Friday, June 03, 2016

Menacing Mosquitoes

Mosquitoes cause a lot of trouble. For most people, their bites lead to itchy bumps that take a few days to go away. You can use bug spray. However, some mosquitoes will bite you anyway. Some people are more likely to get bitten by others. Okay, okay I admit it. I'm one of those people!

Mosquitoes become menacing when they carry a disease. Possibly, a deadly disease. Below is a link to a great website about different mosquito borne diseases. Here's the list:

MalariaChikungunya
Dog Heartworm
Dengue
Yellow Fever
Eastern Equine Encephalitis
St. Louis Encephalitis
LaCrosse Encephalitis
Western Equine (Japanese) Encephalitis
West Nile Virus
Zika Virus

http://www.mosquito.org/mosquito-borne-diseases

I haven't heard of some of them. It's scary, you can't always control if you get bitten or not. You can't know if the mosquito that bit you carried a deadly disease until symptoms show! With Zika virus in the news I decided to outline the more common mosquito borne diseases.


Zika Virus


Strait from the Center for Disease Control, it turns out most cases of Zika virus are mild. So mild, some people don't even know they have it!

Symptoms:

Fever
Rash
Joint Pain
Red Eyes
Muscle Pain
Headache

It could take a few days to a week to show up. It lasts for about a week in the blood. It's rarely deadly and once you have it you are likely to be immune to it in the future.

Treatment is basically rest, drink plenty of fluids, and Tylenol. You can't take a NSAID until Dengue has been ruled out. Try to avoid further mosquito bites. It turns out this in one of the least deadly mosquito borne diseases.


West Nile Virus


70 - 80% of infected people don't have symptoms. 1 in 5 people will develop some symptoms:

Fever
Headaches
Body Aches
Joint Pain
Vomiting
Diarrhea
Rash

Most people recover completely but fatigue and weakness can last for months. Less then 1% of people develop severe symptoms. The red part is copied from the link above.

Severe symptoms in a few people. Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues).
  • The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.
  • Serious illness can occur in people of any age. However, people over 60 years of age are at the greatest risk for severe disease. People with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease, and people who have received organ transplants, are also at greater risk for serious illness.
  • Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent.
  • About 10 percent of people who develop neurologic infection due to West Nile virus will die.

Treatment is Tylenol for fever and pain. For severe symptoms, go to the hospital


The media has been painting these illnesses like they are very deadly. So far, I'm surprised to learn how mild they usually are. If you are pregnant, over 60, a child, or have a low immune system, you are more likely to feel symptoms or get the more severe version of these viruses. Even then, you still might not get the severe versions. Now I'll see if some other common mosquito diseases are the same way.


Encephalitis

There are four versions of Encephalitis






Each has their own variation of the details but they are similar to Zika and West Nile. They are more likely to be deadly then Zika and West Nile. The real difference is you are more likely to have neurological side effects that might linger after the disease is gone. Eastern Equine is the most deadly. 1/3 of infected people get severe symptoms.


Yellow Fever



It is very similar to Zika and West Nile. I'm sensing a pattern. 15% of infected people will get severe symptoms and of those 20 - 50% will die. Symptoms are similar to other mosquito transmitted diseases.



Dog Heartworm


That link has a nice graphic. It doesn't just infect dogs though.


Most people don't have symptoms. It's most likely to be found in Europe. If you do have symptoms, they are most likely to be:

Cough (including possibly coughing up blood)
Chest Pain
Fever
Excessive Fluid in the Chest Cavity

It is caused by a dying adult heartworm. It leaves coin lesions in x-rays. If that's discovered, you are more likely to need an invasive procedure to rule out more serious things like cancer.




Dengue


The principal symptoms of dengue are:
  • High fever and at least two of the following:
    • Severe headache
    • Severe eye pain (behind eyes)
    • Joint pain
    • Muscle and/or bone pain
    • Rash
    • Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)
    • Low white cell count
This one is more likely to be severe. Mostly what you can do it take Tylenol. Like the others, avoid NSAIDs. If you get to the hospital or doctor quickly, you are less likely to die from it. The most disturbing part for me is the symptoms. They are so much like the symptoms for the more mild mosquito diseases. It's so hard to know what you actually have!!!



Chikungunya


Most people do develop some symptoms. The most common are fever and joint pain. You might also have a headache, joint swelling, muscle pain, or a rash. The symptoms are more likely to be severe but you are less likely to die from it. The good news is once you've had it you are more likely to be protected from getting it again in the future. Treatment is the same as Zika.


Malaria




Ah, yes, I'll end with a biggie.

