Malaria is a mosquito borne life-threatening disease caused by a protozoan parasite which is transmitted through the bite of infected female Anopheles mosquitoes.

Five Malaria protozoan parasites infect humans are Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, Plasmodium knowlesi. P. falciparum and P. vivax are the main malaria parasites of public helath in India

There are mainly 2 types of Malaria - Falciparum Malaria and Vivax Malaria in India. The Plasmodium falciparum causes Falciparum Malaria which is the more severe type and can be fatal if not treated promptly and Plasmodium vivax causes Vivax Malaria which is generally mild but can sometimes be fatal.

The common signs and symptoms of Malaria are cyclic high fever, headache, rigors, chills, profuse sweating, nausea, vomiting, diarrhoea, anaemia, muscle pain, convulsions etc. If not treated promptly, the infection can become serious and responsible for kidney failure, seizures, mental confusion, coma and death.

Malaria can cause a number of life-threatening complications. ▪ Cerebral Malaria ▪ Renal Malaria ▪ Cirrhosis of Liver ▪ Hepatomegaly, Spleenomegaly ▪ Pulmonary oedema ▪ Multi-organ failure ▪ Anaemia and Jaundice ▪ Mortality

Yes, if not timely diagnosed, properly treated Malaria may be fatal.

Yes, Malaria is curable if patients get proper treatment in early stage; preferably within 24 hours of the onset of symptoms. After a proper diagnosis is confirmed, a full course of anti- malarial drugs must be taken for the full recovery from the disease. However, if early detection, complete treatment for malaria is not provided, the disease can progress to severe malaria and may results in death.

Malaria can be diagnosed by collecting blood on a microslide (blood smear) by microscopic examination and by a Rapid Diagnostic Test for detection of malaria parasite.

Malaria can be treated using standard malaria drugs approved by NCVBDC according to the malaria type recommended in different regions of India.

There is no vaccine for Malaria till date in India. However, WHO has accorded permission to use ‘Mosquirix’ vaccine in Africa and ‘Novavax’ vaccine is under field trails.

Methods like use of anti-malarial drugs, vector control, by the use of insecticides as larvicides & adulticides, use of Long-Lasting Insecticidal Nets, personal protection methods can be useful for prevention and control of Malaria.

Pregnant women, ante-natal mothers, children, non-immune individuals are at risk of Malaria infection. Anybody from non-endemic areas visiting malaria-endemic area may also be at risk of malaria.

The incubation period in malaria is the time between infective mosquito bite and the initial appearance of signs and symptoms. Normally, the symptoms begin almost 10 to 14 days after the biting of an infective female mosquito.

Vector is described as an arthropod or any living carrier that transports pathogens (disease causing agents) to a susceptible individual. Mosquito is a biological vector of Malaria.

Female anopheles mosquito ingests malaria parasites while taking blood from a malaria infected person and then, inject malaria parasite through its saliva while biting an uninfected person.

Malaria parasite is found in red blood cells of an infected person therefore, transmission of malaria can also occur through blood transfusion, organ transplant or the shared use of needles or syringes contaminated with blood of infected person. Malaria may also be transmitted from mother to growing foetus known as congenital malaria.

Female Anopheles mosquito is ‘sanguivorous’ (feeding on blood) and while taking blood meal from infected person Malaria parasites get entry in mosquito’s in sporozoite stage.

The male and female gametocytes of the malaria parasite find their way into the gut of the mosquito. In the infected mosquito male and female gametes fuse in the mosquito gut to form zygotes, which subsequently become motile, elongated (ookinetes) and invade the mid gut wall of the mosquito where they develop into oocysts. The oocysts grow, rupture, and release sporozoites, which make their way to the mosquito’s salivary glands for the transmission during next bite of mosquito to healthy person.

Infected female anopheles , the sporozoites get inoculated from its salivary glands into the human bloodstream during bite, causing Malaria infection in the human host.

After infected mosquito bites, sporozoits are inoculated in the host and reach the liver cells, there parasite reproduces asexually and increase their number in cells. Subsequently the parasites are released into the blood. In Red Blood Cells (RBC) also parasites reproduce asexually, leading to burst and release the parasites, which infect new RBCs. Some parasites doesn’t attack RBCs and develop into male (microgametocytes) and female (macrogametocytes) gametocytes.

The Malaria parasite life cycle involves 2 hosts - Human (Indefinite host) since asexual life cycle takes place in the body of humans and Mosquito (Definite host) since sexual life cycle takes place in the body of mosquito.

There are 3 phases of malaria parasite life cycle are known as a Hepatic (Tissue) schizogony in humans b Erythrocytic (Blood) schizogny in humans c Sporogony (Vector) in mosquito.

Female mosquitoes require ‘haemprotein’ from blood for development of eggs, therefore, they take blood meal

Female mosquito’s mouthparts (proboscis) are adapted for piercing the skin and sucking the blood. When a female mosquito bite it pierces the skin of human into which it injects saliva containing an anti-coagulant (to keep the blood flowing without clotting) and an anaesthetic (to keep the victim unaware of the bite) and sucks up the blood.

There are only 6 primary (major) malaria vectors and 3 secondary (minior) vectors. Primary vectors are Anopheles culicifacies, Anopheles stephensi, Anopheles fluviatilis, Anopheles minimus, Anopheles baimaii (earlier known as Anopheles dirus) and Anopheles epiroticus (earlier was known asAnopheles sundaicus ). The secondary vectors are Anopheles varuna, Anopheles annularis and Anopheles philippinensis play important role for transmission of Malaria in India.

Malaria is caused by Anopheles mosquitoes. Anopheles mosquitoes prefer to lay eggs in stagnated fresh waters such as rain water collections, overhead tanks, sumps, cisterns, wells, rice fields, quarry pits, slow moving streams, low-lying areas, brackish water (Anopheles epiroticus) etc.

Avoidance of mosquito bites: • Regular use of mosquito nets; preferably treated or long-lasting insecticide nets (LLINs) • Mosquito proof screening of doors and windows • Using of mosquito repelling electronic & electric gadgets • Wearing cloths covering full body e.g. full pants & full sleeved shirts etc. • Use of insecticide treated door and window curtains.

Breeding sources reduction: • Eliminating all unwanted standing water, • Release mosquito larvivorous fish where ever possible • Conduct weekly dry-day once in a Week • Fill all the low-lying areas with minor/major engineering works • Undertake weekly spray with appropriate larvicides.

Malaria can be controlled by the following methods... • Indoor residual spray with recommended insecticides • Fogging (Thermal/Cold) as and when required • Indoor space spry with appropriate insecticides • Use ULV aerosols electric dispensers • Operate electric bats, use insecticide treated bed nets.

Yes. It is possible to eliminate malaria from India, through optimising existing malaria management tools. In addition to this commitment of different stakeholders, Inter-sectorial collaborations, Community participation, Private Public Partnerships and introducing modern tools as an when made available.

