ARTHROPODS

CAMILO B. SANTOS M.D

DEPARTMENT OF MICROBIOLOGY & PARASITOLOGY
EMILIO AGUINALDO COLLEGE OF MEDICINE

Phylum Arthropoda Ectoparasites of humans

- Parasites established in or out of the host body
- Particular interests to Parasitologists
- Vectors for transmissions of:
- Parasites
- Bacteria
- Viruses
- Rickettsial Diseases
- Directly causing Human disease

Distinguishing Characteristics of Arthropods:

1. Paired of Jointed Appendages
2. Chitinized Exoskeleton- Insoluble Polysaccharides
- Provides support for internal organs
3. Hemocele Blood containing spaces
4. Bilateral Symmetry
5. Life Stages more than one involved in human interaction

Laboratory Diagnosis:
- Can be examined directly
- Can use preservatives Ethanol 70% - Maintains the Morphology and color of specimen
- Chloroform or Ether Flying insects
- 5% formalin or Sterile Saline Solution
- Berleses Solution Permanent to kill and Fix specimens
- Some - To small to be seen Microscopy
- Place under glass slides
- Note for the distinguishing Characteristics

Arthropod-Human Relationships
- may affect humans in various ways
1. Temporary Occupants
Producing disease themselves
2. Permanent Occupants
3. Mechanical Transfer agents transmit disease flies , cockroaches Typhoid & Cholera
4. Arthropods part of parasite life Cycle - Direct transmission - During blood meal Ticks,
mosquitoes, kissing bugs.
5. Infestation
6. Venomous arthropods spiders & scorpions

Two Mechanism Arthropod Causes Clinical Symptoms:

1. Bite itself or Presence of Arthropod
2. Invasion by Specific pathogen transferred by arthropods
Treatment
- Lotions or ointments
- Removal of Arthropods
- Additional Treatment From disease brought by Arthropods
Prevention And Control
- Chemical sprays
- Insecticides
- Destruction of arthropod breeding grounds
- Increasing Natural predators
- Use of Protective clothing
- Repellants

Disease
Diagnosis

Organism
Treatment

Transmission

Location of Org.

Clin. Manifxn.

Lab.

Ticks

True flies
Tsetse fly

Mites

Mosquitoes

Fleas

Lice

True
Bugs

MITES
Scabies cause by itch mite Sarcoptes scabiei
Mode of Transmission
- Direct contact with infested skin
- Contaminated clothing or bedding
Geographic Distribution
Worldwide
Higher prevalence Crowded condition & Poor hygiene
Location
- Burrows Upper layers of epidermis
Morphology
Females 0.5 mm in diameter, males smaller
Eggs deposited in the burrows
- Hatched in 3-4 days Larvae mature into adults in 4 days
Clinical Manifestations
Commonly affected Interdigital webs, Genitalia, umbilicus, axillary folds
Extensor areas elbows, knees , flexor areas of the wrists

Initial lesions small, erythematous papules or vesicles

2nd to mites secretion allergic reaction
- Intensely pruritic , excoriation with 2nd bacterial infection
- Resolves within months chronicity persists for years
- Norwegian scabies - In immunocompromised individuals
- Generalized scaling & crusting dermatitis
Laboratory Diagnosis
Clinical observation Hand lens
- Look for burrows
Scrapings from skin lesions
- Eggs and mites in scrapings
Treatment
Lindane
Crotamiton
Benzyl benzoate
Permethrin Cream 5% - highly effective

Mild Dermatitis caused by Species Other than Sarcoples scabiei

1. Chigger Bites - Caused by Trombiculid mites
- Six-legged larvae not the adult mites ( not parasitic)
- Attached to skin & suck tissue fluids
- Saliva causes intense pruritic inflammatory reaction - Maculopapular
lesions
- Locations areas where clothing is tight ankles, groin, waistlines, armpits.