Symptoms:

Fever
Chills
Flu-like symptoms

you know, because the scary stuff can't be more obvious. It'd be great if there was an obvious sign. But, no. It has to make hypochondriacs think a mild flu is malaria. Because if left untreated, you can die from malaria.

http://www.cdc.gov/malaria/about/facts.html

http://www.cdc.gov/malaria/about/disease.html (the red below is copied from this link)

Uncomplicated Malaria

The classical (but rarely observed) malaria attack lasts 6-10 hours. It consists of
  • a cold stage (sensation of cold, shivering)
  • a hot stage (fever, headaches, vomiting; seizures in young children)
  • and finally a sweating stage (sweats, return to normal temperature, tiredness).
Classically (but infrequently observed) the attacks occur every second day with the "tertian" parasites (P. falciparum, P. vivax, and P. ovale) and every third day with the "quartan" parasite (P. malariae).
More commonly, the patient presents with a combination of the following symptoms:
  • Fever
  • Chills
  • Sweats
  • Headaches
  • Nausea and vomiting
  • Body aches
  • General malaise
In countries where cases of malaria are infrequent, these symptoms may be attributed to influenza, a cold, or other common infections, especially if malaria is not suspected. Conversely, in countries where malaria is frequent, residents often recognize the symptoms as malaria and treat themselves without seeking diagnostic confirmation ("presumptive treatment").
Physical findings may include:
  • Elevated temperatures
  • Perspiration
  • Weakness
  • Enlarged spleen
  • Mild jaundice
  • Enlargement of the liver
  • Increased respiratory rate
Diagnosis(http://www.cdc.gov/malaria/diagnosis_treatment/diagnosis.html) of malaria depends on the demonstration of parasites in the blood, usually by microscopy. Additional laboratory findings may include mild anemia, mild decrease in blood platelets (thrombocytopenia), elevation of bilirubin, and elevation of aminotransferases.
 Top of Page

Severe Malaria

Severe malaria occurs when infections are complicated by serious organ failures or abnormalities in the patient's blood or metabolism. The manifestations of severe malaria include
  • Cerebral malaria, with abnormal behavior, impairment of consciousness, seizures, coma, or other neurologic abnormalities
  • Severe anemia due to hemolysis (destruction of the red blood cells)
  • Hemoglobinuria (hemoglobin in the urine) due to hemolysis
  • Acute respiratory distress syndrome (ARDS), an inflammatory reaction in the lungs that inhibits oxygen exchange, which may occur even after the parasite counts have decreased in response to treatment
  • Abnormalities in blood coagulation
  • Low blood pressure caused by cardiovascular collapse
  • Acute kidney failure
  • Hyperparasitemia, where more than 5% of the red blood cells are infected by malaria parasites
  • Metabolic acidosis (excessive acidity in the blood and tissue fluids), often in association with hypoglycemia
  • Hypoglycemia (low blood glucose). Hypoglycemia may also occur in pregnant women with uncomplicated malaria, or after treatment with quinine.
Severe malaria is a medical emergency and should be treated urgently and aggressively.
 Top of Page

Malaria Relapses

In P. vivax and P. ovale infections, patients having recovered from the first episode of illness may suffer several additional attacks ("relapses") after months or even years without symptoms. Relapses occur because P. vivax and P. ovale have dormant liver stage parasites ("hypnozoites"(http://www.cdc.gov/malaria/about/biology/index.html)) that may reactivate. Treatment to reduce the chance of such relapses is available and should follow treatment of the first attack.
 Top of Page

Other Manifestations of Malaria

  • Neurologic defects may occasionally persist following cerebral malaria, especially in children. Such defects include trouble with movements (ataxia), palsies, speech difficulties, deafness, and blindness.
  • Recurrent infections with P. falciparum may result in severe anemia. This occurs especially in young children in tropical Africa with frequent infections that are inadequately treated.
  • Malaria during pregnancy (especially P. falciparum) may cause severe disease in the mother, and may lead to premature delivery or delivery of a low-birth-weight baby.
  • On rare occasions, P. vivax malaria can cause rupture of the spleen.
  • Nephrotic syndrome (a chronic, severe kidney disease) can result from chronic or repeated infections with P. malariae.
  • Hyperreactive malarial splenomegaly (also called "tropical splenomegaly syndrome") occurs infrequently and is attributed to an abnormal immune response to repeated malarial infections. The disease is marked by a very enlarged spleen and liver, abnormal immunologic findings, anemia, and a susceptibility to other infections (such as skin or respiratory infections).

Those menacing mosquitoes! Some diseases they carry are mild some are deadly. You can use bug spray, wear long sleeves and long pants, and try to avoid them. But, they might bite you anyway.

If you're like me, you spend the summer slapping yourself because you think you felt the tingle of a bug landing on your skin. I've killed a lot of mosquitoes. I do fear getting one of these some day. I tend to spend this time of year with a lot of joint pain. For all I know, I get West Nile each year and just don't know it!!!


No comments:

Post a Comment