Lymphatic Filariasis, commonly known as Elephantiasis, because, the most recognizable symptom is swelling in one or both legs, which resembles an Elephant’s foot. It is a painful and disfiguring mosquito borne, helminthic parasitic disease.

No. Lymphatic Filariasis is not life threatening, but it can cause severe damage to lymphatic system, genital organs and kidneys it gives permanent disability and restrict movement of the infected persons.

Female Culex quinquefasciatus and Mansonia spp. (Mansonia annulifera, Mn. uniformis, and Mn. indiana) are the most important Lymphatic Filariasis vectors in India.

The vectors of Lymphatic Filariasis usually breed in polluted & dirty water such as drains, septic tanks, cess pools and in water bodies with hydrophytes.

Helminthic worm Wuchereria bancrofti and Brugia malayi are the parasites responsible for causing Lymphatic Filariasis in India.

Lymphatic filariasis disease spreads from person to person by bites of female vector mosquitoes. After many infected mosquito bites, over several months to years, a person manifest Lymphatic Filariasis.

When a female vector mosquito bites a person, having microfilariae circulating in the blood enter and infect the mosquito. Thus, microfilariae develop into larval stages (L1, L2 & L3) inside the mosquito. When the infective female mosquito bites another person, infective larval stage (L3) pass from the mosquito enters through the skin and travel to the lymph vessels.

The Lymphatic Filariasis parasites are thin, thread-like worms in appearance. Due to the filamentous appearance of the disease-causing worm, the disease is called Filariasis.

No, most infected people are asymptomatic and will never develop any clinical symptoms, but the parasite will keep damaging the lymph system. It subsides with recurrent fever& Lymphangitis.

A small percentage of people will develop Adeno-lymphangitis, Lymphoedema, Lymph scrotum/Hydrocele. Affected people are more prone to bacterial lymphoid and fungal skin infections, which will result in hardening and thickening of the skin called Elephantiasis.

During blood meal, an infective mosquito (carrying L3 larval stage) filarial larvae drops onto the skin of the human host, where they penetrate through the bite wound. The larvae then migrate to the lymphatic vessels, where they develop into adult worms. After mating of male and female worms, the female produces millions of microfilariae (mF) in their lifetime which circulate freely in the blood.

Larval stage-3 (L3) is the infective larval stage of Lymphatic Filariasis transferred from mosquito to humans and microfilariae (mF) stage is ingested by mosquito from humans.

The L3 stage larva enters into lymphatic system and grows into male and female adult worms over a period of 6-12 months. The adult worms can stay alive in the human body for about 6-8 years.

The L3 stage larvae settle down at inguinal, scrotal or abdominal lymphatics and there, they begin to grow into adult worm of male & female.

It takes about 10-15 days for the microfilariae (mF) to develop into infective stage L3 larvae.

The adult worms of Lymphatic Filariasis live in the lymphatic vessels and lymph nodes, while the microfilariae (mF) it also stay in the lungs during day time and freely circulate in the blood during night.

Residing in areas where disease is endemic, frequent travel to the affected regions are at the risk for infection of Lymphatic Filariasis.

The standard method for diagnosing an active infection is the identification of microfilariae in a blood smear by microscopic examination. For increased sensitivity, concentration techniques and using provocative Di-Eethyl Carbamazine (DEC) drug. .

Serological techniques provide an alternative to microscopic detection of microfilariae for the diagnosis of Lymphatic Filariasis. Patients with active filarial infection typically have elevated levels of anti-filarial IgG4 anti-bodies and filarial antigens in the blood can be detected by using routine assays and molecular technique like PCR.

The Filariasis Test Strip (FTS) is a rapid diagnostic test recommended for mapping, monitoring and transmission assessment surveys (TAS) for the qualitative detection of Wuchereria bancrofti antigen in human blood samples.

Treatment for Lymphatic Filariasis depends on whether the infection is acute or has progressed to chronic. In active infections, Di-Eethyl Carbamazine (DEC) 6 mg per kg of body weight alone or in combination with Ivermectin and/or Albendazole is used. Symptomatic and supportive treatment is to be given for the complications of Lymphatic Filariasis.

No, currently there is no vaccine to prevent the infection in humans.

The best way to prevent Lymphatic Filariasis is to avoid mosquito bites. Another approach to prevention includes Annual Mass Drug Administration (MDA) to entire community of the endemic area reduces the level of microfilariae in the blood and thus, diminishes transmission of infection and by destroying breeding sites of Culex mosquitoes.

The optimum environmental conditions prevalent in tropical and sub-tropical regions during most part of the year, which include temperature between 15oC and 33oC and 70% relative humidity, play a pivotal role in survival and endemicity of Lymphatic Filariasis.

Lymphatic Filariasis is widespread throughout the country. As per NCVBDC reports, LF was prevalent in 257 districts in 21 States and Union Territories (UTs) in India.

Hydrocele is a type of swelling in the scrotum that occurs when fluid collects in the thin sticle. It is one of the complications of Lymphatic Filariasis.

Lymphoedema is a long-term (chronic) condition that causes swelling in the body's tissues. It can affect any part of the body, but usually develops in the arms or legs. It develops when the lymphatic system does not work properly.

There are 3 types of microfilarial periodicity. Nocturnal periodicity: The microfilariae that circulate in the peripheral blood at higher levels in the night hours is said to be nocturnal periodicity. Diurnal periodicity: The microfilariae that circulate in the peripheral blood in the day hours also is said to be diurnal periodicity. Aperiodic: The microfilariae that circulate in the peripheral blood in day hours as well as night hours at low levels is said to be aperiodic.

The microfilariae exhibit nocturnal periodicity in many parts of India, therefore to coincide with the appearance of microfilariae, the blood for the filarial diagnostic test should be drawn at night to get better result.

In India diurnal sub-periodic Filariasis (Dsp WB) is prevalent only in the Nicobar district of Andaman and Nicobar Islands. Downsiomyia nivea, a day biting mosquito is said to be the vector diurnally sub-periodic Filariasis.

Dengue is a mosquito-borne febrile viral infection causing a severe flu-like illness, and sometimes causing a potentially lethal complication called assevere Dengue.

There are 4 serotypes of Dengue viruses, namely DENV-1 with 3 genotypes, DENV-2 with 6 genotypes, DENV-3 with 4 genotypes, and DENV-4 with 4 genotypes and all are transmitted to humans.

Dengue virus infection can cause:
1. Mild Dengue fever
2. Moderate Dengue (Hemorrhagic) Fever
3. Severe Dengue (Shock Syndrome) Fever

Dengue virus has 3 structural and 7 non-structural proteins: Structural proteins are E-envelop, M-membrane and C-core proteins. Non-structural proteins are NS1, NS2A, NS2B, NS3, NS4A, NS4B and NS5.

