UNIT VII: VECTOR

BORNE DISEASES

Prepared by: Madonna C. Sudio,

MPH, RPh

09-30-2015

Objectives
At the end of the lesson the
student should be able to:

1.Identify, enumerate and

classify the different infectious
diseases in the Philippines.
2.Know the current mortality
and morbidity rate of this
various diseases.

Objectives
At the end of the lesson the
student should be able to:

3.Understand the occurrence,

natural history and mode of
transmission of diseases
particularly vector borne and
other infectious diseases.
4.Identify the drug intended for
these types of diseases.

Objectives
At the end of the lesson the
student should be able to:

5.

Access, analyze and

diagnose problems related to
cases to patient or
community.

INFECTIOUS DISEASES IN THE

PHILIPPINES

VECTOR BORNE DISEASES

1. Dengue fever
2. Malaria

VECTORBORNE

DENGUE FEVER

VECTORBORNE

DENGUE
FEVER

Necessary Cause: (4 distinct

viral serotypes)
DEN-1, DEN-2, DEN-3 & DEN-4
Note: Recovery from infection
provides lifelong immunity
against particular serotype.

VECTORDENGUE
FEVER
BORNE
Occurrence: (DOH, 2015)
Jan.-May, 2015: reported suspected
dengue cases 22, 903 cases
*8% higher than the same period last
year

Most cases:

NCR, Central Luzon,

CALABARZON

Widespread throughout tropics:

Note: All-year round disease

VECTORBORNE

DENGUE
FEVER

Occurrence: (DOH, 2015)

1950s: was first recognized
(Dengue epidemics in the
Philippines and Thailand)
Today: severe dengue affects
most Asia & Latin American
countries

VECTORBORNE

DENGUE
FEVER

Characteristics of Dengue Fever:

f- febrile illness that affects everybody

SYMPTOMS:
- Appear 3-14 days after infective bite
- Symptoms range from mild fever- to
incapacitating high fever (40C/104F)
- Severe headache, pain behind the
eyes, muscle and joint pain; rash

VECTORBORNE

DENGUE
FEVER

Characteristics of Severe Dengue

Fever (a.k.a. dengue hemorrhagic
fever):
SYMPTOMS:
- Fever, abdominal pain, persistent vomiting,
bleeding and breathing difficulty
Potential deadly complication: due to
plasma leaking, fluid accumulation,
respiratory distress, severe bleeding or
organ impairment.

VECTORBORNE

DENGUE
FEVER

Characteristics of Severe Dengue Fever

(a.k.a. dengue hemorrhagic fever):
Warning signs:
- Occur 3-7 days after the first symptoms in
conjunction with a decrease in temperature
(38C)
- This include: severe abdominal pain, rapid
breathing, bleeding gums, fatigue, restlessness
and blood in vomit.

VECTORBORNE

DENGUE
FEVER

Characteristics of Severe Dengue

Fever (a.k.a. dengue hemorrhagic
fever):
Warning signs:
- The next 24-48 hrs of the critical stage
can be lethal
(Note: Proper medical care is needed to
avoid complications and risk or death)

VECTORBORNE

DENGUE
FEVER

TRANSMISSION:
Indirect contact: Transmitted by the bite
of a female mosquito infected with one
of the four dengue virus serotypes.
Primary Vector: Aedes aegypti
Carrier & multiplier: Infected humans
source of the virus for uninfected
mosquitoes.

VECTORBORNE
Vector:

DENGUE
FEVER

Aedes aegypti
- Lives in urban habitats and breeds mostly
in man-made containers.
- Day-time feeder
- Peek biting period: early in the morning
and in the evening before dusk
- Bites multiple people during each feeding
period.

VECTORBORNE
Vector:

DENGUE
FEVER

Aedes albopictus
- Secondary dengue vector.
- Highly adaptive and can survive in cooler
temperate regions
- It spread is due to its tolerance to
temperature below freezing point,
hibernation and ability to shelter in
microhabitats

VECTORBORNE

DENGUE
FEVER

TREATMENT:
There is no specific treatment
For severe dengue:
- Maintenance of the patients body fluid
volume is critical.

