• Safe Travels: Protect Against Mosquito-Borne Diseases

    IMAGE If travels to Southeast Asia, Africa, or even Florida are in your immediate future, take the time to prepare yourself against mosquito-borne illnesses. Mosquitoes thrive in warm climates, and some may carry viruses that can be passed to humans through their bites. Here is a rundown of mosquito-borne diseases you should be aware of when planning your next trip.

    Encephalitis

    Several mosquito-borne diseases can cause a severe condition called encephalitis (inflammation of the brain). An infected person may first experience flu-like symptoms, such as headache, fever, nausea, vomiting, and fatigue. In some cases, there may not be any symptoms.
    If the condition worsens, it can lead to nerve damage, coma, seizures, long-term disability, and death. For most forms of encephalitis, there is no treatment. Care is given to ease symptoms.
    Below are some forms of mosquito-borne encephalitis:
    Condition Cases Reported in… Mosquitoes Transfer the Virus to Humans From…
    Japanese encephalitis Rural areas of Asia Infected pigs and birds
    St. Louis encephalitis Most cases in East and Central United States, but virus found in all lower 48 states Infected birds
    –Severe cases usually seen in older adults.
    La Crosse encephalitis Upper Midwest, Mid-Atlantic, and Southeast United States Infected small mammals (eg, squirrels)
    –Severe cases usually seen in children 16 years old and younger.
    Eastern equine encephalitis (EEE) Southeast and East United States Infected animals (eg, horses)
    Western equine encephalitis West and Central United States Infected animals (eg, horses)
    Venezuelan equine encephalitis Central and South America Infected animals (eg, horses)

    West Nile Virus

    West Nile virus has been reported in Africa, Asia, the Middle East, Europe, and the United States. Mosquitoes spread the virus to humans from feeding on infected birds. Symptoms are similar to the flu (eg, fever, vomiting, and headache).
    Symptoms may progress to memory loss, difficulty walking, or muscle weakness. There is no treatment for West Nile virus. Care is given to ease symptoms.

    Dengue Fever

    Several viruses carried by the Aedes aegypti mosquito cause dengue fever. Dengue fever is commonly reported in tropical urban areas in Asia, South America, Central America, North America, Africa, as well as the South Pacific and Caribbean. Fever is the main symptom, along with at least two of the following:
    • Headache
    • Pain in the back of the eyes
    • Nausea
    • Vomiting
    • Muscle or joint pain
    • Flushed face (rosy-colored face)
    • Rash
    • Spontaneous bleeding
    A more severe form of the disease can cause:
    • Massive blood loss through bleeding
    • Shock
    • Organ damage
    Symptoms are treated with rest, fluids, and pain medicines.

    Yellow Fever

    Yellow fever occurs in tropical cities, towns, and villages of Africa and South America. It spreads from an infected human to other humans by the Aedes aegypti mosquito. Symptoms include:
    • Fever
    • Chills
    • Headache
    • Muscle aches
    • Backache
    • Vomiting
    Symptoms can progress to:
    Treatment includes rest, fluids, and pain medicines.

    Rift Valley Fever

    Rift valley fever is a condition found in parts of eastern and southern Africa where cattle and sheep are raised. The condition has also been reported in sub-Saharan Africa and the Middle East. It most often occurs after heavy rainfall or flooding. Humans contract the virus from a mosquito that has fed on an infected animal. Symptoms include:
    • Fever
    • Weakness
    • Back pain
    • Backache
    • Extreme weight loss
    More severe symptoms include:
    • Fever with shock or hemorrhage (bursting of blood vessels)
    • Eye diseases
    • Inflammation of the brain
    There is no standard treatment. Recovery usually takes a few days to a week.

    Malaria

    Unlike other mosquito-borne diseases, malaria is caused by a parasite, not a virus. Malaria has been reported in Africa, Asia, and Latin America. The disease is spread by the Anopheles mosquito. Symptoms are similar to the flu (eg, fever, chills, nausea, body aches).
    Severe symptoms may include:
    Antimalarial drugs are used to treat malaria by killing the parasite.

