Mohamed Ben Rashed

MBBCh, DCH, DTCH, Msc, PhD

Clinical Parasitology and Medical Entomology Department
Medical Faculty / Alatah !ni"ersity
Tripoli/#i$ya
First Edition
Preace
I am presenting this book , to become as a reference for medical students of third
class, the teaching members of this field and the busy physician, I have prepared this
synopsis in the hope that it will convey the correct , and modern information of
medical entomology . I exert my best efforts to collect and to add of the best benefit
from various modern books and references, most of it from the internet, to present this
book in a complete Image. Iam sorry for any incompletion or non clear of any part,
but certainly I will correct that in the coming edition. In intended more explaining in
some of the diseases such as Plaque, Scabies, Myiasis and others, because these are
the most important and dangerous diseases transmitted or caused by arthropoda which
can leads to high rate of morbidity and mortality in the community . I wrote this to be
an easy scientific reference to the student, that because I found many of them
suffering and asking of non availability of any specific comprehensive reference
covering their needs, also due to the expensive price of the references. nd the
contradictions of the teaching members on the priority of teaching, this happened in
the different medical faculties in the !amahirya.

Mohamed Ben Rashed
Ac%no&ledgments
cknowledgments to "enters for #isease "ontrol and Prevention ,
#ivision of Parasitic #iseases , for prevention to copy photographs.
I also acknowledge with gratitude the assistance received from $ #r%
&abile !abr, head of parasitology department ' Medical faculty' (anha
university) *gypt, for his effort to revise the book.
+he uther
Contents
Preace
Ac%no&ledgments
'ntroduction
Phylum Arthropoda
Features o Arthropods
(eneral arthropods morphology
The arthropoda and its &ays can aect our health
Class 'nsecta
)rder* Diptera +true lies,
Biting lies
Mosquitoes
Simulium:Black fly
Chrysops:Horse fly
Stomoxys calcitrans:Stable fly
Glossina: tsetse fly
Phlebotomus/Lutoomiay:San! fly
Culicoi!es: Mi!"es
-on.$iting lies
#ilth flies
Musca $etstissima:Bush fly
Musca !omestica: House fly
Myiasis
)rder* Dictyoptera
Cockroaches
)rder* Coleoptera
Beetles
)rder* Hymenoptera
%nts& Bees& 'asps
)rder* /iphonptera
#leas
Plaque
San!flea
)rder* Anoplura
Lice
)rder* Hemiptera
Cimici!ae:Be! bu"s
(riatominae:%ssassin bu"s
Class*Arachnides
)rder* Acarina or Acari
(icks
Mites
Scabies
)rder * Araneida
Spi!ers
)rder /corpionida
Scorpions
Class Myriapoda
)rder*Diplopoda*Millipedes
)rder* Chilopoda*Centipedes
Class Crustacea*Cyclopes
Phylum Pentastoma*#inguatula serrata
Terms and &ords meanings
Reerences
'ntroduction
+he discipline of medical entomology, or pu$lic health entomology, is focused
upon insects and arthropods that impact human health. It include the insects of
medical importance. n arthropod phylum is an invertebrate animal having an
exoskeleton ,external skeleton-, a segmented body, and .ointed appendages.
rthropods are members of the phylum Arthropoda ,from /reek arthron, 0.oint0,
and podos 0foot0, which together mean 0.ointed feet0. rthropods are characteri1ed by
their .ointed limbs and cuticles, which are mainly made of 2%chitin. +he rigid cuticle
inhibits growth, so arthropods replace it periodically by molting. +he arthropods
constitute an extremely diverse numbers of species .Most species are ectoparasites.
Some species are directly responsible for morbidity and mortality of their hosts. Many
arthropods serve additionally as intermediate hosts for helminth parasites, or vectors
for serious proto1oan, bacterial, or viral diseases.
-ote$ +he phylum rthropoda are divided into five classes. +he class Insecta and
rachnida include most of the parasitic species or vectors of disease. +he class
Myriapoda have only the poisonous millipedes and centipedes, the "rustacea class
contain few species that serve as intermediate host for animal parasites. +he
3nychophora class are not in.urious.
Features o Arthropods
*xoskeleton % a hard protective covering around the outside of the body
,divided by sutures into plates called sclerites-
Segmented body % that allows movement
!ointed limbs and .ointed mouthparts % that allow extensive specialisation
(ilateral symmetry % whereby a central line can divide the body into two
identical halves, left and right
4entral nerve chord % as opposed to a vertebrate nerve chord which is dorsal
#orsal blood vessel.
(eneral arthropods morphology
'nsects such as flies, wasps and cockroaches all have
5 body segments
6 legs
7 pair antennae
Arachnids include spiders, scorpions, ticks and mites. +hey all have
8 body segments % cephalothorax and abdomen
9 legs
no antennae
Head
+he insect head is a sclerotised capsule of mainly rigid sclerites. It houses the
compound eyes, simple eyes ,ocelli-, antennae and mouthparts.
"ompound eye.
In most insects there is one pair of large, prominent compound eyes. It is composed of
several units called ommatidia. +here may be up to 5:,::: ommatidia in a compound
eye. +his type of eye gives less resolution than the vertebrate eye, but it gives acute
perception of movement %important in flight.
Digesti"e system
+he digestive system is complete. +he mouth is surrounded with .ointed mouthparts
that gather ,possibly through piercing or biting- and manipulate food. +he gut is
usually divided into a foregut, midgut, and hindgut.
Circulatory system
+he circulatory system is open) blood is pumped by a heart and circulates through the
body cavity.
-er"ous system
+he nervous system is well developed, usually including eyes, antennae and other
sensory structures.
Reproducti"e system
+he male reproductive system consists of paired testes, each connected by vas
deferens to a seminal vesicle, and then uniting to form an e.aculatory duct that enters
a penis, which may have complex supporting structures associated with it. +he female
system consists of paired ovaries, each of which is connected by an oviduct to a
vagina. spermatheca is present. ccessory glands are present in both male and
female systems.
#ie cycles
#evelopmentally, arthropods proceed from an egg, through larval and'or nymphal
stages, to the adult.
-ote$ rthropods are usually ectoparasites, and may require 7 or more hosts to
complete their life cycle. Many species move freely from one host to another, but
others become attached permanently. Some species complete the entire life cycle on
the host, but others attach only to feed and mate.
Di"ersity
+here are over 7,:::,::: described species of arthropod) of course only a fraction are
parasites. Probably the greatest morphological diversity occurs among the
crustaceans. Some species look nearly identical to their free%living relatives except for
some minor adaptations for attachment) others are barely recogni1able as arthropods.
The arthropoda and its &ays can aect our health
-uisance
flies, ants etc
Pho$ia
Spiders, cockroaches etc
Biting, suc%ing
nts, bed bugs, ;orse flies, mosquitoes, sand flies, fleas
0enoms and allergies
<asps, ants, bees, spiders, ticks, dust mites
Disease, inestation
;ead, body and pubic lice, mites ,scabies-, Myiasis
Disease "ectors
+wo vector methods$
Mechanical % myxomatosis, bacteria by cockroaches and flies
Biological % requiring hosts in which the disease proliferates e.g. Malaria
,disease- in humans ,host- carried by mosquito ,vector-
Class 'nsecta
)rder Diptera +true lies,
+he true flies are one of the most important and popular insect orders comprising
more than 7::,::: described living species. Minute to medium si1e, rarely large
insects, usually with good flight abilities. ntennae variable, formed by two basal
segments and multi%segmented ,usually up to 8: flagellomeres- to one%segmented
flagellum bearing sensory style or arista in the latter case. Mouthparts licking or biting
. Pro% and metathoraces small, immovably fused with large mesothorax.
A. Bitting lies
Mos1uitoes
Mos1uito ,from the /panish or Portuguese meaning little ly- is a common insect.
Mosquitoes have mouthparts that are adapted for piercing the skin of plants and
animals. +here are about 5,=:: species of mosquitoes found throughout the world. In
some species of mosquito, the females feed on humans, and are therefore vectors for a
number of infectious diseases affecting millions of people per year. <hile males
typically feed on nectar and plant .uices, do not bite and therefore they do not transmit
disease. the female needs to obtain nutrients from a 0blood meal0 before she can
produce eggs.
-ote* +he mosquitoes of medical importance are divided into$
A.nopheline mosquitoes which contains the important genus %nopheles)
B. "ulicine mosquitoes which contain three important genera, %e!es& Culex, and
Man* sonia.
Morphology
'dentiying Features o the morphology
*ggs of some mosquitoes float on the water in rafts.
>arvae, often called wigglers, have a soft body, a hard head and a
breathing tube, or siphon, at the tip of the abdomen.
Pupae are shaped like a comma, and are commonly called tumblers.
dults have delicate legs, a long proboscis and one pair of transparent
wings.
+he mosquitoes have two wings, but unlike other flies, their wings have scales. +he
mouthparts of female mosquitoes form a long piercing%sucking proboscis which can
pierce skin and suck blood. Males differ from females by having feathery antennae
and mouthparts not suitable for piercing skin. ?emale mosquitoes are usually larger
than males. ?emales have fine thread like antennae with few hairs, whereas males
have bushy antennae.
Adult % >ength of the adult varies but is rarely greater than 76 mm ,:.6 in- and weight
up to 8.= mg ,:.:@ grain-. ll mosquitoes have slender bodies with three sections$
head, thorax and abdomen. Mosquitoes are long%legged insects with one pair of wings
5 to @ mm long. +he wings, legs, back ,thorax-, and abdomen are variously colored.
Mosquitoes can be distinguished from all other two%winged insects by the long beak
,pro$oscis-, which is used in feeding, and the scales on their wings. Male mosquitoes
have $ushy antennae and do not bite.

+he male on the left, females on the right. &ote the bushy antennae .

nopheles wing pattern showing pattern Aedes, showing distinctive white scales.
*gg % +he small, white cylindrical eggs taper at one or both ends and darken with age.
dult anophelus females lay =:%8:: eggs per oviposition. +he eggs are quite small
,A:.= x :.8 mm-.
#ar"a % Boung larvae are difficult to see because they are light colored or nearly
transparent and only about 5 mm long. Mature larvae, on the other hand, are usually
greenish%brown or brown and up to 7: mm long. +he head is distinct and usually dark
on all four instars. Cpon close inspection, most of these elongate larvae are quite
hairy. >arvae breathe through spiracles located on the eighth abdominal segment, or
through a siphon, and therefore must come to the surface frequently. +he larvae
spend most of their time feeding on algae, bacteria.
Pupa % Smaller than mature larvae, pupae are comma%shaped with a slender, curved
abdomen. +hey move through the water in a tumbling motion) hence, they are
commonly called 0tumblers.0 +he head and thora2 ar e merged into a cephalothora2
with the abdomen circling around underneath. s with the larvae, pupae must come to
the surface frequently to breathe,
The main dierences $et&een Anopheline and Culicine mos1uitoes are
Adult$ Anopheles mosquitoes can be distinguished from other mosquitoes by the
palps, which are as long as the proboscis, and by the presence of discrete blocks of
black and white scales on the wings. dult Anopheles can also be identified by their
typical resting position$ males and females rest with their abdomens sticking up in the
air rather than parallel to the surface on which they are resting.
Eggs$ *ggs of %nopheles and %e!es mosquitoes are laid singly, while those of Culex
mosquitoes are deposited in raft%like masses.
#ar"ae* nophelus mosquito larvae have a well%developed head with mouth brushes
used for feeding, a large thorax and a nine segmented abdomen. +hey donDt have legs.
In contrast to other mosquitoes, Anopheles larvae lack a respiratory siphon and for
this reason position themselves so that their body is parallel to the surface of the
water.
%e!es& %nopheles and Culex lar"ae3 n indication of the genera of mosquito larvae
can be made from the length of the siphon. Anopheles have very short siphons ,see
below also-, while Culex tend to have the longest siphons.

%e!es, Culex lar"ae and pupa3 (oth Aedes and Culex larvae hang down from the
water surface at an angle.
#ie cycle
Mosquitoes go through four stages in their life%cycle$ egg, lar"a, pupa, and adult or
imago. dult females lay their eggs in standing water, which can be a salt%marsh, a
lake, a puddle, a natural reservoir on a plant, or an artificial water container such as a
plastic bucket. ?or most species of mosquito, the life cycle from egg through the
larval stage to the adult takes about 7:%7@ days. ?or Mansonia species the life cycle
takes up to 5 weeks. +he lifespan of an adult mosquito is generally 5%@ weeks,
although it may be reduced in nature due to natural enemies.