VECTORDENGUE
FEVER
BORNE
IMMUNIZATION:
- There is no vaccine yet
- Three tetravalent live-attenuated
vaccines: under development in phase
II and phase III clinical trials
- 3 other vaccine candidates ( based
on subunit, DNA and purified
inactivated virus platforms):
At earlier stages of clinical development.

VECTORDENGUE
FEVER
BORNE
PREVENTION AND CONTROL:

(WHO May,

2015)

At present: only method is to combat

vector mosquitoes
Preventing mosquitoes from accessing
egg-laying habitats by environmental
management and modification;
Disposing of solid waste properly and
removing artificial man-made habitats;

VECTORDENGUE
FEVER
BORNE
Covering, emptying and cleaning of
domestic water storage containers
on a weekly basis;
Applying appropriate insecticides to
water storage outdoor containers;
Using personal household protection
such as window screens, longsleeved clothes, insecticide treated
materials, coils and vaporizers;

VECTORBORNE

DENGUE
FEVER
Improving community participation and
mobilization for sustained vector
control;
Applying insecticides as space spraying
during outbreaks as one of the
emergency vector-control measures;
Active monitoring and surveillance of
vectors should be carried out to
determine effectiveness of control
interventions.

VECTORDENGUE
FEVER
BORNE
PREVENTION AND CONTROL: (DOH 2015)
June is dengue awareness month
Theme: Eskwelahan, Simbahan,
Barangay, Palengke at Buong
Komunidad, Sama-Sama Nating
Sugpuin ang Dengue
Aims: to heighten awareness of the
strategy to fight dengue by
adopting 4S Kontra Dengue.

VECTORDENGUE
FEVER
BORNE
PREVENTION AND CONTROL: (DOH 2015)
DOH 4S Kontra Dengue Strategy

Search and Destroy

Seek early consultation
Self-protective measures
Say no to indiscriminate fogging

VECTORDENGUE
FEVER
BORNE
PREVENTION AND CONTROL: (DOH 2015)
DOH Advisory:
Destroy all possible breeding sites
like old tires and tin cans, clean roof
gutters, replace water in flower
vases regularly and to use mosquito
nets or protective clothing
Fogging may be done only in
outbreak areas.

VECTORDENGUE
FEVER
BORNE
Protect yourself from day bites by
using topical insect repellants or
wearing long-sleeved shirts
Seek treatment if there are
persistently high fever,
appearance of skin rashes or any
signs of bleeding.

VECTORBORNE

MALARIA

VECTORBORNE

MALARIA

Necessary Cause: Plasmodium

parasite
Plasmodium falciparum
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale
Vector: Anopheles mosquitoes
Bite: between dusk and dawn

VECTORBORNE

MALARIA

Plasmodium knowlesi (recent

years)
- Some human cases have also
occurred
- A species that causes malaria
among monkeys and occurs in
certain forested areas of SouthEast Asia.

VECTORMALARIA
BORNE
Occurrence: (DOH, March 11, 2014)
Note: Malaria cases declined
since the mid-2000s
83% reduction from 2005-2013
92% reduction in the # of deaths
Number of cases went down:
2005: 46, 342 cases 2013: 7,
720 cases

VECTORMALARIA
BORNE
Occurrence: (DOH, March 11, 2014)
2005: 150 deaths 2013: 12
deaths
Note: Achieved MDG target for
2015 as early as 2008.
Of 53 known provinces (endemic)
27 have already declared
malaria-free.

VECTORMALARIA
BORNE
TRANSMISSION: (WHO, April, 2015)
Malaria is transmitted exclusively
through the bites of
Anopheles mosquitoes. The
intensity of transmission
depends on factors related to
the parasite, the vector, the
human host, and the
environment.

VECTORBORNE

MALARIA

TRANSMISSION: (WHO, April, 2015)

- Depends of climatic conditions:
Such as: rainfall patterns,
temperature and humidity
Seasonal: peak during and just
after rainy season.
Favor with low immunity among
people move into areas with
intense malaria transmission.

VECTORBORNE

MALARIA

Symptoms: (WHO, April, 2015)

- Acute febrile illness
- Non-immune: appear 7 days or
more (10-15 days) after infective
bite.
- Fever, headache, chills and
vomiting
- If not treated w/ 24 hours: progress
to severe illness leading to death.

