46

Western black-legged tick, 104Western equine encephalitis, 46

geographic distribution, 55vectors, 46

White-footed mouse, 110Wigglers

mosquitoes, 31Wild rats, 138Winterbottom’s sign, 161Wood rats, 138, 148Wright’s stain

plague diagnosis, 136Wuchereria bancrofti, 70

Bancroftian filariasis, 70–72life cycle, 73lymphatic filariasis treatment, 74

XXenopsylla, 135–138Xenopsylla cheopis, 135, 137–138

illustration, 136

YYellow fever mosquitoes, 65Yellow fever (YF), 63–68

geographic distribution, 64history, 65–66jungle vs. urban, 67medical significance, 63treatment and prevention, 67

Yellowjacketsting apparatus, 204

illustration, 204Yersinia pestis, 133

ZZoonoses

encephalitis, 45