LICE
Pediculosis Caused by three Species of Louse
1. Pediculus humanus humanus or Pediclusus humanus corporis - Body louse
2. Pediculus humanus capitis Head louse
3. Pthirus pubis Crab louse or Pubic louse
Mode of Transmission
Louse Infestation Direct contact
Head louse sharing of contaminated comb
Pubic louse Sexual contact, contaminated toilet seats or clothings
Geographic Distribution
Worldwide populated areas Crowding & poor personal hygiene
- Refugee populations
- Wars and Population displaced by wars
Head louse common in 3-10 years old , regardless of good hygiene
Prevalence Rate in U.S range from 10-40%
Habitat
P. humanus clothing, intermittently feeds on skin
P. capitis - hair of scalp
P. pubis hair about genitalia also hair of axilla and eye lashes, perianal areas

Morphology or General Characteristics

Head & Body louse measures 2-3mm in length
Pubic louse 2mm in diameter, oval in shape
Claw-like legs and rounded body resembles miniature crab
Body louse lives clothings , lay eggs( Nits ) along seams of materials
Head & Pubic louse glue their nits to hair shafts.
- Nymph hatch from the eggs and grow to adult ( 1 month )
- Both feed on blood
Clinical Manifestations
- Hemorrhagic macules & Papules - site of bite
- Pruritus & excoriation intense itching
Laboratory Diagnosis
- Adult lice or nits seen in hair and clothings
- Eggs or nits white round objects attached to hair shafts and or clothing
Treatment and Prevention Education and Practice of Good health
Head lice Lindane- , permethrins
Body Louse Treatment of clothing or insecticides or dry cleaning, boiling
Patients Lindane Applied to whole body x 24 hours
Pubic lice Lindane or Pyrethroids . Shaving the area- Adjunct
- require retreatment after 10 days - Elimination

TICKS
General Characteristics
- Vertebrate, Blood sucking ectoparasites
- Opportunistics rather than host specific
- Have four-stage Life Cycle
- Eggs Larva Nymph Adult
- Larva, Nymph & adults Blood suckers
- Adults Usually bites humans
Families of Ticks
1. Ixodidae or Hard Ticks - Dorsal plate or Scutum, Mouth parts clearly visible
- Feeds slowly , taking 7-9 days to become engorged.
2. Argasidae or Soft Ticks - leathery body, lacks hard dorsal scutum, mouth parts located
ventrally , is not visible
- Completely engorge in a matter of minutes or most few hours

ology
ed and rural areas of the world
America Hard Ticks - Dermacentor variabilis * American Dog Tick
andersoni Rocky Mountain Wood tick
Amblyomma americanum Lone Star Tick
Rhipicephalus sanguinues - Brown Dog Tick
Ixodes dammini Deer Tick
- These are vectors of Several Infectious Diseases
RMSF
Dermacentor species
Tularemia
Q fever
Lyme Disease
Ixodes species
Babesiosis
Ehrlichiosis D.variabilis & A. americanum
Soft Ticks Genus Ornithodoros Relapsing Fever Borrelia species

l: People at risk Outdoor activities in wooded areas

- Stays in rural cabins inhabited by small rodents - serves as host for ticks & other ectop

manifestations
tes minor consequences erythematous papules
- Serious consequences Tick Paralysis - Substances released by ticks
- Transmission Rickettsial, Viral, Spirohetal, Protozoan dieases
ments Scalp, hairline, ears, axilla & groin
ite painless, latter become reddened, painful and pruritic
- 2nd infected wound , necrotic and if mouth part not removed

of Tick Paralysis
ndersoni
ariabilis
mericanum

RALYSIS - Due to toxic substances released in the saliva of ticks

- Common in young children Scalp, head and neck areas
- reversed by removal of ticks
estations :
ending Flaccid paralysis
er, intoxication
piratory compromise
th