Pathophysiological changes in Dengue viral infection are mainly 4 types: Cytokine storm, Antibody enhancement, Vasculopathy and Coagulopathy. There are 3 main clinical phases of Dengue illness are Febrile phase lasts about 2-7 days, Critical or leakage phage lasts about 24-72 hours and Convalescence phase lasts about 4-14 days.

Following are typical signs and symptoms of dengue fever: • High fever
• Severe frontal headache
• Pain behind the eyes (Retro-orbital pain) which worsens with eye movement
• Pain in the muscles and joints, especially in knees, ankles, elbows
• Loss of taste in mouth
• Loss of appetite
• Nausea and vomiting
• Rashes on the arms and the legs
• Fatigue and extreme tiredness.

Moderate dengue (Haemorrhagic) fever is also considered as severe dengue. The mosquito borne dengue viral infection occasionally develops into potential lethal complication called moderate dengue (Haemorrhagic) fever.

Following are symptoms of moderate dengue (Haemorrhagic) fever:
• severe abdominal pain
• persistent vomiting
• rapid breathing
• nose bleed and bleeding gums
• restlessness and blood in vomit

Some dengue haemorrhagic fever cases develop shock, known as the severe dengue (Shock syndrome). Shock syndrome is a dangerous complication of dengue infection and is associated with high mortality and the pathogenesis of shock in dengue is complex.

No, dengue is not contagious and can’t be spread from person-to-person by contact. Female mosquitoes belong to Aedes aegypti and Aedes albopictus act as vectors in dengue transmission.

Incubation period for Dengue in humans is the time from virus infection to development of signs and symptoms of dengue appears. The incubation period ranges from 3 - 14 days with an average of 4-7 days. The virus circulates in the blood of infected humans for 2 -7 days, at approximately the same time they have a clinical symptom.

Dengue is spread by the bite of Aedes female mosquitoes. These mosquitoes (Ae. aegypti or Ae. albopictus) spread the disease by biting an infected person and then biting the healthy person.

An infected mosquito is capable transmitting of virus for the rest of its life once it is infected. Dengue virus can also get transmitted to their off springs by trans-ovarial (via the Eggs) transmission in infected female Aedes. Infected humans are the main carriers and multipliers of the virus, and serving as a source of the virus for other mosquitoes.

Aedes mosquitoes prefer to breed in water containers of domestic (within the houses) and peri-domestic (around the houses). Their preferential breeding sources are cement barrels, drums, jars, pots, buckets, tanks, overhead tanks, junk materials, rooftop, underground tanks, desert coolers, sun shade parapets, pot holes, ornamental tanks/fountains, flower/plant pots/vases/saucers, bamboo stumps, tree holes, coconut shells, tyre dumps etc., where water stagnates for more than a week. They also breed in exposed water collections like discarded bottles, tins, tyres, water coolers, disposable plastic cups/plates etc.

Aedes mosquito attaches its eggs on the inner walls of water containers/breeding places just above the water line, larvae hatch when eggs are submerged in water. It takes 7-10 days for larva to become adult. The eggs can survive desiccation for months in absence of water, and can hatch again on availability of water in containers with eggs.

Aedes aegypti rest both indoors & outdoors, whereas Aedes albopictus prefers to rest outdoors. They stay in dark and cool places inside the house, mainly in corners, under furniture, beds, shelves, almirah and dark clothing, hanging objects. Tree holes, vegetation, discarded tyres, dark and humid places etc., in outdoors.

Dengue mosquitoes are usually day biters, bites during dawn and dusk. , However, they are also observed to bite in night where low illumination. Mosquito can bite any exposed body parts such as legs, hands, face, neck, ears.

Life span for adult male mosquito is 1 week and female around 3 weeks.

There are 4 stages in the life cycle of Aedes mosquito, among them 3 are in water and only the adult will be in air: Egg: They are laid singly on the inner walls of water containers in the house and patio as well as on damp soil that can be flooded by water. Larva: There are 4 larval instars, lives freely in water for feeding and comes to the surface to breathe. Larvae shed skin at each stage (moulting) and grow in size. Pupa: It is resting, non-feeding stage of development and mobile swiftly. Adult: Adults emerge by splitting the pupal case. The newly emerged adult rests on the water surface for a short time, to allow its body parts to dry and harden.

No, Aedes breeds only in clean water having rich in organic food materials.

No vaccine to prevent dengue fever. It is under clinical trials in other countries, at present it is not available.

Yes, dengue is deadly disease. People who suffer from mild dengue fever have no risk of death, but people developed moderate and severe dengue may get fatality.

Yes, infection with one viral serotype does not protect a person against infection from the other three serotypes. So, if a person has suffered from one serotype, there can be a repeat occurrence of a different serotype is subsequently involved. Hence, infection with different serotypes increases the risk of severity, complications and fatality.

The best way to prevent dengue infection is by protecting ourselves from mosquito bites. Aedes mosquitoes bite during the day and the highest biting intensity morning and evening hours . To avoid being bitten one should: • Wear full-sleeve clothes and long dresses to cover as much as possible. • Use mosquito repellents as topical applicantion • Children and the elderly people should be applied recommended repellents and dosage so that they are safe. • Use mosquito coils/mats and electric/electronic gadgets, vaporizers during the daytime in indoors. • Use insecticide treated bed nets to protect children, pregnant women, dengue patient, old people and others who, may rest during the day. • Restrict your activities during mosquito biting periods, so that you are not exposed to mosquito bite. • Do not allow water collections in and around houses, cover water containers,change stored water weekly and dispose solid waste properly.

The tests include antigen detection test (NS1) which can be done during first few days of illness, and antibody detection tests after 3 to 5 days of illness. Whereas molecular detection tests can aslo be done during initial 1st to 5th days of illness.

Test helping in determining dengue infection are: • Complete blood picture: Severe Dengue fever is associated with low levels of haemoglobin and red blood cells. Dengue infection can damage the platelets therefore a low platelet count would be seen in CBP. 14 | Page • NS1 Antigen testing: Presence of NS1 antigen in blood is indicative of acute Dengue infection. This antigen can be detected as soon as 24 hours and up to 9 days after the onset of symptoms. • Antibody tests: When a person is exposed to the virus, the immune system produces antibodies IgM and IgG and these antibody titres are detected by the antibody assays. ✓ IFA – Immuno Fluorescent Assay detect infectious agent dengue viral antibody activity ✓ PRNT- Plaque Reduction Neutralization Tests are specific for neutralizing antibodies of Alpha virus ✓ HAI – Haem Agglutination Inhibition assay test distinguish the dengue strain by kinetic haemagglutination-inhibition tests. • Molecular Tests: Polymerase Chain Reaction test helps in detecting Dengue viral genome to identify specific strain of virus that has caused the infection. • Basal Metabolic Panel: This test can help in determining the severity of dehydration in cases of severe Dengue complications.

