Vector borne diseases

useful

1. Disease Prevention and Outbreak Response Cell (DPORC )
Centre for Community Medicine
All India Institute of Medical Sciences, New Delhi
1

2. Outline of Presentation
•Common Vector Borne Diseases in India
•Malaria
•
Dengue
•
Dengue
•Chikungunya
•Filaria
•Japanese Encephalitis Kala azar
•Prevention from the Vector Borne Diseases
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3. Common Vector Borne Diseases in India
•Malaria
•Dengue
•Chikungunya
Small Bite - Big Threat
Mosquito
•Filaria
•Japanese
Encephalitis
•Kala azar -
Sandfly
Mosquito
Mosquito
Sandfly
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4. Malaria
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5. Malaria
•Mal’ariameans “bad air”
(Originally thought to be caused by foul air)
•A life-threatening protozoan disease
•
40% of the world’s population is at risk of getting the disease
•
40% of the world’s population is at risk of getting the disease
•80% of population in India lives in low malaria end emic
region
•80% of malaria burden in India is confined to 20% o f
population that live in malaria endemic region in I ndia
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6. Trend of Malaria indices in India, 2001-13
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Source - http://nvbdcp.gov.in/malaria3.html

7. Mosquito
•Female anopheles mosquito is
the vector
oP. vivax
oP. Falciparum
•
The mosquito breeds in polluted
•
The mosquito breeds in polluted water bodies, brackish water,
wells, cisterns, fountains,
overhead tanks etc.
•Mosquito bites during
night time
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8. Transmission Cycle
of humans
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humans
healthy humans
Mosquito

9. Common Symptoms
Symptoms:
o
Fever (High grade)
o
Chills & rigors
o
Chills & rigors
o
Headache
o
Body ache
o
Non specific symptoms
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10. Severe Malaria -consequences
•Jaundice
•Seizure
•
Bleeding problems
•
Bleeding problems
•Liver failure
•Kidney failure
•Multi organ failure
•“Death” also as a possible outcome
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11. Diagnosis
Rapid Diagnostic Kit Test
Traditional slide test for parasite
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12. Treatment
•Rest and fever control (Tab.Paracetamol)
•Cold Sponging
•Chloroquinefor three days
•Plasmodium vivax–Primaquinefor 14 days (in addition t o
chloroquine
)
chloroquine
)
•Plasmodium falciparum–ArtesunateBased Combination therapy
•Severe malaria may require
oArtesunatebased combination therapy
oQuinine
•Infants and pregnant women for giving special attenti on
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13. “Require immediate attention”
with danger signs
•Patient becomes unconscious
•Severe headache
•
Seizures
•
Seizures
•Bleeding from any site
•Development of jaundice
•Unable to pass urine
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14. Facilities available at AIIMS
•Diagnosis of Malaria and
its complications
oKit test
o
Slide test
•Management of malaria
and its complications
o
Treatment
of malaria
o
Slide test
oFluorescent microscopy
oPCR
o
Treatment
of malaria
oBlood transfusion
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•Availableat:
oDeptof Microbiology
oDeptof Pathology
•Availableat:
oDeptof Medicine/Pediatrics
oBloodbank

15. Dengue Dengue
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16. •Dengue fever is caused by Dengue virus
•It is pronounced as
“Dengee” Dengue
•Occurs in
epidemic form
from time to time
•Common name of the disease is
‘break-
bone fever’
(HaddiTodBukhar)
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17. Reported Dengue Cases in Delhi,
2002 –2013
40005000
6000
7000
3366
6259
5574
Numbers
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0
1000
2000
3000
4000
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
45
2882
606
1023
3366
548
1312
11531131
2093
No. of Dengue cases in Delhi
Years
Numbers
Source - http://nvbdcp.gov.in/malaria3.html

18. •Common disease in tropical
and subtropical countries
•Causative agent is a
virus
•
The vector is mainly a
What is Dengue ?
•
The vector is mainly a mosquito called Aedes
aegypti commonly known as
Tiger Mosquito
•Environment Helps
transmission
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19. Know Your Enemy !!
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Presence of black and white patches
over the legs (Tiger Mosquito)

20. Environmental Factors
•Season:
July –December
•Biting time mostly during
day
•
Ideal Temperature
-
20
-
28
•
Ideal Temperature
-
20
-
28
degree Celsius.
•Humidity -high
•Tiger mosquito breeds in fresh
water pools
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21. •All age groups & both sex are
vulnerable
•
Those
previously
infected
by
Vulnerability to Dengue
•
Those
previously
infected
by
dengue are more likely to
experience severe form of
disease,ifre-infected
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22. Infected mosquito
Transmission Cycle
Man-Mosquito-Man
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Uninfected
human
Infected
human
Uninfected mosquito

23. Symptoms
•Fever
•Rash
•
Headache
•
Headache
•Muscle pain
•Joint pain
•Pain behind the eyes
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24. Dengue Hemorrhagic fever
•Decrease in Platelet count
(a component of blood) leads
to bleeding
oBleeding from gums
o
Bleeding into joints
o
Bleeding into joints
oBleeding under the skin causing its
discolouration
oPetecheal hemorrhages
oIn gut causing black colored stools or even
frank blood
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25. Treatment
•Fluids
•Rest
•No injections are required
•
Paracetamol for pain and fever
•
Paracetamol for pain and fever
•Monitor platelet count and
Blood pressure
•In severe cases, platelet
transfusion /blood transfusion
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26. “Require immediate attention”
with danger signs
•Bleeding from any site
•Severe abdominal pain
•Prolonged frequent vomiting
•Unconsciousness
•Raise in the temperature
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27. Facilities Available at AIIMS
•Diagnosis
oKit test
oVirus culture
oReverse Transcriptase
Polymerase Chain Reaction
(RT
-
PCR) test
•Treatment
oIn-door admission
oIV infusion
o
Blood transfusion
(RT
-
PCR) test
oArterial Blood Gas (ABG)
analysis
o
Blood transfusion
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•Availableat:
oDeptof Microbiology
oDeptof Pathology
•Availableat:
oDeptof Medicine/Pediatrics
oBloodbank