VECTORBORNE

MALARIA

Symptoms: (WHO, April, 2015)

- Children with severe malaria: This
includes:

Severe anaemia, respiratory

distress in relation to metabolic
acidosis, or cerebral malaria. In
adults, multi-organ involvement
is also frequent

VECTORBORNE

MALARIA

Treatment: (WHO, April, 2015)

WHO recommends:
- all cases of suspected malaria be
confirmed using parasite-based
diagnostic testing (either microscopy
or rapid diagnostic test) before
administering treatment.

VECTORBORNE

MALARIA

Treatment: (WHO, April, 2015)

- Early diagnosis and treatment of
malaria reduces disease and prevents
deaths.
- It also contributes to reducing
malaria transmission
- best available treatment, particularly
for P. falciparum malaria, is
artemisinin-based combination
therapy (ACT)

The choice of
artemisinin combination
therapy (ACT)

Combinations which have been evaluated:

chloroquine

mefloquine
artemisinin ++ piperaquine

amodiaquine

mefloquine
artemether + lumefantrine

mefloquine

sulfadoxinepyrimaethaminine

artesunate ++

mefloquine

dihydroartemisinin + piperaquine
naphthoquine

proguanil-dapsone
chlorproguanil-dapsone
atovaquone-proguanil
clindamycin
tetracycline
doxycycline

There are now more trials involving artemisinin and its

derivatives than other antimalarial drugs, so although there
are still gaps in our knowledge, there is a reasonable evidence
base on safety and efficacy from which to base
recommendations.

VECTORBORNE

MALARIA

Antimalarial drug resistance:

- Widespread in the 1970s and
1980s, Resistance of P. falciparum
to previous generations of medicines,
such as chloroquine and
sulfadoxine-pyrimethamine (SP)
- Recently, parasite resistance to
artemisinins has been detected:
Cambodia, Laos, Myanmar,
Thailand and Vietnam.

VECTORBORNE

MALARIA

Prevention:
- Vector control is the main
way to reduce malaria
transmission at the
community level.
- For individuals, personal
protection against mosquito
bites as first line of defense.

VECTORBORNE

MALARIA

Prevention:
- Two forms of vector control:
Insecticide-treated mosquito nets
(ITNs)
a. Long-lasting insecticidal nets
(LLINs) are the preferred form of ITNs
for public health distribution programs.
b. Indoor residual spraying (IRS)
with insecticides- is a powerful way
to rapidly reduce malaria transmission.

VECTORBORNE

MALARIA

Prevention:
b. Indoor residual spraying (IRS)
with insecticides
- Indoor spraying: effective for 3-6
months
- Pyrethroids: (insecticides) mosquito
resistance

VECTORBORNE

MALARIA

Prevention:
- Vaccines
- No licensed vaccines yet.
- RTS, S/AS01: under research vaccine
against
P. falciparun

ADDITIONAL
INFORMATION
OTHER INFECTIOUS
JAPANESE
ENCEPHALITIS
DISEASES
09-30-2015

VECTORBORNE

JAPANESE
ENCEPHALITIS

CHARACTERISTICS:
- Type of viral brain infection
- Spread through mosquito bites:
Culex tritaeniorhynchus
- Common in rural areas throughout
South East Asia, the Pacific islands
and the Far East
- Rare in travellers

VECTORBORNE

JAPANESE
ENCEPHALITIS

CHARACTERISTICS:
- Flavivirus related to dengue,
yellow fever and West Nile
viruses
- Symptomatic
- rare: case-fatality rate can be
high as 30%
- No cure for the disease

VECTORJAPANESE
ENCEPHALITIS
BORNE
CHARACTERISTICS:
- host: pigs and birds while humans
are incidental or dead-end hosts
- Treatment is focused on relieving
severe clinical signs and
supporting the patient to
overcome infection.
- Safe and effective vaccines are
available.

VECTORBORNE

JAPANESE
ENCEPHALITIS

Sign and Symptoms:

- Mild: mild fever and headache or w/o
apparent symptoms
- Severe: rapid onset of high fever,
headache, neck stiffness, disorientation,
coma, seizures, spastic paralysis and
death
- Survive: suffer permanent intellectual,
behavioral or neurological problemsparalysis, recurrent seizures or
inability to speak

End