Most of the people suffered with dengue recover in 1-2 weeks. Some may feel tired for several weeks. If symptoms persist longer than it can be consulted with doctor.

To prevent the mosquitoes from, drain out the water from desert coolers/air conditioners (when not in use), tanks, barrels, drums, buckets, etc. Remove all objects containing water from the house. Collect and destroy discarded containers in which water collects e.g., bottles, plastic bags, tins, used tyres, etc. In case it is not possible to drain out various water collections or to fully cover them, Temephos as chemical to control mosquito larva and Pyrethrum space spray, Malathion fogging, Cyphenothrin for controlling adult mosquitoes.

Community participation is the key to dengue prevention. The main strategy in the prevention and control of dengue is "source reduction" or prevention of domestic & peri- domestic breeding places inside and in the vicinity of houses. Every household should undertake simple measures to prevent water collections from becoming places for mosquito breeding by draining out water, by regular changing of water once in a Week. Conduct “Weekly Dry Day”, discarding/destroying unused items, keep "every house clean and tidy".

Yes, many Urban Local Bodies (ULBs) adopted and implementing civic bye-laws in India. Delhi it is up to ₹ 500/-, Mumbai ₹ 200-500 for households and ₹ 2,000-10,000/- for builders, Bengaluru ₹ 200-500/- and Chennai up to ₹ 500/-.

Chikungunya is a febrile viral disease transmitted to humans by the bite of infected female Aedes mosquito.

It is caused by Chikungunya Virus (CHIKV) which is a member of Family: Togaviridae and Genus: Alphavirus.

Female Aedes aegypti and Aedes albopictus mosquitoes transmit Chikungunya virus.

Symptoms of Chikungunya include a sudden onset of fever, severe headache, chills, nausea, vomiting, fatigue, muscle pain, joint swelling and joint pain. Patients who are afflicted with severe joint pain develop contorted posture (Bent-up) other than that Chikungunya patients develop skin rashes which usually appears between 2-5 days.

No. At present there is no vaccine available for prevention of Chikungunya.

The time between the mosquito bite which carry Chikungunya virus and start of symptoms of Chikungunya ranges from 4-7 days.

Aedes mosquito breeds in rural, urban and semi-urban areas and major reservoir of Chikungunya virus is humans. The mosquito picks up Chikungunya virus by biting an infected person and then transmit the virus by biting another healthy person.

Anyone who is at risk of infected Aedes mosquito bite can get disease. one can get chikungunya only once because of life time immunity.

No. Chikungunya is not contagious and the virus needs vector as means of transportation which is mosquito in case of Chikungunya.

In Chikungunya, the fever duration is shorter, there is more frequent maculopapular rash, severe joint/bone pain is frequent and lasts over a month but shock and haemorrhage are rare. Dengue, on the other hand, has a longer duration of fever, infrequent maculopapular rash and a shorter duration of joint/bone pain. Dengue fever 17 | Page can develop into severe Dengue (Haemorrhagic fever), with bleeding from the nose, gums or skin, and/or gastrointestinal bleeding. Dengue may leads to death sometimes but in case of Chikungunya no death is reported so far.

Chikungunya can spread all year round but epidemics most likely to occur during post- monsoon periods.

In case you suspect any signs/symptoms of Chikungunya fever, report to your doctor or to the nearest health centre as soon as possible. Otherwise, the disease may aggravate and leads to further complications.

Chikungunya is diagnosed by doing blood test to detect CHKV antigen by ELISA. It can also be diagnosed by molecular and other serological tests of anti-body detection and viral genome such as RT-PCR.

Following are different tests done for Chikungunya: • RTPCR – Reverse Transcription Polymerase Chain Reaction can detect Viral genome
• ELISA – Enzyme-Linked Immunosorbent Assay detect both anti-CHIKV immunoglobulin IgM and IgG antibodies from either acute or convalescent phase samples.
• IFA – Immuno Fluorescent Assay detect infectious agent Chikungunya viral antibody activity
• PRNT- Plaque Reduction Neutralization Tests are specific for neutralizing antibodies of Alpha virus
• HAI – Haem Agglutination Inhibition assay test distinguish the Chikungunya strain by kinetic haemagglutination-inhibition tests.

The Aedes mosquito can rest in dark, cool and shaded places in and around houses, schools, bushes/shrubs, cattle sheds and other areas near to human settlements.

Aedes mosquitoes are small with black and white or silvery stripes / spot marking on their legs and body. These are otherwise called as Asian Tiger mosquitoes. In Aedes aegypti a pair of curved lines (lyre shaped) laterally and a pair of sub-median white lines on thorax. In Aedes albopictus a distinct single band of white scales on thorax.

Reduce or eliminate mosquito breeding sites as follows:
• Check weekly for water-filled containers
• Throw away or recycle water containers that are not needed
• Large containers such as drums or old appliances must be stored, covered
• They must be turned over or placed under a roof and does not allow them to collect
• Clean and scrub flower vases and pot’s water containers weekly and dump the water from overflow saucers under potted plants and flower pots
• Check that roof gutters are not holding water
• Fill tree holes and other cavities in plants with soil or sand
• Check for hidden bodies of water such as clogged drains, wells, septic tanks, manholes etc.

Many bites can be avoided by many was which include:
✓ Use mosquito repellents such as coils, mats, liquids.
✓ Sleep under a mosquito net.
✓ Cover body as much as possible.
✓ Use air conditioner when indoors, if not available stay in well-screened areas.

It is important to eliminate mosquito breeding grounds during transmission season in order to control the mosquitoes as well as disease. Efforts should be intensified before the expected transmission season, particularly during and after the rainy season and at the time of an epidemic. Filling of low-lying areas, de-silting of drains, de-weeding of hydrophytes, inspection of domestic and peri-domestic water collecting objects and their removal, covering of all water containers with lids.

House hold level activities to control Chikungunya...
▪ Use pyrethroid- based aerosol for spraying during peak biting time i.e., early morning or late afternoon.
▪ Also use mosquito coils, electric mats, vaporizers, etc.
▪ Ensure all house members wear fully covered clothes.
▪ Infants and others required to sleep under bed nets during daytime.
▪ Any member if suspected with Chikungunya should be made to rest under bed nets during viraemic phase which is first 4 days.
▪ If possible, install wire mesh / nets on doors and windows.
▪ In ornamental water tanks, garden pools, larvivorous fishes should be introduced to diminish the vector population.
▪ Change stagnant water from containers at least once in a week in manner to reduce potential larval habitats in and around the house.

Zika is a febrile viral infection that is usually spread by bite of an infected female Aedes mosquito.

Disease is caused by Zika virus (ZIKV)which belongs to the Family: Flaviviridae and Genus: Flavivirus.

