CRC PHYSN GUD ARTH MEDIC IMPTNC PDF

PREFACE

Among the scientific disciplines, the relative importance of medical entomology continues to increase. Malaria affects hundreds of millions of people annually, and development of the much-needed malaria vaccine seems as distant as ever. Also, dengue fever inflicts pain and suffering on millions of persons each year and now is threatening the southern United States. There are even "new" or emerging vector-borne diseases being recognized. Lyme disease was unknown 30 years ago. Now it is the most commonly reported vector-borne disease in the United States, with about 20,000 cases reported each year. Human cases of tick-borne ehrlichiosis were first described in the United States in 1986; now at least three different ehrlichial agents have been found affecting humans.

Age-old vector-borne diseases such as epidemic typhus, plague, yellow fever, and relapsing fever are still around. These agents remain endemic in many parts of the world, and under the right conditions (e.g., war or disaster) can quickly erupt into epidemics. Arthropod adaptability, combined with ecological and environmental change and frequent air travel, ensure that vector-borne diseases will continue to be a problem for humankind.

For most people living in the industrialized nations, the threat from insects, spiders, or mites lies primarily with stings and bites of various species and the reactions, both allergic and nonallergic, to them. For example, due to the ubiquity of honey bees or fire ants (in many areas), almost every person is occasionally stung. Allergic reactions can be severe, resulting in death. In addition, for unknown reasons, fire ant invasions into nursing homes — resulting in attacks on patients — seem to be increasing in the southern United States.

This book was written to provide physicians, other health care providers, and public health officials with a reference of these insects, mites, scorpions, and spiders of public health importance as well as topics related to these organisms. Voluminous works could be developed on many of these topics. However, a deliberate effort has been made to keep extraneous information to a minimum. Also, as in all areas of science, entomology includes controversies over certain points and "facts." In many cases these facts are constantly changing and being revised. Accordingly, I have chosen to streamline the references in this book and to provide views that represent a general consensus of the current status of each subject.

The primary focus of this arrangement is to provide easy, almost instant access to essential information concerning these topics. It is not the intent of this reference to make entomologists out of the readership. Specialists should be consulted whenever possible for definitive identification of an arthropod. Extensive technical jargon has been avoided as much as possible in the "General Description" sections. However, a glossary is included to aid the reader in defining and locating descriptive terms and characters.

The volume begins with several chapters on the pathologic conditions caused by arthropods, and the principles of treating those conditions. These are provided because a physician may first have to identify the nature of an arthropod-caused problem (sting, bite, blistering, etc.). Chapter 1, Principles of Treatment, includes the rationale behind the various treatment regimes. This should be helpful because, although specific recommendations may change through time, the underlying principles of controlling the immune response will not. When arthropods are mentioned in Part I, there will be a parenthetical reference indicating where in Part III the reader can go for more detailed information. Part II consists of a chapter on identification of arthropods and a chapter on common signs and symptoms of vector-borne disease.

The third major part of the book is an alphabetical arrangement of the arthropods of medical importance with clearly marked subheadings for easy information access. To find a topic or insect section, the reader should look for that name or topic alphabetically. Keep in mind that all flies are grouped together, as are all lice, all mites, etc. A person wishing to find the topic "screwworm fly" would consult the flies chapters. Also, it is important to remember that common names vary with locality. A "blue-tailed darner" may mean one thing to the author and something totally different to someone else. Often the geographic distributions of the arthropods are given in relation to zoogeographic region. Figure 1 is provided to reacquaint the reader with these regions. The index includes the various pathologic conditions and as many of the common names as possible to aid the reader in finding a particular topic or insect. Also, it is important to remember that if a patient brings in to the clinic an insect, mite, or spider associated with a particular health problem, it is prudent to deal with the problem (with this reference, hopefully) at hand but also to submit the specimen to a university or health department entomologist for definitive identification. This might be important for later follow-up, consultation, or legal matters.

In Physician's Guide to Arthropods of Medical Importance, Fifth Edition, the chapters have been updated with much of the latest information and current references. The mosquito chapter was revised with the help of Dr. Bruce Harrison at the North Carolina Department of Environment and Natural Resources. Lastly, many of the older photographs have been replaced with new, improved ones (or line drawings), and some color photographs were replaced with better ones. More importantly, a CD-ROM was developed to accompany the new edition. The CD-ROM contains helpful identification aids, additional reading materials, and more photos. I am very excited about this new edition and wish to extend appreciation to my colleagues for continued interest in this book.

Finally, every effort has been made to ensure that the treatment recommendations herein are current and widely recognized as appropriate. However, it must be emphasized that treatment recommendations may change over time and should not be construed to be the sole specific treatment guidelines for any one case. Physicians should consult appropriate medical literature (Conn's Current Therapy, for example) and/or drug package inserts for the most up-to-date treatment recommendations.