-ote. ny water surfaces such as in the small pond, marsh or swampy area and even
water buckets are the breeding ground of mosquitoes.
Medical importance
%0iruses diseases transmitted $y mos1uitoes
Arthropod.$orne "iruses ,ar$o"iruses- are viruses that are maintained in nature
through biological transmission between susceptible vertebrate hosts by blood feeding
arthropods ,mos1uitoes and tic%s-. +he ma.ority of human infections are
asymptomatic or may result in a nonspecific flu%like syndrome. 3nset may be
insidious or sudden with fever, headache, myalgias, malaise and occasionally
prostration. Infection may, however, lead to encephalitis, with a fatal outcome or
permanent neurologic sequelae. ?ortunately, only a small proportion of infected
persons progress to frank encephalitis.
Chi%ungunya +he disease occurs through frica, India and Southeast sia, generally
from May to !uly. ,Aedes spp,3
Dengue 3ccurs in most tropical regions including Southeast sia, ustralia, "entral
merica, &orth merica, South merica, India and frica. ,Aedes spp-.
Eastern E1uine Encephalitis Infections occur mainly between May and ugust,
mostly in the CS and also "anada.,Aedes and Mansonia-.
4apanese Encephalitis Enown from southeast sia, "hina, !apan, India, Eorea and
was recently introduced into the +orres Strait Islands of far north ustralia. +Cule2
spp,3
/t #ouis Encephalitis)+he disease mainly occurs in the CS, peaking through the
months from !une to 3ctober.,Cule2 spp,3
0ene5uelan E1uine Encephalitis) 3ccurs in southern and "entral merica. ,"ulex
spp-.
6estern E1uine Encephalitis 3ccurs in the western areas of &orth merica and also
in South merica, generally midsummer. ,Cule2 spp,3
7ello& e"er8 +he disease occurs in tropical regions of frica, and central 'south
merica, peak incidence during rainy seasons3 ,Aedes spp-
Mayaro "irus) +he disease has been recorded from South merica and the <est
Indies and the virus has been recorded infecting humans in "entral merica.
*pidemics occur during and around the rainy season. +Cule2 spp,
Murray 0alley Encephalitis and 9un:in) Enown from ustralia and &ew /uinea
and generally occurs through the first four months of the year. +Cule2 spp,
);-yong.nyong "irus) 3nly known from frica and tends to be more common when
the vectors are in large numbers following seasonal rains. +Anophelus spp,
)ropouche Fe"er) 3ccurs through the rainy seasons of !anuary to !une mainly in
(ra1il. +Cule2 spp,
Rit 0alley Fe"er) 3utbreaks tend to follow heavy rains. 3nly occurs in frica.
+Aedes spp,
Rocio Encephalitis *pidemics peak from March to May. +he disease occurs in
southern (ra1il. +Cule2 and Aedes spp,
Ross Ri"er and Barmah Forest "irus) both produce a disease traditionally known as
0*pidemic Polyarthritis0. +he disease occurs in ustralia and mostly peaks in the first
three months of the year. 3utbreaks have occurred in the western Pacific Islands.
+Aedes and Cule2 spp,
/ind$is and )c%el$o "irus) 4ery widespread and occurs in most continents,
although disease from Sindbis is rare in ustralia. +Aedes spp,
6est -ile Fe"er). ctivity is mostly confined to the summer months and occurs in
frica, *urope, the Middle *ast and the former CSSF3+Cule2 and Aedes spp,
#a Crosse encephalitis Most cases of >"4 disease occur in the upper Midwestern
and mid%tlantic and southeastern states. +Aedes spp,
B. Parasitic diseases
Malaria) this disease results from infection with a proto1oan blood parasite
transmitted by various species of mosquitoes belonging to the genus Anopheles.
#ymphatic Filariasis) caused by nematode worms which block lymphatic vessels
and produce the condition known as 0*lephantiasis0 ,a gross swelling, usually in the
legs and scrotum-. transmitted by various species of mosquitoes belonging to the
genus Culex,Aedes, Mansonia.and nophelus transmit Malayan filariasis.
Blac% ly
$lac% ly ,sometimes called a $ualo gnat, tur%ey gnat, or &hite soc%s- is any
member of the family /imuliidae. It is small blackish stout%bodied biting fly having
aquatic larvae) sucks the blood of birds as well as humans and other mammals. +hey
spread several diseases. Simulium flies are found in forest or savannah regions along
the courses of free flowing well%oxygenated rivers and streams .
Morphology
dult black flies ,Simulium spp.- are small , measuring 7.=%@ mm in length with a
humpbacked appearance. +hey have short horn like antennae and short legs . +hey are
mostly black and white ,a few species are yellow or less commonly orange-. +he head
bears large compound eyes and short mouth%parts. In the female the mouth%parts are
adapted for tearing and piercing the skin.

Adult #ar"ae +top, . Pu$a +$ottom,
#ie cycle
+he eggs are laid on rocks .ust below the surface of flowing water or on vegetation
dipping into the water. +he larvae and pupae remain attached to rocks and dead
leaves, feeding on small organic particles filtered from the water. +here are six to nine
larval stages. (reeding is greatly increased in the rainy season.
Medical importance
+he black fly is central to the transmission of the parasitic nematode +nchocerca
$ol$ulus, which causes 3nchocerciasis, also known as ri"er $lindness3 (lack fly
attacks on people, cattle, horses and pigs tend to be concentrated around the ears and
head. In addition to the blood loss, effects of the insect saliva can cause a variety of
problems, with swelling and intense skin irritation most common. llergenic asthma,
nausea and more systemic effects can also occur, a condition known as 0$lac% ly
e"er <3 .
-ote$ dult black flies are migratory, commonly flying many miles from larval
breeding sites. s an extreme example, migrations of more than G: miles are reported
in "anada , this an important cause of control failure .
Chrysops lies +Horselies,
?amily Ta$anidae, are commonly called horse lies or deer lies. they are among the
worldDs largest true flies. +hey are known to be extremely noisy during flight. ?lies of
this type are among those known sometimes as gadlies, 5im$s or clegs3 In ustralia,
they are known as <March Flies<. In some areas of "anada, they are also known as
Bull Dog Flies. <orldwide distribution. live in the frican equatorial rain forest.
ttracted by smoke or human activity in forest .+he female feeds on blood and plant
.uices and the male on plant .uices only.

Morphology
Chrysops flies are medium to large ,6%5: mm-ntennae are small but
stout,Mouthparts adapted for biting,hang downwards from head , triangular head ,
broad wings.+he abdomen is yellow or orange and often patterned with black stripes
or other markings. +he abdomen, thorax, and legs are covered with small hairs.
#ie cycle
*ggs are laid on plants . +he larvae hatch and drop into the mud where they live for
several months, feeding on small organisms. fter growing and moult% ing they
pupate on drier ground. #evelopment takes several months.
Medical importance
+abanids known vectors for some (lood%borne diseases of animals and humans.
+abanids are very good vectors of the *quine Infectious naemia 4irus, as well as
some +rypanosome species. Species in the genus Chrysops are biological vectors of
Loa loa, transmitting this parasitic filarial worm between humans.+he western deer
fly ".discalis has transmitted tularemia to both man and animals. lso act as
mechanical carriers of bacteria and some proto1oa. +hey have also been known to
transmit nthrax among cattle and sheep. (lood loss is a common problem in some
animals, when large flies are abundant. Some animals have been known to lose up to
5:: ml of blood in a single day, which can severely weaken or even kill them .
/ta$le ly
Stomoxys calcitrans is commonly called the sta$le ly, $arn ly, $iting house
ly, dog ly, or po&er mo&er ly. It is an annoying pest of man and animals. It
is small oval, grayish fly resembles but it is larger slightly than the house fly,
distinguished by its bayonet Hshaped proboscis, robust appearance, dark color,
thorax with four dark longitudinal stripes. +he habit stable flies have of
leaving one animal to feed on another makes them ideal mechanical vectors of
disease . S.calcitrans is the mechanical vector of +rypanosoma evansi ,surra-
in cattle and horses

Adult /ta$le ly
(lossina +Tsetse, Flies
bout 85 species belong to this family of the diptera.divided into two main groups$
/a"annah group ,Morsitans- which are associated with rhodesiense
trypanosomiasis. Ri"erine group ,Palpalis-which are mainly the vector of
gam$iense trypanosomiasis. (oth the male and female tsetse flies suck blood. +hey
feed from humans, other mammals, and reptiles. Species of the palpalis group of flies
live in vegetation bordering rivers, lakes, and other water places, whereas tsetse flies
of the morsitans group prefer arid wooded savannah areas away from water.
Morphology
+setse flies are large yellow%brown or brown%black flies, measuring 6%7= mm in
length., widely spaced eyes, forward%pro.ected mouth parts and the wings show a
characteristic axe% shaped venation . +he thorax shows markings and in some species
the abdomen is striped and spotted.
#ie cycle
tsetse fly does not lay eggs but produces a single fully developed larva, which on
leaving the female, pupates in an area of shaded vegetation .ust below the surface of
the soil. +hen the adult emerges .
Medical importance
+setse flies transmit human african and animal trypanosomiasis ,sleeping sickness-.
/andlies
Sandfly is a colloquial name for any species or genus of flying, biting, blood%sucking
#ipteran encountered in sandy areas. re minute biting insects .+hey fly near to the
ground in short hop%like flights . Sand flies survive by sucking blood from humans
and animals. ?emales need blood to survive, whereas males do not need it and cannot
bite. Phlebotomus species are found in warm and hot climates, in dry desert%like
regions .>uto1myia species in humid forest areas.
Morphology
Sandflies are small, hairy, yellow or grey%coloured insects, measuiing 5%= mm in
length with long antennae, long weak legs and upward erected wings .

#ie cycle
fter blood meal, female lay 5:%=: elongated eggs in dark moist crevices. fter 6%78
days the eggs develops into segmented caterpillar like larva with long caudal bristles,
the larva molts four times befor become a buff coloured pupa . +he adult emerge from
the pupa in 6%7@ days.
Medical importance
Phle$otomus sandflies are vectors ,in old world- of$
I 4isceral leishmaniasis
I "utaneous leishmaniasis
I Sandfly fever
I 3roya fever ,"arrionJs disease-
#uto5omyia are vectors ,in new world- of$
I 4isceral leishmaniasis
I "utaneous leishmaniasis
I Mucocutaneous leishmaniasis
I Sandfly fever
I 3roya fever ,"arrionJs disease-
Midges +Culicoides -
Culicoi!es is a genus of biting midges. midges are minute insects, often called 0no.
see.ums0 because they are so small that they can pass through typical porch
screening. ;owever, despite their si1e, they can be painful biters and highly annoying.
Culicoides species live in swampy areas along the banks of rivers and pools, in mud
and sand soaked by sea water.+he female sucks blood. +he male feeds on plant .uices .
Morphology
"ulicoides flies are small, measuring less than 8 mm in length. +hey are dark
coloured with a humped thorax and small spotted wings. +he antennae are long and
the mouth%parts of the female are adapted for sucking blood .

(iting midges
#ie cycle
+wo to 5 days after a blood meal, females will lay their eggs in well lit, damp areas on
plants in the water or on mud containing large amounts of decaying organic material,
which favor larval development. +he eggs will hatch @9 to K8 hours later, the larvae
will go through four larval instars. <ithin 7: to 7@ days the larval instars are complete
and the larvae will become pupae) within 8 to 5 days adults will emerge from the
pupae.

Medical importance
Culicoides flies, also known as biting midges, transmit a wide range of both human
and veterinary diseases. less pathogenic filarial worms Mansonella perstans,
Mansonella streptocerca, and Mansonella ozzardi lso it transmit 3ropoche virus ,
(lue tongue virus and frican horse sickness viruses.
B. -on.Biting Flies
Filth lies
+hese flies are responsible for contamination and spoilage of foodstuffs, annoyance,
mechanical transmission of disease%causing pathogens, and invasion of living tissues
,myiasis-. "ollectively known as 0ilth lies0, they are distributed throughout the
families of "alliphoridae ,$lo& lies-, Sarcophagidae ,lesh lies- and Muscidae
,house lies-. ?lies can be strongly attracted to uncovered, malodorous wounds, body
openings, open sores or damaged skin. Some species will deposit their eggs or larvae
on the site if the circumstances are suitable. +his can result in myiasis, wherein young
maggots feed on healthy or diseased tissue to complete their growth cycle.
Bush ly0, Musca $etustissima. +his fly is a ma.or pest which breeds in manure in
pastures and disperses widely to surrounding rural and ad.oining urban environments
throughout the summer months. +hese flies are annoying, constant companions of
humans and livestock which they visit in large numbers, and attempt to feed at the
mouth, nose, eyes or wounds at every possible moment. Bushlies have been known
to transmit eye infections and other enteric diseases by their continual interchange
between other animals and humans.
Houselies +Musca domestica,
3ne of the commonest houseflies is Musca domestica which belongs to the family
Muscidae.
Morphology
M. domestica is about 9 mm in length, grayish black with four dark stripes on its
thorax and a variable amount of orange marking on its abdomen .+he antennae are
short and the proboscis is retractable.
#ie cycle
M. domestica lays its eggs in masses in manure and other decaying refuse. In warm
conditions larvae ,maggots- hatch within 8@ hours and pupate after about 5 days.
dults emerge after about 5 days and live for about 7 month.
Medical importance
Diseases which M) !omestica can transmit mechanically include$
I typhoid = $acillary dysentery = cholera= $rucellosis = tetanus = streptococcal
inections = amoe$ic dysentery = poliomyelitis, hepatitis,
and other "iral disease plus various parasites such as pin&orm and tape&orm)
however, in modern developed societies with high standards of hygiene, fly%borne
disease is relatively uncommon.
-ote$lthough M. domestica is a non%blood sucking, it is important medically
because it can ingest and transfer parasitic eggs and cysts, bacteria, and viruses from
infected faeces to human food. Pathogenic organisms are easily transmitted because
the feeding habits of the fly involve regurgitation of its crop contents and defaecation
while feeding.
Myiasis
Myiasis,In /reek, 0myia0 means fly- is the infestation of tissue with parasitic
dipterous fly larvae, feeding on the hostDs necrotic or living tissue. >arvae commonly
referred to as maggots. It is widespread in the tropics and subtropics of frica and
the mericas, and occurs with significantly less frequency in most other areas of the
world. Myiasis can come in all sorts of variations, depending on the fly species and
where the larvae are located. Some flies may lay eggs in open wounds, other larvae
may invade unbroken skin or enter the body through the nose or ears, and still others
may be swallowed if the eggs are deposited on the lips or on food. Myiasis may be
caused in human hosts by several species of arthropods of the order #iptera, the two%
winged true fly.
,ectors in humans
+here are three main fly families causing economically important myiasis in livestock
and also, occasionally, in humans$
"alliphoridae ,blowflies-
3estroidea ,botflies-
Sarcophagidae ,fleshflies-
3ther families occasionally involved are$
nisopodidae
Piophilidae
Stratiomyidae
Syrphidae