The most common symptoms of Zika virus disease are fever, rash, joint pain or conjunctivitis (red eyes). Other symptoms include muscle pain and headache. About One in Five people infected with Zika will get sickness.

The incubation period (the time from infection to symptoms) of Zika virus disease is estimated to be 3–5 days

The Aedes aegypti mosquito is the only mosquito that can spread this disease. If the mosquito bites someone who having ZIKV, the mosquito becomes infected and carrier of the virus and infects any one it bites later.

The virus is mainly transmitted by infected mosquitoes that act as vectors and infect individuals during the bite. However, the virus can also be transmitted from person to person by and infected individual. Following are modes of transmission:
• Bite from infected mosquito
• Maternal-foetal
• Sexual transmission from infected male partner
• Laboratory exposure of infected specimens
• Blood transfusion, organ and tissue transplant

Life stages of Aedes aegypti and Aedes albopictus mosquitoes are as follows:
Egg: Female mosquitoes lay eggs on the inner, wet walls in water container. Eggs can survive up to 8 months in case of drying (desiccation).
Larvae: They emerge from egg and known as wigglers and there 4 larval instars
Pupa: It lives in water, which responds to stimuli. They don’t feed and take two days to develop in to adult.
Adult: Adults emerge by splitting open the pupal case and emerge head first. Aedes aegypti mosquitoes prefer to live near human habitations and prefer to bite people. Aedes albopictus bite people and animals as well, live near homes or in neighbouring vegetation.

Zika infection is diagnosed with a high degree of accuracy using a Reverse- Transcription Polymerase Chain Reaction (RT-PCR) test to identify the genetic material of the virus in the first 3-5 days after the onset of symptoms. While serological tests detect the presence of antibodies but are useful only after 5 days.

No, there is no vaccine or medicine to treat Zika at present. As of January 2017, about 40 Zika vaccine candidates are in the pipeline. Five of them are entering, or about to enter, Phase I trials in which the vaccine’s safety and ability to produce an immune response is being evaluated.

Following are different prevention strategies:
Reduce or eliminate mosquito breeding sites as follows:
• Check premises weekly for water-filled containers.
• Throw away or recycle water containers that are not needed.
• Containers such as drums should be fully and tightly covered.
• Turned over or placed under a roof that does not allow them to fill with water.
• Clean and scrub flower vases and pet’s water containers weekly.
• Dump the water from overflow saucers under potted plants and flower pots.
• Clear roof gutters and eaves to prevent water from settling.
• Fill tree holes and other cavities in plants with soil or sand.
• Repair leaking pipes and outside faucets.

Following are different personal protection measures are advised:
• Protect yourself from mosquito bites
• Using a mosquito repellent coil, mats, liquids and other electrical or electronic gadgets
• Sleeping under a mosquito net
• Wearing light coloured clothing and cover body as much as possible
• Changing your activities in accordance of mosquito behaviour

Yes, deaths have been reported due to Zika virus disease.
People at risk are as follows:
• Infants
• The elderly
• Pregnant women
• Ante-natal mothers
• Persons with underlying medical conditions such as heart diseases, diabetes, hypertension and sickle cell disease.

Zika virus infection triggers congenital Zika virus syndrome, microcephaly in infant, childerns, Guillain-Barré syndrome, neuropathy and myelitis, particularly in adults and older children.

Zika virus can pass from a pregnant woman to her foetus. Infection can cause birth defects called microcephaly and other severe foetal brain defects. Neuro-developmental abnormalities like problems with hearing and vision, joints with limited range of motion, seizures, too much muscle tone, swallowing abnormalities and possible developmental delay can also occur. Other than that, Zika can cause foetal loss, stillbirth and preterm birth.

• The best way to prevent Zika is to avoid mosquito bites when staying an area where Zika is present.
• Use recommended mosquito repellents. Many insect repellents are safe for pregnant women and children to use.
• When indoors, use air conditioning, window screens or insecticide-treated mosquito netting to keep mosquitoes out of the home.
• Reduce the number of mosquitoes outside the home by source reduction or routinely changing standing water from containers.
• Wear long sleeves and pants when outdoors.

Zika needs a mosquito vector (a means of transportation) to infect people. However, Zika virus has been found in semen and person-to-person sexual transmission has been documented.

There are 4 categories which are as follows:
Category 1: Areas where Zika virus is introduced since 2015 or areas where the virus has been re-introduced with ongoing transmission.
Category 2: Area with evidence of Zika virus circulation before 2015 or with transmission but the area doesn’t satisfy the criteria for 1 or 3. Areas in category 2 can experience Zika outbreaks.
Category 3: Defined as areas with interrupted transmission but with potential future transmission of Zika virus.
Category 4: Zika-genic areas with population of Aedes aegypti but no transmission is documented for past and current scenario.

India comes under category 2 i.e., Area with evidence of Zika virus circulation before 2015 or with transmission but the area doesn’t satisfy the criteria for 1 or 3. Areas in category 2 can experience Zika outbreaks.

Similar symptoms are present in all the 3 diseases, but some symptoms support one disease or another:
✓ Dengue is usually associated with high fever and more severe muscle pain.
✓ Increased fever and more extreme joint pains occur in Chikungunya, affecting the hands, feet, knees and back. It is able to disable bending them over so that they can’t walk or perform basic acts.
✓ The characteristics of Zika are not obvious, but most patients have skin rashes and some have conjunctivitis.

Microcephaly is a neurological condition where a baby is born with an abnormally small head because its brain did not develop correctly. These children almost always have lifelong mental retardation and many live many years, or die soon after or even before birth. Zika virus infection during pregnancy is a cause of microcephaly. During pregnancy, a baby’s head grows because the baby’s brain grows. Microcephaly can occur because a baby’s brain has not developed properly during pregnancy or has stopped growing after birth.

Zika vector mosquitoes Aedes aegypti and Ae. albopictus usually bites during day time, early morning, late afternoon and evening.

Following are the steps:
• Do not touch blood or body fluids or surfaces with these fluids with exposed skin.
• Wash hands with soap and water immediately after providing care.
• Remove & wash clothes immediately if they have body fluid or blood over them.
• Clean the surroundings using household cleaners and disinfectants.
• Take care of injuries, wounds, abrasions while visiting a patient of consolation

Following are the things to keep in mind:
• Avoide using insect repellent on babies younger than 2 months old.
• Do not use products containing oil of lemon, eucalyptus or para-menthane-diol on children younger than 3 years old
• Do not apply insect repellent onto a hands, eyes, mouth and cut or irritated skin incase of small childerns.

Monitoring the numbers and the geographical distribution of mosquitoes over time (surveillance) helps to make timely decisions about how best to manage mosquito populations. Entomological surveillance of Aedes spp.in the context of Zika virus, is a critical component of prevention and control programmes as it provides the information necessary for risk assessment, epidemic response and programme evaluation.

