UNDERSTANDING DENGUE VECTOR AND ITS MANAGEMENT

Prof. Dr. Waseem Akram, Head Research and Development Program on Dengue Punjab, Chief Ministers Secretariat

Synopsis of Module 1
Insects of Public Health Concern in Institutions Vector borne disease Understanding the Dengue mosquito and general mosquitoes Mosquito breeding places

INSECTS OF PUBLIC HEALTH CONCERN IN INSTITUTIONS

FLIES MOSQUITOES BED BUGS COCKROACHES FLEAS DERMESTID BEETLES LOUSE SANDFLIES ROVE BEETLES

VECTOR BORNE DISEASE

YELLOW FEVER MALARIA FILARIASIS JAPANESE ENCEPHALITIS DENGUE ASTHAMA LESHMINIASIS SKIN ALLERGIES THYPHOID

INSECTS OF PUBLIC HEALTH CONCERN IN INSTITUTIONS

MOSQUITOES AND THEIR ROLE

Mosquito-borne diseases cause significant human health problems, largely in the subtropics and tropics WHO reports three mosquitoborne diseases around the world:
500 million cases of malaria with 2.7 million deaths, mainly in children.
Lymphatic filariasis with 120 million people effected every year. Dengue fever virus, particularly its hemorrhagic form, is a threat to >2.5 billion people.

SOME OF THE VECTOR BORNE INFECTIONS

DENGUE SITUATION AT AN ALARMING TONE

Since the 1960's, dengue has re-emerged throughout the world. Some notable outbreaks in the last two decades: - 1977, Cuba: mild epidemic of dengue-1. - 1977, Seychelles (Africa) - first major epidemic - 1979, Laredo, Texas: two residents developed hemorrhagic fever. - 1981, Havana, Cuba: A new strain of dengue-2 from Southeast Asia causes its first major epidemic: 350,000 infected; 115,000 hospitalizations; 156 dead. - 1982, New Delhi, India: 20% of the 5.6 million residents fall ill to dengue-2 - 1982, Keyna - first major epidemic of dengue-2 - 1982-1984, Somalia - dengue-2 - 1985 - Mozambique, first major epidemic (dengue-3) - 1985-1986, Nicaragua: indigenous population of Managuans - 1985, Hainan Island, China - first major epidemic of dengue-2 - 1988, U.S.: 124 suspected cases of imported dengue, of which 27 (in 7 states) were definite, and 25 were uncertain. - 1990, Venezuela - 1991, Brazil: epidemic, indigenous population. - 1991-1992, Djibouti (Africa) - first major epidemic - 1993, Somalia: U.S. troops. - 1994, Pakistan, first epidemic - 1994, Nicaragua: dengue-3 reappears (a new strain genetically distinct from previous dengue-3 strains in the Americas) and causes an epidemic of dengue hemorrhagic fever. - 1994, Saudi Arabia, first major epidemic of dengue-2

History of Dengue in Pakistan

First reported in 1980 and then showed regular turn outs from 1994 to 1998 Pakistan faced the worst ever reported dengue epidemic in the world
0.6million suspected cases, 22000 confirmed 375 deaths in a span of 73 days during the year 2011.
Year 2006 2007 2008 2009 2010

S
Cases in Punjab 756

C
448

D
0

S
320

C
288

D
0

S
1248

C
1148

D
5

S
170

C
115

D
2

S
7835

C
6195

D
4

10

Known Vectors
DF and DHF are caused
Aedes aegypti and Aedes albopictus
These have extended their ranges from Asian region to other continents through trade and transportation.

Both the species have the capacity to vector

Four serotypes (DEN1, DEN2, DEN3 and DEN4) Transfer the virus to the people after extrinsic incubation period of 4-6 days

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How has the disease spread

Climatic changes Unplanned urbanization Growing environmental concerns
Have led to the expansion of vectors ranges and finally the prevalence of the disease.

Places which have shown sever epidemics have opened doors to other vector borne issues.
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Ecological Determinants affecting dengue incidence

13

Factors Contributing to the Emergence of Dengue Fever

No effective mosquito control efforts are underway in most countries with Dengue.
Public health systems to detect and control epidemics are deteriorating around the world. Rapid growth of cities has led to overcrowding, urban decay, and substandard sanitation, allowing more mosquitoes to live closer to more people. The increase in non-biodegradable plastic packaging and discarded tires is creating new breeding sites for mosquitoes. Increased jet air travel is helping people infected with Dengue viruses to move easily from city to city.

Dengue Mosquito and Usual Mosquitoes

Aedes

Culex

Lands with the head and tip of abdomen pointing towards the surface

Lands with the head and tip of abdomen pointing towards the surface

Anopheles

Dengue Mosquito and Usual Mosquitoes

Lands vertically on Malaria the surface

Eggs of different Mosquitoes

Eggs laid on raft which has many eggs that floats on the surface of water Eggs laid singly on the surface of water
Anopheles

Culex Aedes

Eggs like rice grains very small in size Laid singly on dry/wet/ or moist vegetation/ sides of containers or on the surface of water

Larval Stage of Anopheles Mosquito

Larva without siphon tube Rests horizontal with the surface of water
Anopheles spp.

Siphon tube ABSENT

Larva of Culex Mosquito

Larva with long thin siphon tube used for respiration Position of larva dependent upon the depth of water it may swim vertically upward or slightly tilted

Larva of Aedes mosquito

Larva with short and thick siphon (Respiratory tube) Moves in water either vertically or slightly tilted depending upon the depth of water

Larval Stages of Different Genera of Mosquito

Siphon and its size

Siphon absent

Siphon and its size

PUPAE OF DIFFERENT GENERA OF MOSQUITOES

Aedes Anopheles spp. Culex spp.

Head small Rest of the body distinctly away from head capsule

Head capsule large Rest of the body firmly attached with head capsule

Head capsule slightly smaller than anopheles Rest of the body partly away from head capsule

MORPHOLOGICAL DIFFERENCES BETWEEN SEXES

Male Plumose antenna

Female Pilose antenna

Morphological Appearances
Aedes aegypti Aedes albopictus

TWO WITH A SINGLE MISSION

Adults of albopictus and aegypti

Adults of albopictus and aegypti

Larvae of albopictus and aegypti

Pupae of albopictus and aegypti

Mosquito breeding places

This is what we Generally Understand

What and where do mosquitoes feed upon

DIURNAL NOCTURAL
What do they feed upon Mosquitoes feed upon blood Anthropophagic

Exophilic

Endophilic

Where do they feed upon

Endophagic Exophagic

MOSQUITO BREEDING PLACES

IS IT CLEAR WATER?

Is small quanity water enough?

Are tree wholes active breeding places?

Is blood the only food? female

Is blood the only food? male

Behavior Pattern of various Mosquito types

Culex swarms mostly large and commonly found
Anopheles swarms large and commonly found near water collecting places and the near sewerage pipes

Aedes swarms very few and mostly in the concealed environment

Disease Transmission Cycle

Environment

Vector

Pathogen

Transmission of Dengue Virus

Replication and Transmission of Dengue Virus (Part 1)

1. Virus transmitted to human in mosquito saliva 2. Virus replicates in target organs 3. Virus infects white blood cells and lymphatic tissues 4. Virus released and circulates in blood

Replication and Transmission of Dengue Virus (Part 2)

5. Second mosquito ingests virus with blood 6. Virus replicates in mosquito midgut and other organs,infects salivary glands 7. Virus replicates in salivary glands

Dengue Infected Patient

Thanks