Clinical and Laboratory Diagnosis

Rest on finding of a tick
History of exposure to tick-infested areas
Observation of Organism Morphology
- Dorsoventrally flattened, four pairs of legs , no visible
segmentation
Better to Consult Entomologist or Parasitologist for further identification
Treatment and Prevention
Early removal of attached tick important
- Steady traction on the tick body grasp by forceps close to the
skin as possible
- Avoid twisting or crushing the tick to avoid leaving the mouth
part
- Cleaning the area after removal of tick
- Use gloves, proper hand washing
- Proper disposal of ticks
Preventive Measures ( Tick Infested Areas )
- Protective clothing
- Insect repellants
-

FLEAS
- Siphonaptera small wingless insects
- Laterally compressed bodies
- Long legs adapted to jumping
- Mouth parts adapted for sucking or siphoning blood
- Does not penetrate the skin
Epidemiology
- Cosmopolitan in distribution
- Most species adapted to a particular host
- feed on humans when deprived of their preferred host
- Important Vectors of : 1. Plague
2. Murine Typhus
- Intermediate hosts for dogs ( Dipylidium caninum ) and Rodents Hymenolepis species
- Tunga penetrans or Chigoe flea actively invades the skin
- under the toenails and between the toes sucks blood
and lays eggs
- not known to transmit human pathogens
- Infected Tissues severely inflamed and ulcerated
- Complicated by Tetanus or Gas
gangrene Amputation

Clinical Manifestations:
Bites pruritic, erythematous lesions varying severity
- Intensity of infestation
- sensitivity of bitten person
- Irritation due to the fleas saliva
- Small red welts Diffuse red rash
- Secondary infection may occur
Clinical and Laboratory Diagnosis
- Patients with annoying bites and a pet (Dog or Cat ) owner
Treatment and Prevention
Antipruritics
Antihistamines
Surgical removal Chigoe flea is indicated
Topical repellants
Pets Flea collars or powders
Flea control Insecticides

MOSQUITOES

phology
mall delicate legs, 2 pairs of wings, long antennae, greatly elongated
outhparts adapted for piercing & sucking

cidae Family
Anophilanae Subfamily
Culicinae Subfamily

gs layed on or near water, good flyers , feed on nectars and sugars

males feed on blood every 2-4 days
Aedes aegypti Yellow fever Mosquito
- Required for each clutch of 100-200 eggs
- Flower pots, gutters, cans
demiology
nophilinae Anopheles
- Species responsible for transmitting malaria
- Tropics Bread continuaaly in relation to rainfall

linae Aedes
- Largest genus of the Family
- Habitat tropics to Arctic
- Tundra, marshes, pasture or flood water

MOSQUITOES

Clinical Syndromes
Mild pain and irritation Itching , swelling
Small flat wheal surrounded by a red flare
Treatment, prevention and Control
Medical attention- not sought
Antihistamines or Anesthetics
Window screens
Netting and protective clothings
Insect repellants

SPIDERS
CHELICERATA OR ARACHNIDA
- Eight legged, no antennae
- Body divided into:
1. Cephalothorax
2. Abdomen
True Spiders venomous & kill their prey by bitting
Chelicerae have fangs pierces human skin , inject venom powerful local irritation
Venomous Spiders Classification According to Effects or Tissue Damage Produced
1. Systemic Arachidism caused by Tarantulas ( Theraposidae ) large hairy spiders of Tropics &
Subtropics
- Not aggressive & avoid
human habitations
- Bite Intense pain
Agitation Stupor Smnolence
- Black Widow Spider Latrodectus mactans
- Mortality Rate 4-5%
2. Necrotic Arachidism Genus Loxosceles
- Loxosceles reclusa ( Brown recluse Spider )
- Severe Tissue Necrosis