Recommendations range from how to provide psychosocial support to pregnant women and families affected by Zika and neurological complications. How to diagnose Zika virus infection in laboratories to how to protect the health and safety of workers in emergency mosquito control.

Japanese Encephalitis (JE) is a vector-borne viral zoonotic infection of the Central Nervous System (CNS) including brain and spinal cord.

A disease that can be transmitted from animals to people or, more specifically, a disease that normally exists in animals but that can infect humans as well.

Japanese Encephalitis Virus (JEV) is the main cause of JE. Wild birds serve as reservoirs and pigs act as amplifiers of the virus.

The incubation period of Japanese Encephalitis is between 4-14 days.

The virus primarily affects birds & animals and man is infected incidentally.

JE virus isolation has been made from a variety of mosquito species. Culicine mosquitoes, mainly Culex vishnui group are the primary vectors of JE virus. However, some other mosquito species of Anopheline and Mansonoides also play a role in transmission under specific conditions.

hey are principally cattle feeders, though human and pig feeding is also recorded in some areas. These vectors are primarily found out door, resting in vegetation and other shaded places but in summer may also rest indoors.

The mosquito species of JE vectors generally breed in ground water habitats, particularly in paddy fields, irrigation canals, ground pools and shallow ditches. These vector mosquito breeding increases during rainy seasons

JE primarily affects children it do not affect much to adults as in endemic countries they acquire natural immunity after childhood infection. But individuals of any age may be affected where JE virus is newly introduced areas.

Less than 1% of people infected with Japanese Encephalitis (JE) virus develop clinical illness. Initial symptoms often include fever, headache and vomiting. Mental status changes, neurologic symptoms, weakness and movement disorders might develop over the next few days. In children, gastrointestinal pain and vomiting may be the dominant initial symptoms.

JEV can lead to encephalitis in horses and miscarriage in pigs.

The JE natural cycle is maintained in vector mosquitoes, vertebrate animals and wading birds such as herons, egrets etc. However, during high mosquito density humans are bitten accidentely and can get infection..

JE virus transmission occurs primarily in rural agricultural areas, often associated with rice production and flooding irrigation. Transmission increases in the rainy season due to increase in the vector population.

Mosquitoes become infected with the JE virus by feeding on wild birds and domestic pigs. Infected mosquitoes then transmit the JE virus to humans and animals during the feeding process. The JE virus is amplified in the blood systems of domestic pigs and wild birds.

Natural hosts of JE virus include water birds of Family: Ardeidae, mainly pond herons and cattle egrets.

Pigs play an important role in the natural cycle and serve as an amplifier host since they allow manifold virus multiplication without suffering from disease and maintain prolonged viraemia. Due to prolonged viraemia, mosquitoes get opportunity to pick up infection from pigs easily.

Humans are the dead end in transmission cycle of JE virus.

Due to low and short-lived viraemia, mosquitoes do not get infection from a JE patient for further transmission. Hence, humans are the incidental or dead-end-hosts of JE.

Two epidemiological patterns of JE are recognized: Epidemic and Endemic.

Diagnosis is based on blood or cerebrospinal fluid, PCR and ELISA testing.

Preventing mosquito bites and vaccination against JE is important in JE prevention.

Inactivated Mouse Brain-Derived JE Vaccine is available against JE in India.

Yes. Infection with Japanese Encephalitis confers lifelong immunity.

Residents of rural areas in endemic locations and long term visitors of rural areas are at a higher risk of getting JE and it does not usually occur in urban areas.

In humans, Leishmaniasis has three general forms – Cutaneous, Mucocutaneous and Visceral and different species of Leishmania tend to cause each type.

Cutaneous Leishmaniasis is a form of Leishmaniasis which produces skin lesions on body. Although this form is often self-healing, it can create serious disability and permanent scars in absence of proper treatment.

Mucocutaneous Leishmaniasis is a form of Leishmaniasis which causes disfiguring lesions to the face; it destroys the mucous membranes of the nose, mouth and throat. It is also known as ‘Espundia’ in South America.

Visceral Leishmaniasis is the most severe form of Leishmaniasis. It is a slow progressing, intracellular, parasitic protozoan infection without any external presentation. However, person infected present symptoms such as loss of appetite, low grade fever, spleenomegaly and thining of limbs.

The other names for Visceral Leishmaniasis are Kala-azar and Dumdum fever.

The Leishmania parasites migrate to internal organs (viscera) like liver, spleen and bone marrow, hence it is called as ‘Visceral Leishmaniasis’. It is associated with blackening of the skin in its more severe form, hence, called ‘Kala-azar’. ‘Kala’ means black ‘Zwar’ means fever.

Irregular bouts of fever, loss of appetite, weight loss, fatigue, anaemia, substantial swelling of the liver and spleen, dry and scaly skin and in severe forms blackening of the skin.

In India, the obligate intracellular protozoa Leishmania donovani is the only parasite causing Leishmaniasis. The only vector of Kala-azar in India is sandfly Phlebotomus aregentipes.

Sandflies are small (1.5 to 3.5 mm), fuzzy, delicate flies with erect dorsolaterally upheld V shaped wings h silvery legs. The entire body including wings is heavily clothed with long hair.

Leishmaniasis is presently endemic in 54 districts of 4 states in the country, of which 33 districts of Bihar, 4 districts of Jharkhand, 11 districts of West Bengal, besides that, cases occurred in 6 districts of eastern Uttar Pradesh.

A. Amastigote (aflagellate) or Leishmania stage occurs in humans. Promastigote (flagellate) or Leptomonad stage occurs in gut of the sandfly.

Kala-azar is transmitted by the bite of infected sandfly i.e., Phlebotomus argentipes. Female sandflies pick up parasite (Amastigote or Leishman–Donovan bodies) while feeding on an infected human host. Parasite undergo morphological change to become flagellate (Promastigote or Leptomonad), development and multiplication in the gut of sandflies and move to mouthparts. Such sandfly when bites to the healthy human it transmits the infection.

Incubation period ranges from 10 days to 2 years however, in India it may range from 4 months to one year. Extrinsic incubation period may vary from 4-25 days.

Yes, if left untreated, Kala-azar is fatal. In India, only humans are the known reservoir host of Kala-azar.

People generally do not recognise the presence of sandflies because of their small size, because they do not make any noise and their bites are painless and they hide themselves in cracks and crivices of houses.

No, they are opportunistic feeders of humans. Sandflies are usually nocturnal and are active during twilight, evening, and from dusk to dawn. They may bite if they are disturbed.

Kala-azar can be diagnosed using number of laboratory tests like rK-39 (RDT),IFA, ELISA, DAT, freeze-dried antigens and dipsticks, etc. The PCR technique is the most sensitive test, but it remains expensive. The “gold standard” proof of visceral Leishmaniasis is microscopic examination.

