1. Pest, Plagues & Politics Lecture 20 Medical Entomology

2. Key Points: Medical Entomology How did Yellow fever impact trade Why did Napoleon’s campaign to Russia fail How did Typhoid Mary impact US immigration laws? What is currently the most dangerous ARBOR disease globally

3. The mosquito - the most dangerous animal in the world Why?? As an ARBOR vector Yellow fever Typhus not this one West Nile Virus Malaria

4. MOSQUITOES Order = Diptera ( “ two wings) –Family = Culicidae 3,000 species worldwide 150 species in the U.S. Aquatic in their immature life stages Female mosquitoes require a blood meal for egg development Male mosquitoes do NOT feed on blood –nectar feeders

5. Larval & pupal stages are aquatic Mosquito Life Cycle Holometabolous Egg - larva - pupa - adult

6. Gary Larson ’ s view on mosquitoes

7. Plague impact: Yellow Fever Pathogen: –a virus Hosts: –monkeys & humans Vector: –a mosquito (Aedes aegypti et alia) Reservoir: –resistant monkeys in Africa Central America South America

8. Yellow Fever Today of historical significance –<400 cases a year worldwide Before the 20 th century a major problem –to North America via the slave trade –1647: 6,000 fatalities among Europeans (Barbados) –1741: 20,000 British soldiers dead of a force of 27,000 in South America –1802: 29,000 French soldiers dead of a force of 33,000 in Haiti an influence for the French to sell the Louisiana Territories to the U.S.

9. All because of a little biting fly Political impact

10. Yellow Fever & Trade Canals Yellow fever (& malaria) were major causes for the French to abandon both the Suez (1869) and Panama Canal projects The U.S. took both over & by “ defeating ” arbor disease we conquered both Big Ditches

11. Yellow Fever Yellow Fever and the Panama CanalYellow Fever and the Panama Canal –“ We have three diseases to contend with in building this canal; malaria - yellow fever and cold feet. ” Mr. Stephens - American CEO of the project.

12. Yellow Fever An urban problem in Colonial America and the U.S. for 200 years –e.g. 1879 - epidemic in over 100 population centers of eastern U.S. left 20,000 dead of the “ Black Vomit ” Aedes aegypti –Note: Aedes aegypti is somewhat of a coyote of the mosquito world and thrives in urban environments

14. Another “ Disease ” Another Vector

15. TYPHUS Also known as “ classic typhus, ” louse-borne typhus, “ war fever, ” & “ jail fever ” Pathogen –A bacteria –Rickettsia (R. prowazekii) Host –Homo sapiens Vector –the human body louse (Pediculus humanus humanus)

16. TYPHUS A disease normally expressed in times of war and mass movement of populations A disease expressed during times of the unwashed and unclean

17. TYPHUS Route of infectionRoute of infection –healthy louse bites an infected human –rickettsiae enter louse ’ s gut –rickettsiae penetrate the epithelial lining of the louse ’ s gut and reproduce –gut cells rupture and release rickettsiae into the lumen & ultimately into the feces –transmitted to the next human via the louse feces NOT via the bite or saliva of the louse.

18. Political impact: TYPHUS 420 BC: first recorded typhus epidemic in Athens 1566: Germans attacking the Ottoman Empire in Hungary - typhus breaks out among the Germans and they go home 1741: Austria cedes Prague to the French after 30,000 Austrian soldiers die from typhus 2 - 3 millionWWI: an estimated 2 - 3 million typhus caused deaths

19. Contributing factor as to why France failed to conquer Russia in the 19 th century.

20. Russian invasion during 1812-13

21. Typhus Risk Areas – High red, Low green

22. DDT saving lives during WWII Political impact: during WWII

23. Political impact: Typhoid Mary http://en.wikipedia.org/wiki/Typhoid_Mary

24. MALARIA: The most important global arbor disease Infecting ca. 300,000,000 persons (right now)Infecting ca. 300,000,000 persons (right now) –5% of the world ’ s population –a child dies every 30 seconds from malaria –an adult dies every 30 seconds from malaria –two million fatalities per annum –90% of all cases in sub-Saharan Africa

25. “ During the last 150 years, the Western world has virtually eliminated death due to infectious disease. Smallpox was eradicated, tuberculosis and polio were in decline and, WITH THE EXCEPTION OF MALARIA, so were all of the other major infectious health threats of the 20 th century. ” Levins, et al. 1994. American Scientist

26. MALARIA http://www.childinfo.org/malaria_progress.html

27. MALARIA http://blog.lib.umn.edu/mccl0222/gdes_4365w/2010/10/poverty-environmental-nahil-khalife.html

28. Mosquito Control Vector Control Basic reproduction rate of malaria How many female offspring will a mosquito produce m(a) = relative rate of a given mosquito population that will bite on a given day p = proportion of female mosquitoes surviving daily pn = proportion surviving with plasmodial parasite [Java: 1 infectious bite per week per human – areas of Africa where it is 1 infectious bite per day]

29. MALARIA Generally restricted to humid regions where the average temperature is >61°F.Generally restricted to humid regions where the average temperature is >61°F. –equals about 45% of the earth Continued global warming could result in 60% of the earth hosting malaria.Continued global warming could result in 60% of the earth hosting malaria.

30. MALARIA - the parasite Caused by a unicellular Plasmodial parasiteCaused by a unicellular Plasmodial parasite –Plasmodium falciparum - malignant or tertian malaria chills and fever every two dayschills and fever every two days –Plasmodium vivax - benign malaria –Plasmodium ovale - similar to P. vivax, but limited to a small geographical area –Plasmodium malariae - quartian malaria chills and fever every three dayschills and fever every three days

31. MALARIA - the parasite Plasmodia are parasites of human red blood cells Plasmodia are parasites of the gut epithelium in the vector (mosquito) The life cycle of this parasite is involved and complicated……very complicated.

32. Infected cells Selection for Sickle Cell alleles distribution: http://anthro.palomar.edu/synthetic/synt h_4.htm

33. Malaria bad airMalaria: from the Italian language for “ bad air ” 1897: Ronald Ross proves that mosquitoes are involved in the transmission of malaria 1899: The Italian team of Grassi, Bignami & Bastianelli prove that human malarial parasites are vectored by Anopheline mosquitoes.

34. Malarial Mosquitoes Over 100 species of mosquito are capable of vectoring malaria Most capable vectors are in the genus Anopheles

35. Malaria Control Disease control via anti-malarial drugs –drug resistance a big problem –“ Gin & Tonic Please ” Disease prevention via a vaccine –the hoped for “ magic bullet ” which, while not yet achieved, is continually sought Disease prevention via mosquito control –a very complex subject

36. Malaria Control Today Anti-malaria drugs (wide spread resistance) –Suppressives Quinine Mefloquine Malarone Chloroquine Doxycycline & Tetracycline (antibiotics) –Causals Primaquine (only one available in U.S.) Mosquito control

37. Problems with malaria today Loss of effective insecticides for mosquito control. –U.N. WHO receives an exemption for DDT in a proposed world wide ban Loss of effective anti-malarial drugs –resistance development Failure to develop an effective vaccine –and maybe things are changing in this arena

38. Ethical Issues Poverty and Malaria http://sspp.proquest.com/archives/vol2iss2/0512-022.pattanayak.html

39. Food for thought!! 1990 Data from the Wellcome Trust (world ’ s largest philanthropy)

40. Key Points: Medical Entomology How did Yellow fever impact trade Why did Napoleon’s campaign to Russia fail How did Typhoid Mary impact US immigration laws? What is currently the most dangerous ARBOR disease globally