    Ways to Protect Yourself

    Visit the Centers for Disease Control and Prevention Travelers’ Health website at http://www.cdc.gov/travel for updates on traveler’s health concerns in various countries. Also, visit a traveler’s health clinic or talk with your doctor to find out if vaccinations or other preventive measures are required before travel.
    Once you are at your destination, take the following steps:
    • Avoid or limit outdoor activity during peak exposure times. Mosquitoes are active and biting at all times. They are especially active at dawn, dusk, and in the evenings.
    • Stay out of vegetated areas and grassy areas.
    • Apply repellant to exposed skin. Look for active ingredients, like DEET or picaridin, which provide long-lasting protection against mosquitoes and other insects. Other types of repellants include those with EPA-registered products that have oil of lemon eucalyptus, PMD (the manmade version of oil of lemon eucalyptus), or IR3535.
    • Wear protective clothing. Keep mosquitoes from making contact with your skin by wearing long-sleeved shirts that are tucked into your long pants, socks, boots or other closed shoes, and a hat.
    • Wear repellent on your clothing. Add an extra layer of protection to your clothes, shoes, and gear by applying repellents or insecticides (like permethrin). Re-apply after washing clothes.
    • Check the screens on the doors and windows. Look for small holes and gaps in the screens. If you notice any problems, repair them yourself or ask someone to help you.
    • Put up a net. Your sleeping area should have screens or be air-conditioned. If not, put up nets around your bed. The nets should reach the floor. If they do not, tuck the ends into your mattress. Spray the net with repellent or insecticide. Pretreated nets are also available.
    • Remove stagnant water. Mosquitoes lay their eggs in stagnant water. That's why it is so important to get rid of water that has collected around the property. Even small containers, like jars and cans, can be a breeding ground for mosquitoes.

    References

    Badash M. Malaria. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated March 10, 2011. Accessed April 19, 2011.

    Carson-Dewitt R. Dengue fever. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated March 10, 2011. Accessed April 19, 2011.

    Dengue fever & dengue hemorrhagic fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/diseases/submenus/sub%5Fdengue.htm. Updated October 1, 2007. Accessed April 19, 2011.

    Fact sheet: western equine encephalitis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dvbid/arbor/weefact.htm. Updated November 7, 2005. Accessed April 19, 2011.

    Information on arboviral encephalitides. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dvbid/arbor/arbdet.htm. Updated November 7, 2005. Accessed April 19, 2011.

    Japanese encephalitis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dvbid/jencephalitis/index.htm. Updated April 10, 2010. Accessed April 19, 2011.

    Malaria. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/malaria/. Updated December 3, 2010. Accessed April 19, 2011.

    McCoy K. St. Louis encephalitis. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated December 1, 2010. Accessed April 19, 2011.

    McCoy K. Western equine encephalitis. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated December 1, 2010. Accessed April 19, 2011.

    Rift valley fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/rvf.htm. Updated March 3, 2006. Accessed April 19, 2011.

    Rymaruk J. Yellow fever. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated December 1, 2010. Accessed April 19, 2011.

    Saint Louis encephalitis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/sle/. Updated January 29, 2010. Accessed April 19, 2011.

    Stresing D. Eastern equine encephalitis. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated December 1, 2010. Accessed April 19, 2011.

    West Nile virus. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated March 10, 2011. Accessed April 19, 2011.

    Yellow fever. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncidod/diseases/submenus/sub%5Fyellow%5Ffever.htm. Updated October 24, 2007. Accessed April 19, 2011.

    Zielinski-Gutierrez E, Wirtz RA, Nasci RS. Protection against mosquitoes, ticks, and other insects and arthropods. Centers for Disease Control and Prevention website. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/protection-against-mosquitoes-ticks-insects-arthropods.aspx. Updated July 27, 2009. Accessed April 19, 2011.

    9/12/2012 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Haley RW. Controlling urban epidemics of West Nile virus infection. JAMA. 2012:1-2.

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