Yes, Kala-azar is curable with proper treatment. As of now, there is no vaccine available for Kala-azar.

The current control strategies rely only on reservoir and vector control and of course, early diagnosis and treatment of cases. For prevention, the only way is to avoid sandfly bites. Sandflies can be controlled using IRS with recommended insecticides.

In India, VL pathogen reservoirs are found only in humans, hence it is Anthroponotic in India. Asymptomatic/PKDL cases which are known to exist in endemic areas may act as an important reservoir for re-infection.

Post Kala-azar Dermal Leishmaniasis (PKDL) is a condition in which Leishmania donovani parasites are found in skin. PKDL develops in some of the Indian Kala-azar patients usually 1-2 years or more following recovery of Kala-azar; less commonly without showing any sign or symptoms of Kala-azar and they act as reserviour for transmission.

Signs and symptoms of PKDL include early hypopigmented macules on face, diffuse nodular lesions on those macules, erythematous papules and nodules usually occurring on face and chin, verrucous lesions, xanthematous rash, pityriasis rosea like lesions, etc.

Yes. People with PKDL can transmit Visceral Leishmaniasis, thus complicating efforts to eliminate the disease even more.

Visceral Leishmaniasis affects the poorest of the poor and people living in endemic area because they are associated with malnutrition, population displacement, poor housing, improper sanitation and a weak immune system.

Environmental factors such as deforestation, urbanization and migration of non-immune people to endemic areas can lead to an increase vector density as a result of which may increase transmission of Kala -azar.

Plague is an acute infectious zoonotic disease caused by bacteria Yersinia pestis.

Three types of plague are as follows:
• Bubonic plague
• Septicaemic plague
• Pneumonic plague

Bubonic plague is most common form of plague, the bacterium travels through the lymphatic system to the nearest lymph node where it replicates. The lymph node then becomes inflamed, tense and painful and is called a "bubo".
Pneumonic plague is lung-based plague which is the most virulent form of plague. Typically, the pneumonic form is caused by spread to the lungs from advanced bubonic plague. A person with secondary pneumonic plague may form aerosolized infective droplets and transmit plague via droplets to other human.
Septicaemic plague occurs when infection spreads through the bloodstream following a bubonic or pneumonic plague.

Plague bacteria Y. pestis is easily destroyed by sunlight and drying. On release of bacterium in the air, it will survive for an hour depending on environmental factors.

Fleas are small, wingless bloodsucking insects with laterally flattened body and legs adapted for hopping and jumping movements.

Important fleas for plague transmission are Xenopsylla cheopis as primary, X. astia and X. brasiliensis as secondary.

Given are the different behaviours of fleas
• Fleas avoid light and found mostly among hairs or feathers of animals.
• They feed several times during day or night.
• In absence of normal host, they feed on humans or other animals.
• Fleas can survive up to several months without food and can jump as high as 30 cm from host to host.

Egg: It is a minute oval body and in fresh condition it is white in colour visible to the naked eyes. Female flea is capable of laying 300-400 eggs during its life time.
Larva: It has maggot like appearance. Larva moults twice and has 3 larval stages and eventually forms pupae.
Pupae: They are in cocoons that are often covered with debris from the environment like sand, pebbles etc.,
Adult- Adults are 1-4 mm long and have flat narrow body. They seek out a warm -blooded host for blood meals.

Fleas breed close to the resting and sleeping places of the host, in dirt, dust, rubbish, cracks in floors or walls, carpets, animal burrows and birds’ nests.

Wild rodents are the natural hosts of Y. pestis. Rats, squirrels, rabbits etc., can act as amplifying hosts.

A host in which infectious agent can multiply rapidly at high levels and increase virulancy , for an important source of infection.

In India, wild rodent Tatera indica acts as a main reservoir of infection. Generally, the infection is maintained by the resistant species of the wild rodents.

Symptoms include sudden onset fever with chills, vomiting, nausea, weakness, head and body ache. In case of bubonic plague, painful and inflamed lymph nodes can also appear. Symptoms of pneumonic plague appear quickly after infection and include severe respiratory symptoms like shortness of breath and coughing often with blood tainted sputum.

Plague is diagnosed using following methods:
• Smear examination - During epidemics or epizootics, the examinations of smears stained with Wayson's stain show the presence of characteristic bipolar stained plague bacilli are helpful in preliminary diagnosis.
• Culture - Samples are collected for culture can be transported to laboratory in Cary- Blair transport medium then cultured on other biological media. Presence of bacilli can be confirmed by Bacteriophage Lysis Test.
• Serology- Presence of a single high titre of plague antibody in individual who has not been vaccinated earlier gives a presumptive diagnosis of plague. Whereas a fourfold rise in antibody in two serum samples collected at least 10 days apart gives the confirmation of plague diagnosis.

Following are other diagnostic tests:
• PCR for the detection of selected Yesinia pestis genes.
• ELISA based rapid serological tests. • Animal inoculation.

Plague is transmitted between humans and animals by the bite of infected fleas, unprotected direct contact with infected tissues or body fluids. However, pneumonic plague. can be transmitted through droplet infection .

Avoid direct contact (under 2 metres) with someone who is coughing, and decrease the time spent in crowded areas, to prevent the spread of pneumonic plague. Do not touch dead animals and use insect repellent when in plague-endemic regions to avoid flea bite.

It refers to the central points where wild animals are affected by the disease. They are the tri-junction of south Indian states of Karnataka, Andhra Pradesh and Tamil Nadu; Beed belt in Maharashtra; Rohru areas of Himachal Pradesh and Uttarakhand.

Beed district in Maharashtra and Surat district in Gujarat were reported plague in 1994. Pneumonic plague was reported from Delhi, Varanasi, Karnataka, Himachal Pradesh. Bubonic plague from Dangud village of Uttar Kashi district and Uttarakhand.

No, currently there is no vaccine.

The incubation period i.e. the time taken between getting infection and appearance of symptoms of the disease is 3-7 days.

If a person is died after being infected with plague can infect people who are in closed contact with the body like those who are preparing the body for burial. Infection occurs due to presence of bacteria in body fluids.

There are major two reasons which are as follows:
• Rainy season causes the rats from outside shelters to herd into burrows indoors and remain there perforce which results in considerable increase in rat population within houses.
• Rainy season brings sown the temperature and increase the humidity to such an extent as to result in a rise in flea population and to allow rat fleas to come out of burrows to attack human being.