Dermatobia hominis ,(ot fly- ?rontal 'lateral view.
Classiication o Myiasis
Myiasis can be classified in two ways$
A%+he classical classification describes the myiasis by the infected area of the
host. #ermal, sub%dermal, cutaneous , nasopharyngeal , ocular , intestinal'enteric ,
or urogenital .
B%nother classification is based on the relationship between the host and the
parasite . +hus the myiasis is described as either speciic, semispeciic, or
accidental3 +his describes whether the fly larvae require a host for development
as the following.
>. )$ligatory +/peciic, Agents
(oth D. hominis and C. anthropophaga are obligatory parasites, whose larval stages
can occur only in the living tissue of animal or human hosts. Myiases caused by
larvae of the human botfly and the tumbu fly predominate, but several other species
that generally parasiti1e animals occasionally cause infections in humans as well.
3ther obligatory flies include the genera Oestrus, Rhinoestrus, asterophilus,
!ypoderma, Chrysomyia, and "ohl#ahrtia. +ransmission and the type of tissue
affected varies with the species of the parasite.

?. Facultati"e +/emi.speciic, Agents
?lies of the family Sarcophagidae normally develop in decomposing tissue and are
considered facultative parasites. >arvae of these flies parasiti1e wounds and other
damaged tissues, and some species further invade living tissues ad.acent to the
wound. Important genera in this category include Musca, Calliphora, and $ucilia.

@. Accidental +-on.speciic, Agents
ccidental myiasis occurs when egg%stage flies are ingested on contaminated food or
come in contact with the genitourinary tract. ?lies of the families Muscidae,
Calliphoridae, and Arcophagidae may be involved ,Powers and Borgensen-.

dult of Cochliomyia homino%orax, the primary screw worm fly in the &ew <orld.
Cochliomyia homino$orax is the primary screwworm fly in the &ew <orld. >arvae
are obligate parasites of living flesh in humans and other mammals. ;uman cases are
not common but may be seen in regions where livestock is tended. ?emale flies
oviposit on or near pre%existing wounds or on mucous membranes .ust inside the nose
or mouth. >arvae feed subdermally and may cause extensive tissue damage. ;uman
deaths have occurred from tissue destruction. ;uman cases have been drastically
reduced in the Cnited States and Mexico by a sterile male release program. ?emales
mate only once, so mating with a sterile male ensures the next generation will not
happen.
Clinical Presentation in Humans
;ow myiasis affects the human body depends on where the larvae are located. >arvae
may infect necrotic ,dead- or living tissue in various sites$ the skin, eyes, ears,
stomach and intestinal tract, or in genitourinary sites. +hey may invade open wounds
and lesions or unbroken skin. Some enter the body through the nose or ears. >arvae or
eggs can reach the stomach or intestines if they are swallowed with food and cause
gastric or intestinal myiasis.
Several different presentations of myiasis and their symptoms$
/yndrome /ymptoms
"utaneous Myiasis
Painful, slow%developing ulcers or furuncle% ,boil%- like sores that
can last for a prolonged period .
&asal Myiasis
3bstruction of nasal passages and severe irritation. In some cases
facial edema and fever can develop. #eath is not uncommon .
ural Myiasis
"rawling sensations and bu11ing noises. Smelly discharge is
sometimes present. If located in the middle ear, larvae may get to
the brain .
3phthalmomyiasis ?airly common, this causes severe irritation, edema, and pain .
?uruncular breast lesion with multiple sinuses containing +umbu fly larvae.
-ia"nosis
Myiasis is often misdiagnosed in the Cnited States because it is extremely rare and its
symptoms are not specific. Intestinal myiasis and urinary myiasis are especially
difficult to diagnose. "lues that myiasis may be present include recent travel to an
endemic area, one or more non%healing lesions on the skin, itchiness, movement under
the skin or pain, discharge from a central punctum ,tiny hole-, or a small, white
structure protruding from the lesion.
Treatment
?irst the larvae must be eliminated through pressure around the lesion and the use of
forceps. Secondly the wound must be cleaned and disinfected. ?urther control is
necessary to avoid further reinfestation.
>arvae removal by foreceps
-ote$ Fecent research overseas has revived the interest in the 0benefits0 of some
maggots and some medical units are now using 0clean0 maggots to aid in the
cleansing of decaying flesh of humans.
Pre"ention
+he prevention of myiasis is mainly by reducing the numbers of flies, by sanitary
measures, and the use of insecticides. It may also be necesary to use repellants,
screening, and protective clothing.
)rder Dictyoptera
Coc%roaches
+here are nearly @::: species of cockroach, distributed throughout most parts of the
world. >iving mainly in humid places, including human dwellings, caves and antsD
nests,Scavenge most organic matter.?amily (lattidae are important household pests
and may be mechanical vectors of pathogenic organism as well as intermediate hosts
of helminthic parasites.
Morphology
"ockroaches vary greatly in si1e from 5 mm to & cm in length. +hey have three pairs
of legs and most species have two pairs of wings . +he body is divided into$
clearly defined head which bears a pair of long antennae. thorax which has a
large pronotal area. large elongated abdomen.

#ie cycle
"ockroaches after mating the female lays an egg%case which contains 78 to @9 eggs
according to species. +he eggs hatch nymphal insects which look like adults except
they are much smaller and have no wings. +he nymphs become adults by passing
through as many as twelve moults and therefore may take as long as 79 months to
reach maturity.
Medical importance
+here is increasing evidence that cockroaches may act as mechanical carriers and
efficient reservoirs of pathogenic organisms. #omestic cockroaches
have been shown to harbour a wide variety of pathogens in their hindgut and on their
body surface, including$
I ma.or pathogenic entero$acteria
= polio"iruses
= hepatitis "iruses
. /ntamoeba histolytica
= se"eral nematodes3?
"ockroaches can transmit pathogens by walking over and defaecating on food or by
transmitting pathoges in vomit drops or from their legs and body surfaces.

)rder Coleoptera
Beetles
Many species are medically important such as >ytta vesicatoria ,Spanish fly- contain
blister fluid, from this beetle a substance obtained by beetles grounding known as
cantharidin , this substance cause irritation with erythema and vesicle formation
formation when come in contact with the skin.. this powder ,cantharidin- used as a
rubefacient, diuretic and aphrodisiac. ?lour (eetle larva and adult serve as
intermediate host of some helminthic disease such ;ymenolepiasis.
)rder Hymenoptera
Ants, Bees, 6asps
+he most familiar ;ymenoptera are the bees, wasps and ants) insects feared by many
people because of their stings3 ;owever, these make up only a small proportion of the
order.


Ant Bee 6asp
Hymenoptera is one of the largest orders of insects, comprising the wasps, bees, and
ants. +he name refers to the heavy wings of the insects, and is derived from the
ncient /reek ,hymen-$ membrane and ,pteron-$ wing. +he hindwings are connected
to the forewings by a series of hooks called hamuli.
Bee, 6asp /tings
;ymenoptera stings will only cause local pain and swelling. ;owever, some
individuals may be allergic to (ees and wasps stings cause, n allergic reaction to
;ymenoptera stings occurs once the victim becomes sensiti1ed to the venom from a
previous sting. +he allergic reaction is caused by the immune system, which has now
been oversensiti1ed to the venom and releases histamines into the bloodstream.
;istamines dilate blood capillaries, causing the skin to appear red and feel warm, and
also make the capillaries more permeable, which allows fluid to escape into the
tissues. +his causes swelling, which is manifested as rapidly appearing hives,
accompanied by severe itching. In a severe allergic reaction called anaphylactic
shock, the tissues of the throat swell and the victim may have difficulty breathing and,
unless promptly treated, death may result.
-ote$ (ee stings cause about 7K deaths per year in the CS.
/ymptoms o &asps and $ees stings
pain, redness, s&elling, and itching. produce immediate pain and a red, swollen,
sometimes itchy area about ,7 cm- across. In some people, the area swells to a
diameter of = cm or more over the next 8 or 5 days. +his swelling is sometimes
mistaken for infection, which is unusual after bee stings. llergic reactions may cause
rash, itching all over, whee1ing, trouble breathing, and shock. llergic reactions are
uncommon but may be serious.
Treatment
bee may leave its stinger in the skin. +he stinger should be removed as quickly as
possible by scraping with a thin dull edge ,for example, the edge of a credit card or a
thin table knife-. n ice cube placed over the sting reduces the pain. cream or
ointment containing an antihistamine, an anesthetic, a corticosteroid, or a combination
of them is often useful. Severe allergic reactions are treated in the hospital with
epinephrine, intravenous fluids, and other drugs. People who have had a severe
allergic reaction to a bee sting sometimes undergo desensiti1ation ,allergen
immunotherapy Lsee llergic Feactions
Ant sting
+he stinging ants cause little in.ury, but the small fire ant of the genus Solenopis,
which is found in southern united states, cause a fiery sting and pruritic vesicles.+he
ire ant sting usually produces immediate pain and a red, swollen area, which
disappears within @= minutes. blister then forms, rupturing in 8 to 5 days, and the
area often becomes infected. In some cases, a red, swollen, itchy patch develops
instead of a blister. Isolated nerves may become inflamed, and sei1ures may occur.

0esicles caused $y +Fire Ant /ting,
)rder* /iphonptera/ siphon A tu$e8 aptera A &ingless
Flea
Small insects generally living as ectoparasites of mammals and birds. ?leas transmit
various pathogens, including tapeworm and bubonic plague. (oth males and females
feed exclusively on blood and may live up to 78 months.
Morphology
?leas are small ,7 to 6 mm- long , agile, usually dark colored ,for example, the
reddish%brown of the cat flea-, wingless insects with tube%like mouth%parts adapted to
feeding on the blood of their hosts. +heir legs are long, the hind pair well adapted for
.umping$ a flea can .ump vertically up to K inches ,79 cm- and hori1ontally up to
75 inches ,55 cm-. and easily recogni1ed because they are greatly flattened laterally.
+he body is covered with backward pointing spines which give easy forward
movement in the fur of animals. +he thorax, as in all insects, is divided into 5
segments, and the abdomen has 7:% 78 segments. +he presence or absence of genal
and pronotal combs is used in the identification of fleas. +he larvae are elongated and
worm%like, Mature larvae are @H7: mm long.
#ie cycle
?leas are holometabolous insects, going through the four life cycle stages of egg,
larva, pupa, and imago ,adult-. +he larva , which hatches from a :.5H:.=%mm%si1ed
egg , has no eyes and reaches a length of @H7: mm when fully grown. +here are
usually three larval instars, but only two in Tunga penetrans. >arvae feed on
organic debris and on undigested blood from the feces of adults. +he differentiated
third%stage larva constructs a loosely woven cocoon ,5 M 7 mm- which may become
encrusted by sand . Inside, the flea pupates , and remains quiescent until it emerges as
an adult ,females emerge 5H@ days before the males-.
Medical importance
Flea $ites
?lea bites are most common on areas of the body with tight clothing, especially the lower
legs N around the waist. +he itching of flea bites is caused by an allergic reaction.
Sensitivity to flea bites varies between people) children often have especially severe
reactions. In sensitive people, the bite is often surrounded by a 0halo0 of red, irritated
skin..
?lea bites
(esides the problems posed by the creature itself, fleas can also act as a vector for
disease. ?leas transmit not only a variety of viral, bacterial and rickettsial diseases to
humans and other animals, but also proto1oans and helminths.
bacteria$ Murine or endemic typhus. ?leas have helped cause epidemics by
transmitting diseases such as the bubonic plague between rodents and humans by
carrying 'ersinia pestis bacteria. ?leas can transmit 'ersinia pestis, Ric(ettsia
typhi, Ric(ettsia #elis, and )artonella henselae.
virus$ myxomatosis.
helminth$ infestation of !ymenolepiasis tapeworm.
proto1oa$ +rypanosome proto1oans such as those of the subgenus !erpetosoma,
use a variety of flea species opportunistically as vectors.
Main fleas of medical importance are especially the tropical rat flea 0enopsylla
cheopis, the sand flea (un"a penetrans, the cosmopolitan human flea Pulex irritans
B all possessing no combs H and the cat flea Ctenocephali!es felis3 +he incidence of
the ma.or transmitted disease, plague, has decreased markedly during the last 9:
years. Since the rodent hosts cannot be eradicated, outbreaks of plague will regularly
occur in many parts of the world, e.g. India and Fussia,
Pule2 species
Pule2 irritans is known as the human flea. dults are 7%@ mm in length and
laterally%compressed. +hey lack both genal and pronotal combs and the ocular setae
are below the eye. +his species is not an efficient vector of any flea%borne diseases,
but its bite can cause allergic reactions due to salivary proteins.
p. irritans is the human flea and has a worldwide distribution. (y its frequent and
prolonged feeding on the blood of its host, it causes discomfort and irritation.
Ctenocephalides species +leas o cats and dogs,
+he cat flea is the most common ectoparasite of both dogs and cats in the Cnited
States and has been found on over a do1en other animals, have both genal and
pronotal combs ,ctenidia-, differentiating them from most other fleas of domestic
animals. .+hese fleas are medically important because they serve as hosts for the
tapeworms D3 caninum, H3 diminuta, and H3 nana . <hen ingested by flea larvae,
the eggs develop into the infective cysticercoid larval forms. ;umans become infected
by accidently swallowing a flea which contains these cysticercoid larvae. +he cat
fleas, "tenocephalides felis felis and ". f. orientis can also cause intense allergic
reactions in humans.