Black Widow Spiders

- Globose shiny black abdomen with orange or redding hourglass markings
- Venom potent peripheral neurotoxin
Clinical Manifestations
Depends on
1. Amount of venom injeted
2. Location of the bite
3. Age, weight and sensitivity of the patient
Systemic Manifestation within an hour after bite. Subsides in 48 hours
- Muscular cramps
- Chest pain, nausea & vomiting
- Intestinal spams, diaphoresis
- Visual difficulties
- Boardlike abdomen mimics surgical abdomen
Treatment and prevention
Calcium gluconate
Specific Antivenin
Good house keeping

Brown Recluse Spider

Yellow to brown, medium in size
Relatively long legs
Dark-fiddled or Violin-shaped marking on the dorsal side of cephalothorax
Six eyed arranged in pairs forming semicircle
Necrotoxin Hemolytic properties Deep tissue damage
Clinical Manifestations
- Painless Later itching, swelling, soreness Bite site
- Blebs in 3-4 days Ulceration radiating Necrosis Does not heal Continuously
spreading
- Intravascular Coagulation Hemolysis Hemoglobinuria Cardiac and renal Failure
Visceral Loxoscelism
Clinical Diagnosis
Appearance of Bleb formation around puncture marks
Nature of developing lesions
Treatment and Prevention
Cleansing the bite wound
Antit-etanus prophylaxis
Systemic Steroids Hemolytic syndrome
Control Indwellings with insecticides

SCORPIONS
Elongated, conspicuous pincer-like claws ( Pedipalps)
4 pairs of walking legs, regimented abdomen tapers
Curved, hallow, needle-like stingers
- Stinger for defense
- Nocturnal , but invades shoes, towels, clothings and closets
Epidemiology
- U.S 1000 Deaths annually Genus Centruroides
- Latin America Tityus
Clinical manifestations:
Scorpion Sting Highly Variable
- Species and age of scorpion
- Kind and amount of venom injected
- Age, size and sensitivity of the person stunged
Two Types of Venom:
1. Neurotoxin Chills, diaphoresis, Excessive salivation, difficulty in speaking & Swallowing,
muscle spasm, tachycardia, generalized seizures
Death Pulmonary edema and Respiratory paralysis
2. Hemorrhagic or Hemolytic radiating & burning pain , swelling, discoloration and necrosis

Diagnosis
cal evidence of a single point of skin penetration sufficient

nt and Prevention
stemic manifestations Analgesics
- Local anesthetics Xylocaine
- Local Cryotherapy reduce swelling and retard systemic Absorption of toxin
n administration

FLIES
Blackflies
- Buffalo gnats
- Mouth parts with 6 blades- for tearing skin
- Blood sucking insects
- Vectors of Onchocerciasis
- Africa and South America
- Black fever headache, fever and adenitis
- Hemorrhagic Syndromes in Brazil
- Resembles Thrombocytopenia Purpura
- Local and Disseminated cutaneous hemorrahages with mucosal bleeding
- Either a Hypersensitivity phenomenon or response to toxin

BUGS
Bedbug and Triatomid Bugs or Known as Kissing bugs
Long proboscis folded ventrally when not in use]
Bed bugs Cimex lectularius
- Reddish brown insect, short wings and cannot fly
Triatomid bugs or Kissing bugs
- Yellow to orange markings on the body
- Elongated head
- have wings , are aerial
Epidemiology
Nocturnal , feed indiscriminately on mammals
Bedbugs cosmopolitan distribution
Triatomid limited to Americas
Clinical Manifestations
Both bites lesions are small red marks to hemorrhagic bullae
Bedbugs linear fashion trunk and arms
- May be associated with nervous disorders & sleeplessness in children
and adult.
Triatomid Higher frequency on the face
Romana Sign Classic Periorbital edema secondary to triatomid
bite

Clinical Diagnosis
- Pattern and location of the bites - Suggests Bedbugs or triatomids
- Bedbug Infestation Detection of tiny spots of blood on bedding and dead insects themselves
Treatment and Prevention
relief of Pruritus Topical palliatives
Antihistamines
Proper hygiene
Environmental control