Mosquito Bites

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was canonized by Pope John Paul II on October 25,. 1987 ... after his family prayed to the doctor; when he awoke, ... “Saint Joseph Moscati,” Jesuits of Naples,.
1138 Mosquito Bites Moscati died of a stroke on April 12, 1927. He was canonized by Pope John Paul II on October 25, 1987, the only layperson chosen at this time. The two miracles attributed to Moscati include the healing of Costantino Narraro from Addison’s disease; Narraro was said to have seen Moscati in a dream after his family prayed to the doctor; when he awoke, Narraro was cured. The second miracle involved Raffaele Perrotta’s recovery from spinal meningitis. SEE ALSO: Addison’s Disease; Cholera; Meningitis. Bibliography. “Saint Joseph Moscati,” Jesuits of Naples,

Italy, www.gesuiti.it/moscati/English/En_Bio1.html (cited August 2007); “St. Joseph Moscati: The Fruit of Daily Commitment,” Word among Us, www.findarticles.com (cited August 2007).

Kelly Boyer Sagert Independent Scholar

Mosquito Bites Is the resulting injury from a mosquito sting, which could produces from a local inflammatory reaction to, after an incubation period, a vector-borne disease, such as malaria, dengue, leishmaniasis, and yellow fever, among others. The mosquito bites its victims (humans or animals) because it is a hemophagus insect (use blood for feed and for its reproductive cycle). Their ability to bite is given by the prosbocis (an extended mouth structure). In the female mosquitoes, the piercing mouthparts allow them to draw blood into their alimentary tract. Many substances that make them able to bite practically being few or none perceived by the victim (anesthetics) and substances that make efficient the extraction of blood (anticoagulants) are secreted from salivary glands of the mosquitoes. Mosquitoes that transmit disease-causing pathogens (parasites, viruses, or bacteria) belong taxonomically to the suborder Nematocera (order Diptera), and particularly to the family Culicidae. In this family are located the two most medically important mosquito subfamilies: Anophelinae and Culicinae. The species of Anopheles (Anopheles gambiae, darlingi, dirius, and funestus, among others) belong to

the first one, being the vector of the most worldwide important parasitic disease, malaria. The species of Aedes (mainly Aedes aegypti, africanus, simpsoni, and albopictus) and Culex (Culex pipiens, sitiens, quinquefasciatus, univittatus, and restuans, among others) belong to the second one, being the vectors of dengue and yellow fever, and of other viral and parasitic diseases such as viral encephalitis (such as Venezuelan and Western equine encephalitis, Japanese encephalitis, and St. Louis encephalitis), West Nile virus, and filariasis, among others, respectively. In the case of yellow fever, the mosquitoes Haemagogus and Sabethes (also subfamily Culicinae members) are the most important vectors in the sylvatic cycle of disease. The risk associated with mosquito bites could be assessed in different ways; but derived from the study of malaria transmission, the entomological inoculation rate describes the number of infecting bites that a person received per night (but can be calculated in other time scales). To properly perform and analyze this, medical entomologists conduct entomological surveillance studies, using different methods of catching anopheline mosquitoes, such as human landing catches, light traps, a double net, a calf-baited trap, and collection of resting mosquitoes on vegetation, among others. These studies allow to public health authorities to perform a guided-vectorial control to reduce transmission of malaria and other vectorborne diseases in the areas where these diseases are prevalent or endemic. Other families in which its members could lead to a disease as a result of mosquito bites include the sand flies (family Psychodidae, subfamily Phlebotominae), the family Simulidae, and the family Ceratopogonidae. Leishmaniasis, bartonellosis, and papatasi fever, among others, are diseases transmitted by sand fly bites (Phlebotomus, Sergentomyia, and Lutzomyia). River blindness is a parasitic disease (produced by a filarial called Onchocerca volvulus) that is transmitted by a mosquito bite by species of Simulium (family Simulidae). Similarly, other filarial parasites, species of Mansonella, are transmitted by mosquitoes of the family Ceratopogonidae: Culicoides, Forcipomyia, Austroconops, and Leptoconops. In any case, thinking of a local inflammatory reaction to an important mosquito-transmitted disease, the exposure to mosquito bites should be avoided.