Cat lea* eggs #ar"a Adult
Adult cat lea
Tunga species
T3 penetrans, also known as the :igger lea, or chigoe, and $icho do pC or sand lea
can be found in South merica, frica, and India. +he head is angular, it has no comb
of spines, and the thoracic segments are narrow at the top.+he female feeds by
burrowing into the skin of its host. +he abdomen becomes enormously enlarged
between the second and third segments so that the flea forms a round sac with the
shape and si1e of a pea. It is the female .igger flea which is medically important
because it requires an endoparasitic existence for egg development. +he pregnant
female burrows into the skin of its host, often around the toes, fingers, or other parts
of the body. +he greatly enlarged flea. Produces an irritating and often painful
swelling .ust under the skin. 3ver a period of several days the eggs are discharged
through the skin, after which the female dies. Irritation causes tissue damage which
may lead to secondary bacterial infection. "ontrol of tungiasis is difficult. In endemic
areas, preventive measures include the wearing of shoes and the use of insecticides.

+he impregnated female *unga embeds itself in the skin under the toe nails and finger nails
where the resultant sores may fill with pus and become infected .
0enopsylla species

0enopsylla cheopis is known as the )riental rat lea and is the primary vector for
'ersinia pestis ,plague-. dults are 7.=%@ mm long and laterally%compressed. +hey
lack both pronotal and genal combs ,ctenidia-.
-ote$ In the genus +enopsylla, the rat fleas O. cheopis, O. astia, and O. brasiliensis
are medically important species because they are carriers of$
I (ubonic plague
I ?lea%borne murine typhus ,endemic typhus-
O. brasiliensis occurs in frica, South merica, and India, infesting rats mostly in
villages and also in ports.
O. astia is found in South *ast sia and Indonesia. It naturally infests rats in fields,
villages, and ports. 3ther rat fleas which can carry plague and can live on humans
include O. %exabilis, found in the Pacific Islands and infesting rats mainly in fields,
and the rat flea ,osopsyllus #asciatus which has a worldwide distribution and is found
mainly in the ports of cool temperate countries.
Plague
If the fleas suck blood of a plague%infected host, the causative agent 1ersinia pestis is
transmitted and multiplies in the lumen of the gut, especially in the foregut, initially
resulting in a plug of bacteria which later is partly reduced. +he blockage is stronger
in the more virulent strains of bacteria which adhere stronger to each other. ?rom the
foregut or contaminated mouth parts the bacterium is transmitted to the vertebrate
host. 'ersinia pestis is pathogenic to fleas due to the blockage of the proventriculus by
a plug. Since only reduced volumes of blood can be ingested, infected fleas attack
hosts more often. Plague is an infectious disease that affects animals and humans. It is
caused by the bacterium Bersinia pestis. +his bacterium is found in rodents and their
fleas and occurs in many areas of the world, including the Cnited States.
Bu$onic plague is the most common form of plague. +his occurs when an infected
flea bites a person or when materials contaminated with B. pestis enter through a
break in a personDs skin. Patients develop swollen, tender lymph glands ,called
buboes- and fever, headache, chills, and weakness. (ubonic plague does not spread
from person to person.
-ote* (ubonic plague was a ma.or factor stopping &apoleonDs invasion of
Palestine and Syria in 7KGG.
Pneumonic plague occurs when '. pestis infects the lungs ,it may occur separately or
in combination. +his type of plague can spread from person to person through the
air.+ransmission can take place if someone breathes in aerosoli1ed bacteria, which
could happen in a bioterrorist attack. Pneumonic plague is also spread by breathing in
'. pestis suspended in respiratory droplets from a person ,or animal- with pneumonic
plague. (ecoming infected in this way usually requires direct and close contact with
the ill person or animal. Pneumonic plague may also occur if a person with bubonic or
septicemic plague is untreated and the bacteria spread to the lungs. +he first signs of
illness are fever, headache, weakness, and rapidly developing pneumonia with
shortness of breath, chest pain, cough, and sometimes bloody or watery sputum. +he
pneumonia progresses for 8 to @ days and may cause respiratory failure and shock.
<ithout early treatment, patients may die.
/epticemic plague occurs when plague bacteria multiply in the blood. It can be a
complication of pneumonic or bubonic plague or it can occur by itself. <hen it occurs
alone, it is caused in the same ways as bubonic plague) however, buboes do not
develop. Patients have fever, chills, prostration, abdominal pain, shock, and bleeding
into skin and other organs. Septicemic plague does not spread from person to person.
'mportant 1uestions *A* 6hat should someone do i they suspect they or
others ha"e $een e2posed to plagueD
/et immediate medical attention$ +o prevent illness, a person who has been exposed
to pneumonic plague must receive antibiotic treatment without delay. If an exposed
person becomes ill, antibiotics must be administered within 8@ hours of their first
symptoms to reduce the risk of death. &otify authorities$ Immediately notify local or
state health departments so they can begin to investigate and control the problem right
away. B* Ho& can the general pu$lic reduce the ris% o getting pneumonic plague
rom another person or gi"ing it to someone elseD
If possible, avoid close contact with other people. People having direct and close
contact with someone with pneumonic plague should wear tightly fitting disposable
surgical masks. If surgical masks are not available, even makeshift face coverings
made of layers of cloth may be helpful in an emergency. People who have been
exposed to a contagious person can be protected from developing plague by receiving
prompt antibiotic treatment.C*Ho& long can plague $acteria e2ist in the
en"ironmentDBersinia pestis is easily destroyed by sunlight and drying. *ven so,
when released into air, the bacterium will survive for up to one hour, depending on
conditions.D*'s a "accine a"aila$le to pre"ent pneumonic plagueD"urrently, no
plague vaccine is available in the Cnited States. Fesearch is in progress, but we are
not likely to have vaccines for several years or more.E* 6hat happen &hen the rats
are %illed $y plagueD +he fleas leave the rats and can become parasitic on humans.
-ote$ Infection with plague or typhus occurs by the infected faeces or contents of a
crushed flea entering the skin which has become damaged by scratching.
plague diagnosis
+he first step is evaluation by a health worker. If the health worker suspects
pneumonic plague, samples of the patientJs blood, sputum, or lymph node aspirate are
sent to a laboratory for testing.
Treatment
s soon as a diagnosis of suspected plague is made, the patient should be isolated, and
local and state health departments should be notified. #rug therapy should begin as
soon as possible after the laboratory specimens are taken. +he drugs of choice are
streptomycin or gentamycin. +hose individuals closely associated with the patient,
particularly in cases with pneumonia, should be traced, identified.
Pre"ention
ttempts to eliminate wild rodent plague are costly and futile. +herefore, primary
preventive measures are directed toward reducing the threat of infection in humans in
high risk areas through three techniques %% environmental management, public health
education, and preventive drug therapy.
En"ironmental Management
*pidemic plague is best prevented by controlling rat populations in both urban and
rural areas. +his goal has been reached in the cities, towns, and villages of most
developed countries. It has not been achieved in either the rural or urban areas of
many developing countries where the threat of epidemic plague continues to exist.
"ontrol of plague in such situations requires two things$ 7- close surveillance for
human plague cases, and for plague in rodents, and 8- the use of an effective
insecticide to control rodent fleas when human plague cases and rodent outbreaks
occur. <earing a close%fitting surgical mask also protects against pneumonic plaque
infection.
Pre"enti"e Drug Therapy
ntibiotics may be taken in the event of exposure to the bites of wild rodent fleas
during an outbreak or to the tissues or fluids of a plague%infected animal. ?or
preventive drug therapy, the preferred antibiotics are the tetracyclines,
chloramphenicol, or one of the effective sulfonamides.
/and lea
sand flea is also known by many other names. also called a beach flea, hop%a%long,
no%see%um, biting midge, and punkie or punky. +he sand flea is less than 7'9 of an
inch ,5 mm- long and is often difficult to see. It is a shrimp%like creature in
appearance and ranges in color from pale to brownish. +he body has seven segments
and it has long legs that are used for swimming or .umping. +hey are known to .ump
to a height of at least @: cm and therefore, it is unusual to experience a sand flea bite
on upper body parts unless the victim was lying down. +he bites are normally found
in clusters around the ankles.
)rder Anoplura . /uc%ing #ice
#ice ,singular$ louse- is the common name for over 5::: species of wingless insects
of the order Phthiraptera) three of which are classified as human disease agents.
;umans host three different kinds of lice$ head lice, body lice , and pubic lice. >ice 3
(oth sexes feed on blood. >ice are affected by temperature changes with a fever or
death of their host causing them to seek a new host.
Morphology
+hey have a leathery surface and are flattened from above ,dorsoventrally-. +he body
is divided into$ head, which is small and bears a pair of short antennae, small eyes,
and mouth%parts adapted for sucking. thorax without wings. +he 5 pairs of legs are
well% developed and terminate in single hooklike clawfor gripping.+he last abdominal
segment in the female bears a median dorsal genital opening and two lateral blunt
gonopods, which clasp the hairs during oviposition.

The lie cycle +he eggs are laid on hair or clothing and fixed firmly to the host or to
clothing by a glue%like substance secreted around the eggs by the female. +he egg
hatches to release a nymph. +he nymph mature after three molts and become adults
about K days after hatching. #evelopment takes 8%5 weeks.
+he three medically important lice are$
Pediculus humanus capitis +head louse,3
Pediculus humanus corporis +body louse, clothes louse-
Pthirus pu$is +crab louse, pubic louse,3
A. Head lice
Pediculus humanus capitis$ ;ead lice infest the head and neck and attach their eggs
to the base of the hair shaft. >ice move by crawling, they cannot hop or fly. ;ead lice
are spread by close person%to%person contact. #ogs, cats, and other pets do not play
role in the transmission of human lice. dult head lice are 8.7%5.5 mm in length. has 6
legs ,each with claws-, and is tan to grayish%white. ?emales are usually larger than
males and can lay up to 9 nits per day. dult lice can live up to 5: days on a personJs
head. +he head louse is an ectoparasite whose only host are humans. +he louse feeds
on blood several times daily and resides close to the scalp to maintain its body
temperature. Infestation with head lice is most common among preschool% and
elementary school%age children and their household members and caretakers. ;ead
lice are not known to transmit disease) however, secondary bacterial infection of the
skin resulting from scratching can occur with any lice infestation.
Life cycle
+he life cycle of the head louse has three stages$ egg, nymph, and adult.
Eggs* &its are head lice eggs. +hey are hard to see and are often confused for
dandruff or hair spray droplets +hey are :.9 mm by :.5 mm, oval and usually yellow
to white. &its take about 7 week to hatch ,range 6 to G days-. -ymphs$ +he egg
hatches to release a nymph. +he nymph looks like an adult head louse, but is about the
si1e of a pinhead. &ymphs mature after three molts and become adults about K days
after hatching.


