Identify a vector-borne or zoonotic disease that you feel has a large, negative impact on the health of the community. Try to choose a disease that has not been identified by your peers. How is it transmitted and how could the transmission be controlled or prevented?
West Nile Virus (WNV) dates to the late 1930s, when it was unveiled that a woman in the West Nile district of Uganda was carrying the virus (WHO, 2017). WNV is a virus, transmitted by mosquitoes to humans, which can cause neurological disease in humans (WHO, 2017). WNV becomes a public health concern during mosquito season, typically summer through fall (CDC, 2017). To date, there is no vaccine to prevent the virus, nor is their medication to treat the virus, which is the primary reason why this disease has a negative impact on the community (CDC, 2017). Insect repellant and protective clothing are recommendations to reduce the risk of becoming infected (CDC, 2017). Moreover, in the case of WNV, certified pesticide applicators often use pesticides to help prevent infection among the public (CDC, 2017). Pesticides consist of active or inert ingredients with the intention of, “preventing, destroying, mitigating or repelling any pest” (EPA, 2016). The Environmental Protection Agency (EPA) is the primary agency, which evaluates and determines whether the pesticide in question meets federal safety standards, which benefits both human and environmental safety (EPA, 2016).
Centers for Disease Control and Prevention (CDC). (2017). Preliminary Maps & Data for 2017. Retrieved from: https://www.cdc.gov/ westnile/statsmaps/preliminarymapsdata2017/Index/html
Centers for Disease Control and Prevention (CDC). (2017). West Nile Virus. Retrieved from:https://www.cdc.gov/westnile/index.html
Environmental Protection Agency (EPA). Basic information about pesticide ingredients. Retrieved from: https://www.epa.gov/ingredients-used-pesticid
One of the more common tickborne diseases that I see in Massachusetts is Babesiosis. Babesiosis is caused by microscopic parasites that infect red blood cells. Human babesiosis is an increasing healthcare dilemma in the United States that is being diagnosed more frequently (Akel & Mobarakai, 2017). In the United States most human cases of Babesia disease are caused by the parasite Babesia microti. This disease is transmitted by Ixodes scapularis ticks, also referred to as blacklegged ticks or deer ticks. Tickborne transmission is most common in specific regions and during particular seasons. The majority of cases occur in the Northeast and upper Midwest, particularly in parts of New England, New York state, New Jersey, Wisconsin, and Minnesota. In the Northeast, babesiosis occurs in both inland and coastal areas, including off-shore islands, such as Nantucket and Martha’s Vineyard, Massachusetts; Block Island, Rhode Island; and Long Island, New York State. It usually peaks during the warmer months (CDC, 2018).
Many people who are infected remain asymptomatic. Some develop symptoms similar to the flu, such as fever, chills, sweats, headache, body aches, loss of appetite, nausea, or fatigue. Additionally, due to the fact that Babesia parasites invade red blood cells, babesiosis can cause hemolytic anemia from the obliteration of red blood cells (Akel & Mobarakai, 2017). In severe cases, this disease can be life-threatening, especially in those who; do not have a spleen, have a compromised immune system, have other serious health issues, or are elderly. For ill patients, babesiosis usually is treated for at least 7-10 days with a combination of two prescription medications, typically either: atovaquone and azithromycin; or clindamycin and quinine. Some patients may require supportive care, such as: blood transfusions, mechanical ventilation or dialysis (CDC,2018).
Since there is no vaccine available to protect people against babesiosis, the use of prevention measures is particularly important. Avoiding exposure to tick habitats, such as wooded and grassy areas, is the best defense. However, people who live, work, or travel in tick-infested areas can take simple steps to help protect themselves against tick bites and babesiosis.
Those who participate in outdoor activities should attempt to stay on cleared trails and minimize contact with brush and high grasses. Additionally, they should be minimizing the amount of exposed skin by wearing light colored, long pants, long-sleeved shirts and tucking pant legs into socks. Furthermore, insect repellants that contain DEET can be applied to skin, and Permethrin applied to clothing for added protection. After outdoor activities, conduct a full-body exam for ticks using a hand-held or full-length mirror to view all parts of the body. It is imperative that children and pets also be checked. Since the Ixodes scapularis nymphs that typically spread Babesia microti are about the size of a poppy seed, they may easily go unnoticed. However, they usually must stay attached to a person for more than 36-48 hours to be able to transmit the parasite, so prompt removal of the tick is essential (CDC, 2018).
Akel, T., & Mobarakai, N. (2017). Hematologic manifestations of babesiosis. Annals of Clinical Microbiology and Antimicrobials, 16(1), 6. doi:10.1186/s12941-017-0179-z
CDC. (2018). Babesiosis. Retrieved https://www.cdc.gov/parasites/babesiosis/diagnosis.html