Mouth Disorders



Personal protection against mosquito bites is based on the use of topical repellents, the use of long clothing to reduce exposed skin, and the use of insecticide sprays, vaporizers, and nets, among others. Up to now, insecticides have remained the main tool for both killing mosquitoes and controlling mosquitoborne diseases. Although other vector-control strategies today should be considered, such as use of biological vector control (using other insects or microorganisms), a combination of those strategies in a balanced way, in what is called integrated vectorial control, should be considered to prevent mosquito bites and mosquito-borne diseases. In the past 10 years, an important ecological approach has been introduced in this management, with the integration of the ecoepidemiology, which considers the environmental aspects in the dynamics of transmission and the impact on the epidemiology of disease.

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Mouth Disorders

tive measures include seeking proper prenatal care, for appropriate nutrition and health management. Prognosis is good with comprehensive therapy (surgical repair, orthodontics, prosthodontics, speech therapy), beginning in early childhood and through to adulthood. Tongue inflammation with a red-surfaced tongue (glossitis) is sometimes associated with burning and pain of the tongue (glossodynia). Both appear to be benign and often secondary to other illnesses, medications, and smoking. Symptoms may cease with medication and smoking cessation. Oral lichen planus is a chronic autoimmune disease causing inflammation, and has similar symptoms to other mouth disorders. Therapy is aimed at managing pain and discomfort using local or systemic steroids. Chronic inflammation of the salivary gland with enlargement of the parotid glands may be due to a variety of disorders—Sjogren’s and sarcoidosis, diabetes, alcoholism and vitamin deficiencies—or as a side effect of drugs stimulating salivary flow and more viscous saliva. Sialolithiasis is calculus formation occurring most often in Wharton’s duct (draining the submandibular), and occasionally in Stensen’s duct (draining parotid glands), causing pain after eating and local swelling. The obstruction may be removed, or in severe cases, excision of the gland may be necessary. Leukoplakia is a white lesion that cannot be removed by rubbing (most often it is benign), and is often caused by irritation. Erythroplakia is similar to leukoplakia but presents with redness. In many cases erythoplakia is dysplasia or carcinoma. Squamous cell carcinoma of the oral mucosa accounts for the majority of oral cancers. Early detection is essential; lesions at 2 mm depth or less have the best prognosis. Treatment is by surgical excision, larger tumors require both excision and irradiation. Major risk factors include alcohol and tobacco use. Salivary gland tumors occur most often in the parotid glands and tend to be benign; tumors in the submandibular gland are less likely to be benign. Surgical excision if needed is sufficient treatment for most salivary gland tumors; post-surgical irradiation is indicated for large or high-grade tumors.

Mouth disorders are illnesses, infections, obstructions, and chronic conditions, related to the oral cavity. A cleft palate is a congenital malformation causing an incomplete closure of the lip and palate. This results in functional (eating, speech) and cosmetic issues. Preven-

Infections Candidiasis, also called oral thrush, is caused by the fungus candida albicans. Symptoms include pain and easily-removed, creamy-white patches over reddened mucosa. Antifungal therapy is used to treat candidiasis.

SEE ALSO: Flea Bites; Medical Entomology; Parasitic Dis-

eases; Tick Bites; Travel Medicine; West Nile Virus.

Bibliography. Antonio Atias, Medical Parasitology

(Mediterraneo, 2005); Rocio Cardenas, “Impact of Climate Variability in the Occurrence of Leishmaniasis in Northeastern Colombia,” American Journal of Tropical Medicine & Hygiene (v.75/2, 2006); Gordon Cook and Alimuddin Zulma, Manson’s Tropical Diseases (Saunders, 2003); Peter Davies, The American Heritage Dictionary of the English Language (Dell, 1977); David Feliciano, Trauma (Appleton & Lange, 1996); Yasmin Rubio-Palis and Christopher Curtis, “Evaluation of Different Methods of Catching Anopheline Mosquitoes in Western Venezuela,” Journal of the American Mosquito Control Association (v.8/3, 1992). Alfonso J. Rodriguez-Morales, M.D. Universidad de Los Andes Carlos Franco-Paredes, M.D. Emory University