, Pediculus humanus capitis
Mode o spread
/etting head lice is not related to cleanliness of the person or their environment..;ead
lice are spread by direct contact with the hair of an infested person. Such contact can
be common among children during play at
school,home, and elsewhere ,e.g., sports activities, playgrounds, camp, and
slumber parties-. Cncommonly, transmission may occur by$
wearing clothing, such as hats, scarves, coats, sports uniforms, or hair ribbons
worn by an infested person)
using infested combs, brushes or towels) or laying on a bed, couch, pillow,
carpet, or stuffed animal that has recently been in contact with an infested
person.
Medical importance
;ead lice are not known to transmit any disease and therefore are not considered a
health ha1ard. Pediculosis capitis ,also known as Head lice inestation and Cooties-
is a human medical condition caused by the coloni1ation of the hair and skin by the
parasitic insect -ediculus humanus capitisLthe head louse. ;ead lice infestations can
be asymptomatic, particularly with a first infestation or when an infestation is light.
Itching ,PpruritusQ- is the most common symptom of head lice infestation and is
caused by an allergic reaction to louse bites. It may take @%6 weeks for itching to
appear the first time a person has head lice. sores on the head caused by scratching.
+hese sores caused by scratching can sometimes become infected with bacteria
normally found on a personJs skin.
;ead lice bites on the nape of the neck
Diagnosis * "lose examination of the hair and scalp is necessary to determine head
lice infestation
.
dult male ,left- and female ,right- head lice
;ead louse nits on human hair
-ote $Misdiagnosis of head lice infestation is common with dandruf. +he diagnosis
of head lice infestation is best made by finding a live nymph or adult louse on the
scalp or hair of a person.
Treatment
+reatment for head lice is recommended for persons diagnosed with an active
infestation. ll household members and other close contacts should be checked.
Fetreatment of head lice usually is recommended because no approved pediculicide is
completely ovicidal. +o be most effective, retreatment should occur after all eggs
have hatched but before new eggs are produced.
Pre"ention
+he following are steps that can be taken to help prevent and control the spread of
head lice$ void the mode or the ways of transmission ,see above-
B.Body lice
dult body louse similar to head louse in shape and nearly the same si1e it is 8.5%5.6
mm in length. (ody lice live and lay eggs on clothing and only move to the skin to
feed. (ody lice infestations ,Pediculosis- are spread most commonly by close person%
to%person contact but is generally limited to persons who live under conditions of
crowding and poor hygiene ,e.g homeless, refugees , victims of war or natural
disasters etc-. Improved hygiene and access to regular changes of clean clothes is the
only treatment needed for body lice infestations.
#ie cycle* Similar to P.capitis life cycle
Medical importance3
-ote$ 3nly the body louse is known to spread disease.
Pediculus species transmit$
I Relapsing +louse.$orne, e"er Trench e"er$ caused by Borrelia recurrentis.
Infection occurs when the borreliae enter damaged skin following the crushing of an
infected -ediculus body louse. +he organisms live in the blood of the louse and are
not passed in the faeces.

I Epidemic +louse.$orne, typhus $ caused by rickettsial organisms, which are found
in the faeces of the louse. Infection occurs when infected louse faeces are deposited
on the skin during or after feeding. Irriration causes the organisms to be rubbed in.
0aga$ondEs disease
<hen body lice infestation is long lasting, heavily bitten areas of the skin can become
thickened and darkened, particularly in the mid%section of the body. +his condition is
called vagabonds disease. Intense itching ,PpruritusQ- and rash caused by an allergic
reaction to louse bites are common symptoms of body lice infestation. s with other
lice infestations, intense itching leads to scratching which can cause sores and
secondary bacterial infection of the skin.
Diagnosis
(ody lice infestation is diagnosed by finding eggs and crawling lice in the seams of
clothing. Sometimes a body louse can be seen crawling or feeding on the skin.
Treatment
body lice infestation is treated by improving the personal hygiene of the infested
person, including assuring a regular ,at least weekly- change of clean clothes.
"lothing, bedding, and towels used by the infested person should be laundered using
hot water ,at least 75:R?- and machine dried using the hot cycle.
Pre"ention
(athe regularly and change into properly laundered clothes at least once a week)
launder infested clothing at least once a week.
Phthirus species
C. Pu$ic +Cra$ , #ice
Cra$ lice ,also known as 0cra$s,0 Phthirus pubis, Pthirus pubis, and 0pu$ic lice are
parasitic insects notorious for infesting human genitals. +he species may also live on
other areas with hair, including the eyelashes. +hey feed exclusively on blood.
;umans are the only known hosts of this parasite. P) pubis lives in the hair of the
pubic region, axillae, and other parts, but not on the head. Its bite causes irritation and
discomfort. Pubic lice infestations ,pthiriasis- are usually spread through sexual
contact. >ice infestations is found worldwide and occurs in all races and ethnic groups
and in all levels of society .
Morphology
Pubic lice are short and crab% like and appear very different from head and body lice.
dult pubic lice are 7.7%7.9 mm in length typically are found attached by strong
clawes to hair in the pubic area but sometimes are found on coarse hair elsewhere on
the body ,e.g% eyebrows, eyelashes, beard, mustache, chest, armpits, etc-.
. Pubic >ouse % -hthirus pubis
Disease
Pubic ,PcrabQ- lice are not %no&n to transmit any disease. Itching ,PpruritusQ- in the
pubic and groin area is the most common symptom of pubic lice infestation. s with
other lice infestations, intense itching leads to scratching which can cause sores and
secondary bacterial infection of the skin.

Pubic lice in genital area Pubic lice on eyelashes
-ote* Persons infested with pubic lice should be evaluated for other sexually
transmitted diseases ,S+#s-.
Diagnosis
Pubic lice infestation is diagnosed by finding a PcrabQ louse or eggs on hair in the
pubic region or, less commonly, elsewhere on the body ,eyebrows, eyelashes, beard,
mustache, armpit, perianal area, groin, trunk, scalp-.
Treatment
7. <ash the infested area) towel dry.
8. >eave medication on hair for the time recommended in the instructions. fter
waiting the recommended time, remove the medication by following carefully
the instructions on the label or in the box.
5. ?ollowing treatment, most nits will still be attached to hair shafts. &its may be
removed with fingernails or by using a fine%toothed comb.
@. Put on clean underwear and clothing after treatment
=. Persons should avoid sexual contact with their sex partner,s- until both they and
their partners have been successfully treated and reevaluated to rule out
persistent infestation.
6. Fepeat treatment in G%7: days if live lice are still found.
-ote$Persons with pubic lice should be evaluated for other sexually transmitted diseases
,S+#s-. ll sex partners from within the previous month should be informed that
they are at risk for infestation and should be treated.
Pre"ention
Pubic ,PcrabQ- lice most commonly are spread directly from person to person by
sexual contact. Pubic lice very rarely may be spread by clothing, bedding, or a
toilet seat. void the mode of transmission ,see above-.
)rder Hemiptera B True Bugs
+rue bugs adults are identified by the O%shaped pattern on their wings and by their
piercing sucking mouth. +he O%shaped pattern is due to the fore wings in which the
anterior half is thickened and the posterior half is membranous. +his is called the
hemelytron
Bugs
There are t&o medically important amilies o $ugs *
Cimicidae
Triatominae
Cimicidae $ugs
+he "imicidae family of bugs includes the bedbugs$
Cimex lectularius
Cimex rotun!atus)
Bed$ugs +Cime2,
Sometimes referred to as 0red coats,0 0chinches,0 or 0mahogany flats0, bed bugs, are
blood feeding parasites of humans, chickens, bats and occasionally domesticated
animals . Bed$ugs are small parasitic insects of the family "imicidae ,most
commonly Cimex lectularius-. >ive in the cracks of walls, floors, and wood%work and
in the furniture of human dwellings. +hey emerge at night in search of hosts from
which to feed. +he bugs suck blood from humans and other warm%blooded animals.
(edbugs are found worldwide .
Morphology
dult bedbugs are reddish%brown, flattened, oval, and wingless. (edbugs have
microscopic hairs that give them a banded appearance. dults grow to @H= mm in
length and 7.=H5 mm wide. &ewly hatched nymphs are translucent, lighter in color
and become browner as they moult and reach maturity.

"imex lectularius
dult bed bug, Cimex lectularius >innaeus, feeding
#ie cycle
+hey lay their eggs in dark cracks and it takes several weeks for the nymphs to
emerge and develop into mature bugs.
Medical importance
(ed bugs are suspected carriers of leprosy, oriental sore, S%fever, and brucellosis but
have never been implicated in the spread of disease to humans .lthough there is no
direct evidence that Cimex bugs are carriers of human disease, their bites are irritating
and the bugs may become infected with bacteria and viruses. Hepatitis B has been
reported in bedbugs from <est frica, *thiopia, South merica, and elsewhere and
there is growing evidence that bedbugs can transmit hepatitis.+he bites can also cause
an allergic reaction in some people.
-ote* +he first sign of bedbugs may be red, itchy bites on the skin, usually on the
arms or shoulders. (edbugs tend to leave straight rows of bites, unlike some other
insects that leave bites here and there.
-ote$ chronic blood sucking cause iron deficiency anaemia.
Straight rows of bugs bites
Pre"ention
Femove debris, such as wood and paper trash piles, where these bugs may hide.
Triatominae
+he members of Triatominae, a family of Feduviidae, are also known as conenose
$ugs, %issing $ugs ,because they often bite around the mouth- , assassin $ugs or
triatomines. Most of the 75: or more species of this subfamily are haematophagous,
,feed on vertebrate blood-) a very few species feed on other invertebrates . +hey are
mainly found and widespread in the mericas, with a few species present in sia,
frica and ustralia. +riatomine bugs feed from humans mainly at night. +hey bite
mainly on the face around the mouth and eyes. +riatomine bugs also feed on many
wild and domestic animals. +he bugs invade houses by flight, often attracted to light.
+hey can also enter human dwellings when the leaves of trees in which bugs are
living are used for roofing. +he bugs coloni1e badly made mud houses, living in the
cracks of floors and walls.
Morphology
Feduviid bugs measure up to 5= mm in length, are dark coloured, and may show red
and yellow banding . winged with a body which is basically divided into$ head
which is long and bears a pair of slender antennae, large eyes, and a proboscis
containing mouth%parts adapted for biting and sucking. thorax with two pairs of
wings. n abdomen which is large and oval.
dorsal view of the Pkissing bug
#ie cycle
+riatomine bug involves five nymphal stages, each stage requiring a blood meal for
its development. +he wings are formed during the last two stages. dults are long
lived and can survive for several weeks without a blood meal.
nymphs and adult +riatomine bugs
Medical importance
+riatomine bugs are vectors of /outh American trypanosomiasis +ChagasE disease-
which is caused by (rypanosoma crui&
Class Arachnids
Arachnids are .oint%legged invertebrate animals . ll arachnids have eight legs,
although in some species the front pair may convert to a sensory function. +he term is
derived from the /reek word meaning 0spider0. +he "lass rachnida are over 9:,:::
named species, they are united by the possession of eight legs, the lack of biting and
chewing mouthparts ,food is ingested in most cases as a liquid, though some help is
often given the food in becoming liquid by the secretion of, or regurgitating onto or
into the food of, digestive en1ymes from the stomach. +he arachnids differ from the
insects in the a$sence o &ings, the presence of our pair o legs in the adult stage,
and the fusion of the head and thorax into a cephalothora2 in spiders and scorpions.
+he head, thorax, and abdomen are fused into a single body region in ticks and mites .
+he "lass rachnida is divided into 75 subclassesTorder. +he best known and
medically important subclass are.
%SubclassT3rder Acarina or Acari contains,+icks and Mites-.
%SubclassT3rder Araneae ,Spiders-
%SubclassT 3rder /corpiones ,Scorpions-
(asic characteristics of arachnids include four pairs of legs ,7- and a body divided
into two segments$ the cephalothorax ,8- and the abdomen ,5 .,
)rder Acarina
Tic%s
+ick is the common name for the small arachnids in superfamily '2odoidea and
family Ixodidae and aragasidsae that, along with mites, constitute the carina. +icks
are ectoparasites ,external parasites-, living by hematophagy on the blood of
mammals, birds, and occasionally reptiles and amphibians. +icks are vectors of a
number of diseases3 tick will attach itself to its host by inserting its chelicerae
,cutting mandibles- and hypostome ,feeding tube- into the skin. +he hypostome is
covered with recurved teeth and serves as an anchor. +icks can be found in most
wooded or forested regions throughout the world3 +here are two well established
families of ticks, the Ixodidae ,hard tic%s-, and rgasidae ,sot tic%s-. (oth are
important vectors of disease causing agents to humans and animals throughout the
world.
'2odidae ,hard ticks ,
Morphology 3
Members of this family -ermacentor, 2xo!es&3hipicephalus and %mblyomma
(oth sexes are blood suckers .;ard ticks have the capitulum ,where the head and
mouthparts are located- exposed and easily visible from the top. +he upper side of
their body also bears a distinctly scleroti1ed shield or scutum. +his structure covers
most of the upper body surface in the male tick, but is restricted to a much smaller
area ,immediately behind the capitulum- in the female. <hen a female becomes
completely engorged with blood, her abdomen increases to many times its normal
dimensions and the scutum will then appear to be extremely small in relation to the
body si1e. Male ticks do not become so large when engorged .