28. Japanese Encephalitis Japanese Encephalitis
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29. Japanese Encephalitis (JE)
•JE is mostly present in in Southern India, Uttar
Pradesh, North Eastern states, Haryana
•Agent -Group B arbovirus(Flavivirus)
•Transmitted by Culexmosquitoes
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30. Symptoms
•Starts with
oFever
oHeadache
oWeakness
Rapidly progress to
•High grade fever
•Neck pain
•Vomiting
•Seizure
•Inability to speak
•Paralysis
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Rapidly progress to

31. Treatment
•Consists of symptomatic management .
•May include
o
Sponging for fever
o
Sponging for fever
oParacetamol
oDrugs for Seizure
oOxygen therapy
oPatient may need referral to higher level of health
care facility
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32. Danger signs
•Unconsciousness •
Seizure
•
Seizure
•Poor respiration
•Paralysis
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33. Chikungunya Chikungunya
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34. Epidemiology
•Viral disease
•Transmitted by tiger mosquito (AedesAegyptus)
•Out break of chikungunyain India occurred in 2006,
affecting 14 lakhpeople
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35. Symptoms
•Fever
•Chills
•
Headache
•
Headache
•Generalized body ache
•Skin rash
•Small joint pains
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36. Treatment
•Analgesics
oParacetamol
oDiclofenac
•Plenty of fluid
•Avoid aspirin
•Normal food intake
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37. Filaria Filaria
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38. Epidemiology
•Caused by : Microfilaria
•Transmitted by : Culex
mosquito mosquito
•Mainly prevalent in costal
areas due to hot and humid
conditions
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Culexmosquito

39. Clinical features
•Majority remains
asymptomatic
•Fever
Swelling and pain in limbs
•
Swelling and pain in limbs
•Permanent disfigurement of
limbs
•Some people may develop
allergic reactions
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40. Diagnosis & Treatment
•DIAGNOSIS
oBlood examination for
microfilaria
o
Antibody test
•TREATMENT
oDi-Ethyl Carbamazine
with Albendazole
oIvermectinwith
Albendazole
o
Antibody test
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41. “Require immediate attention”
with danger signs Generally filariasis do not lead to any life threatening
complication
Medication
cause
larval
death
in
body
which
could
Medication
cause
larval
death
in
body
which
could
sometimes lead to allergic reactions like swelling of
body,itching etc.
Any reactions after taking medication should be reported
tothedoctor
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42. Kala
-
Azar
Kala
-
Azar
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43. Epidemiology
•Caused by parasite
Leishmaniadonovani
•Transmitted by sandfly
•The organism may remain in
the body for a long time in
liver, spleen and bone
•In India found in
Bihar, Jharkhand, West Bengal
and pockets of Uttar Pradesh
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44. Clinical features
•Intermittent fever
•Weakness
•Fullness of abdomen due
to increase in size of liver to increase in size of liver and spleen
•Grey discoloration of skin
with loss of hair
•Decrease in hemoglobin
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45. Management
Diagnosis
•Blood test for antibody
•Dipstick test
•
ELISA
Management
•Sodium stibogluconate
•Pentamidine
•
Amphotericin
-
B
•
ELISA
•Biopsy
•
Amphotericin
-
B
•Miltefosine
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•Availableat:
•Deptof Microbiology
•Deptof Pathology
•Availableat:
•Deptof Medicine/Pediatrics

46. Prevention from the Vector Borne Diseases Prevention from the Vector Borne Diseases
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47. •Don’t allow
water to remain
stagnant in and around your
house.
•
Clean
the blocked drains.
1. Reducing the source where the
mosquito can breed . . . 1
•
Clean
the blocked drains.
•Empty -
room air coolers and
flower vases completely at least
once in seven days
andthen refill
them
•Tray below the fridge also to be
cleaned
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48. •Dispose off old containers, tins,
and tyreetc.
1. Reducing the source where the
mosquito can breed . . . 2
•Keep the water tanks and water
containers tightly covered so that
the mosquitoes can not enter
them and start breeding
•Fill the ditches
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49. •Introduction ofsometypes
ofsmallfish(Gambusia,
Lebister)whicheat
2.Killing the mosquito and larvae . . . 1
mosquitolarvaintowater
bodies
•Pouringoiloverthewater
sources
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50. •Don’t turn away spray
workers whenever they
come to spray your house
2. Killing the mosquito and Larvae . . . 2
•Spraying of
DDT, Malathionand
Pyrethrum etc.
•Spraying over all the walls
of the house
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51. •
Don’t forget to spray
oBehind the photo-frames
o
Curtains
2. Killing the mosquito and Larvae . . . 3
o
Curtains
oCalendars
oCorners of house
oStores
•Use insecticidal sprays in all
areas within the house at-
least once a week
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52. •Wear clothes which cover
the body as much as
possible
•Mosquitonet
•Mosquito nets treated
with
insecticides
3. Personal protection
with
insecticides
•Mosquitorepellent
oSprays
oCreams
oCoils
oMats
oLiquids
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53. Vector Borne Diseases
can be
Easily Prevented!
It is It is
Your, Mine and …
OurRESPONSIBILITY
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