Ixodes
#ie cycle
;ard ticks have three distinct life stages. >arvae which emerge from the egg have six
legs. fter obtaining a blood meal from a vertebrate host, they molt to the nymphal
stage and acquire eight legs. &ymphs feed and molt to the next and final stage % the
adult, which also has eight legs. fter feeding once more, the adult female hard ticks
lay one batch of thousands of eggs and then die. 3nly one blood meal is taken during
each of the three life stages. +he time to completion of the entire life cycle may vary
from less than a year in tropical regions to over three years in cold climates.
Medical importance
mong the hard ticks the genera Dermacentor and
Amblyomma are medically important as follows$
Bacterial diseases
Roc%y Mountain /potted Fe"er
+he causative agent, 3icketsia rickettsii, is carried by the (rown #og tick and the
Focky Mountain <ood +ick ,the two -ermacentor species in the Cnited States-.
Tularemia
+his is also carried by the two -ermacentor species. +ularemia is caused by the
bacterium #rancisella tularensis, which is carried by rodents, rabbits and hares) as a
result tularemia is otherwise known as rabbit fever. 3ne of the several ways that
humans can be infected is by being bitten by a tick that has acquired the bacterium
after biting one of these animals.
F e"er
4arious farm animals ,cattle sheep goats etc- are the primary carriers of the bacterium
Coxiella burnetii which causes S fever. Spread to humans is usually via inhalation of
dust containing dried urine, feces etc of infected animals. ;owever, less commonly,
the bacterium can be transmitted via the bite of Dermacentor ticks. Ingestion of
contaminated milk can also lead to infection.
Ehrlichosis
;uman ehrlichiosis is carried by Dermacentor %ariabilis and by Amblyomma
americanum and is caused by a number of bacteria of the .hrlichia family, in the
Cnited States principally by .hrlichia cha##eensis. +hese bacteria are small gram%
negative organisms that infect leukocytes .
#yme Disease
>yme disease is caused by the spirochete bacterium, Borrelia bur"!orferi, which
typically infects small mammals in the northeast and north central Cnited States. It is
transmitted to humans by 2xo!i! black legged ticks ,deer tic%s-.
Proto5oal diseases
Ba$esiosis
(abesiosis is carried by species of /xodes including the deer tick ,/xodes scapularis-
in the north and mid%west of the Cnited States and in other countries, including
*urope. )abesia microti is the usual causative organism and is a hemoproto1oan ,i.e.
it circulates in the bloodstream-.
0iral diseases
"rimean%"ongo ;emorrhagic ?ever
"olorado +ick ?ever
Fussian spring%summer encephalitis or +aiga encephalitis
Powassan *ncephalitis
+ick%(orne *ncephalitis
Eyasanur ?orest #isease
>ouping Ill 4irus
Disease caused directly $y hard tic%s
Tic% Paralysis In addition to being carriers of disease%causing microorganisms, some
ticks ,Amblyomma americanum and the two Dermacentor species- can cause tick
paralysis. In &orth merica, some tick species secrete a toxin that causes tick
paralysis. person with tick paralysis feels restless, weak, and irritable. fter a few
days, a progressive paralysis develops, usually moving up from the legs. +he muscles
that control breathing also may become paraly1ed. +ick paralysis can be confused
with other acute neurologic disorders or diseases ,e.g., /uillain%(arrU syndrome or
botulism-.
Treatment
+ick paralysis is cured rapidly by finding and removing the tick . Femoval is best
accomplished by grasping the tick with curved twee1ers as close to the skin as
possible and pulling it directly out. +he tickDs head, which may not come out with the
body, should be removed, because it can cause prolonged inflammation. Most of the
folk methods of removing a tick, such as applying alcohol, fingernail polish, or
petroleum .elly or using a hot match, are ineffective and may cause the tick to expel
infected saliva into the bite site. . If breathing is impaired, oxygen therapy or a
mechanical ventilator may be needed to assist with breathing.
Argasidae ,soft ticks ,
Morphology
Members of this family include %r"as and +rnitho!oros .In soft ticks, the body has a
rather non%descript sac%like shape. +he front portion of the body extends forward,
above and beyond the base of the capitulum, so that the capitulum is concealed when
the tick is viewed from above. Soft ticks have no a scutum on the upper side of the
body, and the exoskeleton is rather leathery in texture with a distinctly roughened
surface.
*ngorged rgaside
#ie Cycle
+he first life stage to come out of the egg, a six legged larva, takes a blood meal from
a host, and molts to the first nymphal stage. Cnlike hard ticks, many soft ticks go
through multiple nymphal stages, gradually increasing in si1e until the final molt to
the adult stage. Some soft ticks pass through up to seven nymphal molts before they
become adults. Soft ticks feed several times during each life stage, and females lay
multiple small batches of eggs between blood meals during their lives. +he time to
completion of the entire life cycle is generally much longer than that of hard ticks,
lasting over several years. dditionally, many soft ticks have resistance to starvation,
and can survive for many years without a blood meal .
Medical importance
+ick%borne relapsing fever is a rare disease ,about 8= cases per year in the Cnited
States- and is caused by several spirochete bacterial species of the )orelia family. +he
transmission agents are soft ticks of the genus Ornithodoros.
)rder ACAR'-A
Mites
In this order the abdomen is unsegmented and fused with the thorax, giving the entire
body a more or less sac%like appearance. In many the body is marked by numerous
transverse, fine lines, which are so impressed as to appear like the divisions between
minute segments. +he ma.ority of mites are very small si1e. Mite is a term commonly
used to refer to a group of insect%like organisms, some of which bite or cause irritation
to humans. <hile some mites parasiti1e animals, including man, others are
scavengers, some feed on plants, and many prey on insects and other arthropods. +wo
genera are medically important$ /arcoptes sca$iei ,itch mite- and Trom$icula
/ca$ies mites 4Sarcoptes scabiei5
+he species Sarcoptes scabiei ,itch mite- has medically important because it causes
scabies when the female mite burrows into the skin to lay its eggs.
Morphology
<hite disc%shaped dorsally covered by small peg like protuberance and few bristles
and there are series of lines across the body so the mite appear striated. +he female
si1e range :.5%:.@= mm and the male :.8%:.8= mm.+he adult have @ pairs of short
cylindrical legs , the first 8 pairs of legs have at its end sucker but in female the
posterior 8 pairs end in bristles.+here is no clear real head , but short fatty mouth part
protrude anteriorly from the body.
Sarcoptes scabiei mite
#ie cycle
?emale select places on the body where skin is thin and wrinkled e.g wrist, elbow,
scrotum etc. It digs and eat the stratum corneum layer of the skin and it makes tunnels
7%= mm'day. It feed on liquid oo1ing from dermal cells , lay 7%5 eggs 'day, the eggs
hatch in 5%= days and larva comes out with 5 pairs of legs, few of these larva succed
to burrow into skin or hair follicles make pocket called ,moulting pocket- the rest die.
fter 8%5 days these larvae become nymph with @ pairs of legs, moulting to become
adult and stay in the pocket untill fertili1ed by the male.
Scabies
+he word scabies is derived from the >atin word scabere, which means scratch.
"olloquially it is the disease known as the se"en year itch. It is a contagious skin
infection that occurs among humans and animals. Scabies is a common condition
found worldwide) it affects people of all races and social classes. Scabies can spread
easily under crowded conditions where close body and skin contact is common.
Institutions such as nursing homes, extended%care facilities, and prisons are often sites
of scabies outbreaks. ;uman scabies is caused by an infestation of the skin by the
human itch mite ,Sarcoptes scabiei -. Cnlike other mites, scabies mites actually
burro0 up to 5cm into the skin to lay eggs. +he mites are believed to feed on skin and
secretions. +he entire life cycle ,7:%7K days for human%infesting scabies mites- is
spent on their host. <ithout a host, they survive only a few days. Scabies can be
passed easily by an infested person to his or her household members and sexual
partners. Scabies in adults frequently is sexually acquired.
/ymptoms
<hen a person is infested with scabies mites the first time, symptoms usually do not
appear for up to two months ,8%6 weeks- after being infested) however, an infested
person still can spread scabies during this time even though he'she does not have
symptoms. If a person has had scabies before, symptoms appear much sooner ,7%@
days- after exposure.
Common /ymptoms
+he most common symptoms of scabies, itching and a skin rash, are caused by
sensiti1ation ,a type of PallergicQ reaction- to the proteins and feces of the parasite.
Severe itching ,pruritus-, especially at night, is the earliest and most common
symptom of scabies. pimple%like ,papular- itchy ,pruritic- Pscabies rashQ is also
common. Itching and rash may affect much of the body or be limited to common sites
such as$ between the ingers,.&rist,.el$o&,.armpit,.penis,.nipple,.&aist,.$uttoc%s,.
shoulder $lades3 +he head, face, neck, palms, and soles often are involved in infants
and very young children, but usually not adults and older children.+iny burrows
sometimes are seen on the skin) these are caused by the female scabies mite tunneling
.ust beneath the surface of the skin. +hese burrows appear as tiny raised and crooked
,serpiginous- grayish%white or skin%colored lines on the skin surface. (ecause mites
are often few in number ,only 7:%7= mites per person-, these burrows may be difficult
to find. +hey are found most often in the webbing between the fingers, in the skin
folds on the wrist, elbow, or knee, and on the penis, breast, or shoulder blades.

(urrows sores
Possi$le other se"er complications
+he intense itching of scabies leads to scratching that can lead to skin sores. +he sores
sometimes become infected with bacteria on the skin, such as Staphylococcus aureus
or beta%hemolytic streptococci. Sometimes the bacterial skin infection can lead an
inflammation of the kidneys called post%streptococcal glomerulonephritis.
Crusted +-or&egian, sca$ies
"rusted ,&orwegian- scabies is a severe form of scabies that can affect the elderly,
persons who are immunocompromised, or persons who have conditions that prevent
them from itching and'or scratching ,spinal cord in.ury, paralysis, loss of sensation,
mental debility-. "rusted scabies is characteri1ed by vesicles and thick crusts over the
skin that can contain many mites. Itching ,pruritus- may be absent in crusted scabies
because of a patientJs altered immune status or neurological condition. (ecause they
are infested with large numbers of mites ,up to 8 million-, persons with crusted
scabies are very contagious. Persons with crusted scabies may not show the usual
signs and symptoms of scabies such as the characteristic rash or itching ,pruritus-.

"rusted scabies in person with I#S
Diagnosis
#iagnosis of a scabies infestation usually is made based upon the customary
appearance and distribution of the the rash and the presence of burrows. <henever
possible, the diagnosis of scabies should be confirmed by identifying the mite or mite
eggs or fecal matter ,scy$ala-. +his can be done by carefully removing the mite from
the end of its burrow using the tip of a needle or by obtaining a skin scraping to
examine under a microscope for mites, eggs, or mite fecal matter . ;owever, a person
can still be infested even if mites, eggs, or fecal matter cannot be found.
Treatment
+reatment also is recommended for household members and sexual contacts,
particularly those who have had prolonged direct skin%to%skin contact with the
infested person. (oth sexual and close personal contacts who have had direct
prolonged skin%to%skin contact with an infested person within the preceding month
should be examined and treated. Products used to treat scabies are called scabicides
because they kill scabies mites) some also kill mite eggs. Scabicide lotion or cream
should be applied to all areas of the body from the neck down to the feet and toes. In
addition, when treating infants and young children, scabicide lotion or cream also
should be applied to their entire head and neck because scabies can affect their face,
scalp, and neck, as well as the rest of their body. "lean clothing should be worn after
treatment. (edding, clothing, and towels used by infested persons or their household,
sexual, and close contacts ,as defined above- anytime during the three days before
treatment should be decontaminated by washing in hot water and drying in a hot
dryer, by dry%cleaning, or by sealing in a plastic bag for at least K8 hours. Scabies
mites generally do not survive more than 8 to 5 days away from human skin. Persons
with crusted ,&orwegian- scabies and their close contacts, including household
members, should be treated rapidly and aggressively to avoid outbreaks. Institutional
outbreaks can be difficult to control and require a rapid, aggressive, and sustained
response.
House dust Mites 4-ermatopha"oi!es spp)5
#ust mites live are found in all homes in bedding, carpets, stuffed furniture, old
clothing and stuffed toys. +hey feed on human skin shedding. If droppings of dust
mites are inhaled or come in contact with the skin, they may cause asthma and'or
ec1ema symptoms. +he mites prefer to live in beds and, because we spend about a
third of the day in bed, we inhale large quantities of dust mite allergens.
;ouse mite allergy is a hypersensitive reaction to proteins in the excretion of dust
mites. +he protein attacks the respiratory passages causing hay fe$er, runny nose,
itching, snee1ing,watering eyes and asthma difficulty in breathing. It will aggravate
atopic dermatitis in people who have a tendency to this problem and Infantile ec1ema
,a skin disease- may get worse..
Demode2
#emodex mites, are elongated mites with clear cephalothorax and abdomens .
the former with four pairs of legs. +here are more than 7:: species of
#emodex mite, many of which are obligatory commensals of the pilosebaceous
unit of mammals. +wo distinct #emodex species have been confirmed as the
most common ectoparasite in man. +he larger Demode2 olliculorum, about
:.5%:.@ mm long, is primarily found as a cluster in the hair follicle, while the
smaller Demode2 $re"is, about :.8%:.5 mm long with a spindle shape and
stubby legs, resides solitarily in the sebaceous gland . (oth mites have been
identified in humans and play a role in three facial conditions$ Pityriasis
olliculorum, rosacea.li%e demodicidosis and Demodicidosis gra"is. +he
highly infected sites by this mites are$ forehead, area around the orbit, area
around the nose, chin and area around the mouth. Infection of the skin by
#. folliculorum is more frequent among females and in the elderly people. +he
presence of mites can be determined by microscopic inspection of secretion
from sebum glands and skin surface biopsy .
Trom$iculid mites +Chigger-
Trom$iculidae is a family of mites called trom$iculid mites ,also called berry bugs)
harvest mites) red bugs) scrub%itch mites) aoutas) and, in their lar"al stage, chiggers-.
+he term chigger is sometimes used to refer to a different animal, the "higoe flea.
+rombiculidae live in the forests and grasslands and are also found in low, damp areas
where vegetation is rank such as woodlands, berry bushes, orchards, along lakes and
streams, and even in drier places where vegetation is low such as lawns, golf courses,
and parks. "higgers ,the larvae of red mites or harvest mites ,+rombiculidae- are an
important group of ectoparasites affecting humans. +hey attach to the skin in the
ankles, waistline, armpits and perianal area after the host walks through a grassy
environment. +hey pierce the skin near a hair follicle and feed on partially digested
skin cells using en1ymes in the chiggerDs saliva. +hey then drop off the host. nd after
a few hours an erythematous papule appears that is highly pruritic. +he intensity of
the eruption depends on the sensitivity of the host and may be followed by fever. In
south sia, chiggers are the vectors for scru$ typhus ,)rientia tsutsugamushi-, a
rickettsial disease that can ,rarely- be life%threatening.

/cru$ Typhus) a rickettsial disease carried by several species of mites of the genus
$eptotrombidium. Symptoms include an ulcer%like formation ,called an eschar- at the
bite site, fever, headache and rash. If left untreated, there is a 5:V chance of fatality,
although it is readily cured with antibiotics. 3ccurs in Southeast sia, Siberia, India,
&ew /uinea, ustralia and !apan.
)rder Araneida
/piders
+he Spiders differ from other rachnida in having the abdomen unsegmented and
.oined to the cephalothorax by a short, narrow stalk. +he cephalothorax is also
unsegmented) and the abdomen bears at its end organs for spinning silk 3
/piders +hey are the largest order of arachnids. Spiders are beneficial predators that
reduce pest populations ,flies, crickets, mites, etc.- in and around homes, yards,
gardens, and crops. +he venom of most species is not very toxic to humans, usually
resulting in no more than a slight swelling, inflammation, or itching sensation. Most
spiders, fangs are too small or weak to puncture human skin. Spiders usually will not
attempt to bite unless accidentally trapped against the skin or grasped.

Morphology
Spiders have eight legs ,four pairs-. +hey have two body regions$ a cephalothorax
,fused head and thorax- and an abdomen, which are .oined together by a narrow waist.
Most spiders have six or eight simple eyes in various arrangements. ll have a pair of
.aw%like structures, the chelicerae, each of which ends in a hollow fang through which
venom can be e.ected. +he tip of the abdomen has a group of small fingerlike
spinnerets that produce silk. Boung spiders ,spiderlings- resemble adults except for
their smaller si1e and coloration.
#ie cycle
Spiders lay eggs within a silken egg sac that is often ball%shaped and either hidden in
a web, affixed to a surface, or carried by the female. Spiders may produce several egg
sacs, each containing up to several hundred eggs. spider grows by shedding its skin
,molting-, usually four to twelve times before maturity. Some species of spiders may
live for years, but most spiders only survive for one season. ll spiders produce silk,
which is secreted as a liquid through the spinnerets and hardens on air contact. Spiders
use silk for a variety of purposes, such as making egg sacs, capturing prey, holding
prey, making shelters or retreats, and transferring sperm during mating. lso,
spiderlings extrude silk threads that enable them to be transported by air currents, a
process called $allooning.
Medical importance
Spiders are predators that typically feed on living prey. +hey produce venom that is
poisonous to their normal prey of insects, mites, and other small arthropods. 4enom is
in.ected through the hollow fangs to immobili1e the prey and begin the digestion
process. +he most common poisonous spiders known in the world are widow and
violin spiders.
6ido& /piders
+he widow spiders belong to the genus Latro!ectus . +here are five species found in
&orth merica north of Mexico. +he $lac% &ido& for many years was considered to
be a single species but since is now recogni1ed to be represented by three species,
which are very similar in appearance and habitat. +hese three widow spiders are the
Southern black widow $atrodectus mactans , $. hesperus, and the $. %ariolus . +he
female >. mactans ,black widow- si1e 75mm the male smaller 6 mm, sometimes
called the hourglass, shoe.$utton, and po.%o.moo spider, it is the most dangerous
species in th CS. It has dark brown or black thorax and legs. +he widow spiders are
the most notorious of all spiders. L) "eometricus , the $ro&n &ido& is found
throughout frica. +he venom, a neurotoxin, is highly virulent in all the widow
spiders. Some report that the widow spiders are aggressive but observations shows
that they are very timid and have no instinct to bite humans. Most deaths in the Cnited
States attributed spider bites are caused by the widow spiders, rarely is the brown
recluseDs bite lethal. +he black widow spider is nocturnal. +he best time to observe
their presence in an area is a night.
(ro&n recluse spider or "iolin spider, Loxosceles reclusa,
(rown recluse spiders are usually between 6H8: mm ,W in and X in-, but may grow
larger. <hile typically light to medium brown, they range in color from cream%
colored to dark brown or blackish gray. +hese spiders usually have markings on the
dorsal side of their cephalothorax, with a black line coming from it that looks like a
violin with the neck of the violin pointing to the rear of the spider, resulting in the
nicknames iddle$ac% spider, $ro&n iddler or "iolin spider. Most spiders have
eight eyes) recluse spiders have six eyes arranged in pairs with one median pair and
two lateral pairs. +he abdomen is covered with fine short hairs that give it the
appearance of soft fur.
(rown recluse spider
Arachnidism
rachnidism is a medical term used to describe the symptoms and pathology
produced by the venom of the poisonous spiders, i.e. the black widows and the brown
recluse ,violin spider-. It may be either a systemic reaction or a necrotic local lesion.
+he black widow spider ,Latro!ectus mactans, characteristically produces a systemic
reaction because its venom is a neurotoxin. In contrast, the brown recluse spider
,Loxosceles recluse- venom produces a necrotic local lesion at the site of the bite but
can cause systemic reaction such as #I",disseminated intravascular coagulation-.
&ecrotic arachnidism is mainly reported in cases having been due to envenomation by
$oxosceles recluse, ll black widow and most brown widow spiders are poisonous for
humans. *mergency medical first aid is indicated with the bite of any of these spider
bites, especially the black widow because of its neurotoxic envenomation.
Diagnosis
+here is no way to identify a particular spider on the basis of its bite mark. <idow
spiders are recogni1ed by a red or orange hourglass%shaped marking on the abdomen.
(rown spiders have a violin%shaped marking on their back. ;owever, these
identifying marks can be difficult to discern, and the spider is rarely retrieved intact,
so the diagnosis is usually uncertain and based on symptoms.
Blac% 6ido& /pider Bite
3rder /corpiones ,Scorpions-
/corpions
Scorpions have long been of interest to humans primarily because of their ability to
give painful and sometimes life threatening stings. ?ound on all ma.or land masses
other than ntarctica, and in many different habitats) from high on mountains at
elevations up = =:: metres to the sea shore, from the driest deserts to tropical rain
forest .and from @: metres up to 9:: metres below ground in a cave. Most species
stay within 7 metre of their burrows and some may spend as much as GKV of their
lives inside their burrows.
Scorpions are venomous arthropods in the class Arachnida, relatives of spiders,
mites, ticks, and others. +here are currently 7@:: recogni1ed species of scorpions
worldwide.
Morphology
/corpions are characterised by a metasoma ,tail- comprising six segments, the last
containing the scorpionDs anus and bearing the telson ,the sting-. +he telson, in turn,
consists of the vesicle, which holds a pair of venom glands and the hypodermic
aculeus, the venom%in.ecting barb. +he abdomenDs front half, the mesosoma, is made
up of six segments. +he first segment contains the sexual organs as well as a pair of
vestigial and modified appendages forming a structure called the genital operculum.
+he second segment bears a pair of featherlike sensory organs known as the pectines)
the final four segments each contain a pair of book lungs. +he mesosoma is armored
with chitinous plates, known as tergites on the upper surface and sternites on the
lower surface. Scorpions have mouthparts called chelicerae, a pair of pedipalps, and
four pairs of legs. +he pincer%like pedipalps are used primarily for prey capture and
defense, but are also covered with various types of sensory hairs. +he cephalothorax is
covered above by a carapace ,or head shield- that usually bears a pair of median eyes
and 8 to = pairs of lateral eyes at its front corners ,a few cave and litter%dwelling
scorpions are completely eyeless-. +he 0long%tailed0 frican Scorpion ,Hadogenes
troglodytes- reaches a length of over 9 inches, and is probably the longest scorpion in
the world. Some of the frican and sian *mperor Scorpions routinely reach ,and
probably exceed- K inches. +he largest scorpions in the Cnited States are members of
the genus ;adrurus ,giant desert hairy scorpions-, obtaining a length of about =
inches. /iant desert hairy scorpions also occur in ri1ona. ll the deadly species
belong to the family Buthidae3
/corpion /tings
/corpion 0enom
+he venom of scorpions is used for both prey capture, defense and possibly to subdue
mates. ll scorpions do possess venom and can sting, but their natural tendencies are
to hide and escape. Scorpions can control the venom flow, so some sting incidents are
venomless or only mild envenomations. Scorpion venoms are complex mixtures of
neurotoxins ,toxins which affect the victimDs nervous system- and other substances)
each species has a unique mixture. ?ew species have venom potent enough to be
considered dangerous to humans. +he worldDs most dangerous scorpions live in &orth
frica and the Middle *ast ,species in the genera Androctonus, Buthus,
Hottentotta, #eiurus-, South merica ,Tityus-, India ,Meso$uthus-, and Mexico
,Centruroides-. Some studies suggest typical mortality rates up to about @V in
hospital cases, with children and the elderly being most susceptible. #eath by
scorpion sting, if it occurs, is the result of heart or respiratory failure some hours after
the incident. #uring the 7G9:Ds Mexico averaged about 9:: deaths each year.
;owever, in the past 8: years there have been no reported fatalities in the CS due to
scorpion stings.
Common symptoms
+he sting is painful, sometimes causing numbness or tingling in the area around the
sting. Serious symptoms are more common in children and include
bnormal head, eye, and neck movements
Increased saliva production
Sweating
Festlessness
Some people develop severe involuntary twitching and .erking of muscles. (reathing
may become difficult.
Treatment
Placing an ice cube on the wound reduces pain. cream or ointment containing an
antihistamine, an anesthetic, a corticosteroid, or a combination of them is often useful.
Stings that result in serious symptoms may require the use of sedatives given
intravenously. antivenom rapidly relieves symptoms, but it may cause a serious
allergic reaction or serum sickness. +he antivenom is given only if symptoms are
severe. In areas of the world where scorpions are more poisonous, such as +urkey, the
Middle *ast, and India, stings are treated with drugs and methods that reduce
symptoms and complications. an alpha%adrenergic blocking drug, is sometimes used.
ntivenins to specific scorpion venoms are available, but their effectiveness has not
been proven.
Class Myriapoda
+he members of this class are air%breathing rthropods, in which the head is distinct
from the thorax, and the thorax and abdomen form a continuous region, with from six
to two hundred segments, each bearing a pair of legs. +he head bears a single pair of
antennae. . &early 75,::: species of arthropod are classified in the Myriapoda. they
range in si1e from nearly microscopic to 5: cm in length. +he thousand%legged
worms, as they are commonly called, are well%known and generally feared creatures.
Most myriapods live in humid environments, and can be found in soils, in leaf litters,
or under stones and wood. Many species possess , speciali1ed glands that secrete foul%
tasing compounds and thus function in defense.

+here are four orders of myriapods) +wo of them, the /ymphyla and Pauropoda,
consist of tiny arthropods living in leaf litter and soil) both superficially resemble
centipedes. +he other two principal orders are Diplopoda,millipedes- and +he
Chilopoda ,centipedes-. "hilopods have only one pair of legs per body segment. +hey
are predators) the first pair of appendages on the trunk are modified into a pair of claws
with poison glands, which centipedes use to capture prey ,usually other arthropods-.
+he bite of large centipedes can cause humans some pain and discomfort, although
there are no authenticated cases of human fatalities from centipede bites.+he millipedes
have been incriminated as hosts of the cestode ;. diminuta, and some produce
vesicating agents.
Class Crustacea
+he members of this class are aquatic rthropda, which breathe by true gills. +hey
have two pairs of antennae and at least five pairs of legs.+he most familiar "rustacea
are the Cray.ishes, the #o$sters, the /hrimps, and the Cra$s3 Cray.ishes 3
+hey are invertebrates with hard shells ,exoskeleton- and segmented bodies with pairs
of .ointed appendages. +he aquatic crustacean contain two medically important
species, Decapoda ,literally 0ten footed0- are an order of crustaceans , including
many large crustacean familiar groups, such as crayfish, crabs, lobsters, prawns and
shrimp. Most decapods are scavengers, species of fresh%water crabs and crayfish are
second intermediate hosts of the lung fluke P. westermani. ?resh%water prawn and
land crab harbor the infective rat lung worm larvae ,ngiostrongylus- that infect man
brain. Copepods meaning ,oar feet- small 8%5 mm shrimp%like aquatic crustaceans ,
graceful, symmetrical animals with the head and two thoracic segments fused into a
cephalothorax, and a slender abdomen 5 to = segments ,are inhabitating all types of
aquatic ,fresh, brackish and sea water- . "yclop are intermediate hosts of quinea worm
#.medinensis, the cestode #. latum and the nematode /. spinigerum.#iaptomus
species are hosts of #.latum .

"yclop
The Phylum Pentastoma
?rom the /reek Pente for five and Stoma for mouth.
+he Pentastoma, or Pentastomida are a smallish phylum with .ust over 7:: species
know to science. ll known species are parasites of the respiratory tracts of
vertebrates in the adult form. &inety percent of the known pentastomids use reptiles
as their hosts, the remaining ten percent use birds and mammals as their primary
hosts. ?or example Lin"uatula serrata is a parasite of dogs, ?oxes and <olves, while
3ei"har!ia sternae lives in the air sacs of /ulls and +erns. Pentastomids, or tongue
&orms, are small animals, ranging in length from less than 7 cm ,.ust under :.= of an
inch- to almost 7@ cm ,=.= inches-. +hey are worm%like in appearance, as their
common name suggests, and the adults possess four pairs of hooks near the mouth.
Pentastomids do in fact only have one mouth, the claws are used to hold onto the host.
Pentastomids, like most parasites, have an adult morphology dedicated to
reproduction. +hey have no circulatory or excretory system, no respiratory organs and
a very simple and often greatly reduced nervous system. +hey have a straight through
gut which is adapted to sucking up the hosts blood, or in the case of $inguatula
mucous. +he body is covered in a thin cuticle but they have practically no sensory
apparatus. Internally the body is a pseudocoel. Pentastomids are gonochoristic,
meaning the sexes are separate and distinct. ?ertilisation is internal and involves
copulation. n adult female will live for several years and during this time she will
produce millions of eggs. In most species these eggs are released into the hosts
alimentary system where they pass out of the animal with its faeces. +he exception to
this is $inguatula where some or all of the eggs may be snee1ed out through the
nostrils. Some of these eggs will later be eaten by the secondary host, normally an
insect or small mammal. In the secondary host the larvae go through two instars
before becoming encysted somewhere in the hosts body. <hen the secondary host is
eaten by the primary host the 5rd stage larvae emerge from the cyst, climb out of the
stomach and up the oesophagus to infect the hosts lungs. Most species feed on their
hosts blood through the walls of the lungs. >inguatula is unusual in that it infect the
nasal cavities and does not feed on its hosts blood. #inguatula serrata will
occasionally infect humans, in India and the Middle *ast where it is known as
nasopharyngeal pentastomiasis or hal1oun.
/ome common terms and &ords used in entomology meanings
Ar$o"irus %a virus spread by arthropods. rbovirus is short for arthropod%$orne
virus. +hey are most commonly spread by blood%sucking insects such as mosquitoes.
rboviruses can cause minor illnesses such as mild fevers and rashes or they can
cause potentially fatal illnesses such as encephalitis ,inflammation of the brain-.
Class .a division of the animal kingdom lower than a Phylum and higher than an
3rder. ?or example, the 0"lass Insecta0 is a division of the Phylum rthopoda.
Cuticle .the external skeletal structure of the insect body. +he cuticle is secreted by
the epidermis, is composed of chitin and protein and consists of several differentiated
layers.
Family .in 1oological classification, a level of the taxonomic hierarchy below the
3rder and above the /enus. ll 1oological ?amily names end in the suffix D%idaeD
(enus .an assemblage of Species agreeing in one character or a series of characters.
It is usually considered arbitrary and opinionative grouping, though some consider it
a natural assemblage.
Hemimeta$olous . insects with incomplete metamorphosis, where the individual
develops with gradual changes in si1e and shape. +here are three distinct stages in the
development of a hemimetabolous insect$ egg, nymph ,.uvenile of any instar- and
adult.
Hermaphrodite .an individual that possesses both male and female reproductive
organs.
Holometa$olous . insects with complete metamorphosis, where the body form
changes abruptly. ;olometabolous insects have four distinct forms during their life
cycle$ egg, larva, pupa and adult.
'nstar . the growth stage between two successive moults.
#ar"a .an immature stage of a holometabolous insect that is morphologically distinct
from the adult form. +he larval stage of development follows the egg stage and
precedes the pupal stage.
Metamorphosis .the physical transformation an insect undergoes during successive
stages of development
Moult . the process by which insects shed elements of the integument during growth.
-ymph . an immature insect after emerging from the egg. +his term usually refers to
insects in which there is incomplete metamorphosis ,see hemimetabolous-.
)mnatidium +pl3 )mmatidia, .
the basic visual element that forms the compound eye. +he omnatidium is
composed of a lens, cone, rhabdom and pigment cells. +he si1e, shape and
number of ommatidia that form the compound eye vary among species.
4iew image
)rder . one of the primary taxonomic divisions below "lass level and above ?amily
level. In "lass Insecta, the division of 3rder was originally based on wing structure
with ordinal names usually ending in 1ptera e.g. 3rder #iptera.
)"ipositor .an egg%laying tube of the female insectDs abdomen. +he morphology of
the ovipositor varies among species$ it may be fixed and rigid in length or it may be
flexible and telescopic. +he ovipositor is not present in all insect species.
Parthogenesis . reproduction without fertili1ation. Individuals develop from an
unfertilised egg.
Phylum .a category used in biological classification, below Eingdom level and above
"lass level.
Pupa .the inactive state between larva and adult in holometabolous insects. #uring
pupation, the larva transforms into the adult.
/pecies .the basic unit of biological classification. /enerally defined as an
aggregation of individuals similar in appearance and structure, mating freely and
producing young that themselves mate freely and bear fertile offspring. bbreviated
to sp. for one species and spp. for two or more species.
0ector .any organism which transports or transmits a parasite to a host. In medical
entomology, a vector is an arthropod which carries disease producing organisms to a
vertebrate host.
Reerences
7. Service, M. 8::9. Medical .ntomology #or Students @th *dition "ambridge
Cniversity Press.
8. ldridge, (. ?., and *dman, !. #., eds. 8:::. Medical .ntomology2 A *extboo( on
-ublic !ealth and 3eterinary -roblems Caused by Arthropods. Eluwer cademic
Publishers
5. /ubler #!. Insects in #isease +ransmission. In$ Strickland /+, editor. ;unter
tropical medicine, Kth edition. Philadelphia ,P-$ <. (. Saunders) 7GG7. p. G97%
7:::.
@. Mullen, /. >., and #urden, >. ., eds. 8::8. Medical and 3eterinary .ntomology,
cademic Press, &B.
=. #esowit1, F. S. 7GG7. *he malaria capers. &orton and "o., &ew Bork, &B.
6. /oddard, !. 8::K. -hysician4s uide to Arthropods o# Medical /mportance, ?ifth
*dition.(oca Faton, ?>, "F" Press,
K. ;arwood, F. ?., and M. +. !ames. 7GKG. .ntomology in !uman and Animal
!ealth. Macmillan Pub. "o., &B.
9. ;igley, >. /., >. >. Earr, and >. P. Pedigo. 7G9G. Manual o# entomology and pest
management. Macmillan Pub. "o., &ew Bork, &BL"hapter on medical pests
vector and transmitted diseases table.
G. Mc&eil, <. ;. 7GK6. -lagues and people. nchor Press,#oubleday, /arden "ity,
&B.
7:. !ohn, #avid and Petri, <illiam. Markell and 4ogeJs Medical Parasitology$ Gth
*dition. Missouri$ Saunders *lsevier, 8::6.
77. PIntroduction to Myiasis.Q +he &atural ;istory Museum of >ondon.
Yhttp$''www.nhm.ac.uk'research%curation'research'pro.ects'myiasis%larvae'intro%
myiasis'index.htmlZ.
78. /ubler #!. Insects in #isease +ransmission. In$ Strickland /+, editor. ;unter
tropical medicine, Kth edition. Philadelphia ,P-$ <. (. Saunders) 7GG7. p. G97%
7:::.
75. 0Mosquito%(orne #iseases0. +he merican Mosquito "ontrol ssociation.
http$''www.mosquito.org'mosquito%information'mosquito%borne.aspx.
7@. ;erms <(, !ames M+. Medical entomology. =th ed. &ew Bork$ MacMillan,
7G67$569%G=.
7=. (arkin !S, Mac>eod ", ;amelik P. Intestinal myiasis. m ! /astroenterol
7G95)K9$=6:%7.
76. Eirby ". Stafford III. 0+ick Management ;andbook0 ,P#?-. "enters for #isease
"ontrol. http$''www.cdc.gov'ncidod'dvbid'lyme'resources'handbook.pdf.
7K. 3ckenhouse, "hristian, Samlaska, "urt, (enson, Paul, Foberts, >yman, *liasson,
rn, Malane, Susan, and Menich, Mark. P"utaneous myiasis caused by the
frican tumbu fly.Q rchives of #ermatology 786 ,7GG:-$7GG%8:8.
79. (utler, !. ?. ,8::K-. 0(lack flies, Simulium spp. ,Insecta$ #iptera$ Simuliidae-0 .
http$''entomology.ifas.ufl.edu'creatures'livestock'bfly.htm.
7G. ;olbrook, ?. F3 7GG6. (iting midges and the agents they transmit, p. 77:H776. /n
(. !. (eaty and <. Marquardt ,ed.-, +he biology of disease vectors. Cniversity
Press of "olorado, &iwot, "olo
8:. (olton, (. N "ollingwood, ".. !ymenoptera, 5ormicidae. !andboo(s #or the
/denti#ication o# )ritish /nsects, 6, -art 7c. >ondon$ Foyal *ntomological Society,
7GK=.
87 . 87 . Morgan, #. Cuc(oo 0asps 8!ymenoptera, Chrysididae9. !andboo(s #or the
/denti#ication o# )ritish /nsects, 6, -art 5. >ondon$ Foyal *ntomological Society,
7G9@ .
88 . 88 . ?rishman . 8:::. (ed (ug basics and control measures. Pest "ontrol 69$8@. 8
85.?urman #P, "atts *. 7GK:. Manual of Medical *ntomology, 5rd ed. &ational Press
(ooks, Palo lto, "alifornia.
85. Faoult #, Foux 4 ,7GGG-. 0+he body louse as a vector of reemerging human
diseases0. Clinical /n#ectious Diseases 8G ,@-$ 999HG77. doi$7:.7:96'=8:@=@.
8@. ;ay F! ,8::G-. 0Scabies and pyodermasLdiagnosis and treatment0. Dermatol
*her ?? ,6-$ @66HK@. doi$7:.7777'..7=8G%9:7G.8::G.:78K:.x.
8=. 0Scabies0 . Derm,et ,:. &ew [ealand #ermatological Society Incorporated.
http$''www.dermnetn1.org'arthropods'pdf'scabies%dermnetn1.pdf.
86. 0#P#xLScabies0 . $aboratory /denti#ication o# -arasites o# -ublic !ealth
Concern. "#". http$''www.dpd.cdc.gov'dpdx';+M>'Scabies.htm.
8K. #unston P ,7GGG- Assassin )ugs. Science Publishers Inc., *nfield, &ew
;ampshire. 55K pp.
89. ?oelix, Fainer ?. ,7GG6-. )iology o# Spiders. 7G9 Madison ve. &B, &ew Bork,
7::76$ 3xford Cniversity Press. p. 5.
8G. "enters for #isease "ontrol and Prevention, "#" #ivision of Parasitic
#iseases. ,8::@- . "#" foundation <ebsite.