Following are the methods to prevent plague:
• By eliminating rock piles, junk, cluttered firewood, and potential rodent food sources, such as pet and wild animal food, habitats around the house, workplace, and recreational areas should be free from rodents.
• To avoid contact between your skin and the plague bacteria, one should wear gloves when handling or skinning potentially infected animals.
• Usage of repellent during events such as camping, hiking, or working outdoors to avoid rodent fleas.
• By adding flea control products, keeping fleas off of pets. Freely wandering animals are more likely to come into contact with animals or fleas infected by plague and could carry them into homes. When a pet becomes ill, seek treatment as soon as possible from a veterinarian.
• Dogs or cats who roam free in endemic areas should not be allowed to sleep on his/her bed.

Yes, all forms of plague can be treated and cured.

Kyasanur Forest Disease (KFD) is a hard tick borne tropical zoonotic viral haemorrhagic infection.

KFD is endemic South-western part of India in Karanataka, Tamilnadu and Kerala states.

KFD is caused by Kyasanur Forest Disease Virus (KFDV), which is a single stranded RNA arbovirus belonging to the family: Flaviviridae and genus: Flavivirus.

A hard tick Haemaphysalis spinigera is the KFD vector and act as a reservoir of KFDV in India through transovarial and transstadial transmission.

KFD was first discovered in Kyasanur Forest of Shimoga district in Karnataka, India in 1957. It derives its name from the forest range where the virus was first isolated from a monkey.

KFD is also known as “monkey disease/monkey fever” because of its association with monkey deaths. The incubation period of KFD in humans is 3-8 days.

Signs and symptoms of KFD include sudden chills, fever, frontal headache, conjunctivitis, severe muscle pain, severe prostration, vomiting. Bleeding may occur 3-4 days after initial symptoms onset from nose, mouth and gastrointestinal tract.

Trans-ovarial or trans-ovarian transmission means transmission of the virus from parent to offspring through the ovaries. Trans-stadial transmission occurs when a pathogen remains with the vector from one life stage (stadium) to the next.

KFD is transmitted to any human by the bite of an infected tick. The wild monkeys Semnopithecus entellus and Macaca radiata, also get the disease through the bites of the infected ticks. When infected monkeys die, the infectious ticks drop off from their bodies and spread the disease further. Humans can get infected either from infected tick bite or by contact with an infected animal.

No. Larva and Nymphs cannot transmit virus to humans, they transmit the disease to monkeys and rodents.

KFD is transmitted to humans almost exclusively by ‘adult’ of the vector ticks. Yes. Once infected, the vector remains infected for life.

People who frequently visit the forest areas of the Western Ghats region such as forest guards and officials, shepherds, firewood collectors, dry leaf collectors, hunters. People who handle dead animal carcasses, travellers who camp in the forest areas, tribal communities living inside the forest areas, cashew nut workers and areca nut farm workers will have a high risk of acquiring KFD infection.

Vectors lay eggs in clusters consisting of a very large number, sometimes a few thousand. The eggs are laid either under the litter or in the cracks, crevices and other such holes in the soil.

The egg laying process lasts for several days, usually about a fortnight, but in some cases, may extend to one month or more.

The epidemic/outbreak period of KFD usually begins in October or November and peaks from January to April, then declines by May and June. This is because, the activity of nymphs is very high during November to May.

The black-faced langur and the red-faced bonnet monkey(Semnopithecus entellus and Macaca radiate) act as sentinel animals because they are very susceptible to KFDV like humans.

Epizootic of KFD causing heavy mortality in monkeys indicates, likely outbreaks of the disease.

Infectious vector ticks that drop off the dead bodies of the infected animals generate infection hotspots.

A vaccine is used for prevention of KFD in endemic parts of India. Other control measures include tick bite prevention and tick population control by applying DMP oil and Malathion liquid in monkey mortality areas.

Diagnosis can be made in the early stage of illness by molecular detection by PCR or virus isolation from blood. Later, serologic testing using ELISA can be performed.

The human case fatality rate of KFD is 2-10%. Yes, large animals such as goats, cows and sheep may become infected with KFD but play a limited role in the transmission of the disease..

No, but when someone observes signs and symptoms of KFD, he/she should immediately visit Primary Health Centre. Symptomatic and supportive treatment and case management only.

Yes. Vaccination with formalin-inactivated tissue-culture vaccine has been given as mass vaccination in KFD endemic areas.

No. Human to human disease transmission is not present in KFD. Humans are the dead- end hosts as they do not transmit the disease further to other humans or animals.

Yes, without the tick vector, KFD infection is possible in humans due to contact with KFD infected animals (contagious).

Crimean- Congo Haemorrhagic Fever is a tick-borne zoonotic viral disease that can be severe in humans.

CCHF is endemic in Africa, Europe, the Middle East and Central Asia with sporadic outbreaks recorded in Kosovo, Albania, Iran and Turkey.

In India First confirmed case was reported on January 2011 in Ahmedabad, Gujarat state.

CCHF virus belongs to the family: Bunyaviridae, genus: Nairovirus and species: Crimean- Congo Haemorrhagic Virus.

A common vector for CCHF is a tick which is a member of the genus: Hyalomma and family: Ixodidae. These are hard ticks and suck blood from animals and humans.

CCHF virus infects a wide range of wild and domestic ruminant animals such as hares, rats, camels, goats, cattle and sheep.

Mechanical vectors are the ones which can pick up infectious agents on the outside of their bodies and transmit them through physical contact. In the case of CCHF mechanical vectors are birds and ungulates and domestic animals.

The hosts which have the potential to replicate the virus and pass it to uninfected tick vectors are amplifying hosts for CCHF. In the case of CCHF amplifying hosts are hares and hedgehogs.

Ticks find their hosts by detecting animals’ breath and body odours or by sensing body heat, moisture, vibrations, carbon dioxide, ammonia or body temperature heat. Some species can even recognize a shadow.

The life cycle is completed in 3-4 months or longer.

Gujarat state is endemic for CCHF in India.

Reasons for the outbreak of CCHF in India include the climate and anthropogenic factors such as changes in land use, hunting activities, and movement of livestock that may influence host-tick-virus dynamics and agricultural practices.

People who work in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians.

The onset of symptoms is sudden, with fever, myalgia, muscle ache, dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia. There may be nausea, vomiting, diarrhoea, abdominal pain and sore throat early on followed by sharp mood swings and confusion.

The 2 different modes of transmission include:
a) Animal to human transmission- CCHF virus may be transmitted to humans either by the bite of a hard tick or through contact with infected animal blood or tissues during and immediately after slaughter.
b) Human to human transmission- Humans can become infected if blood, body fluids and wastes from patients with the disease come into contact with broken skin or mucous membranes, or when medical care personnel sustain accidental needle stick injury.

The following diagnostic methods are used:
a) IgG and IgM antibodies detection in serum by enzyme-linked immuno-sorbant assay (ELISA) from about day 6 of illness.
b) Virus detection in blood or tissue samples of patients from the first few days of illness.
c) Polymerase Chain Reaction (PCR) and Real-Time PCR a molecular methods for detecting the viral genome.

Yes, CCHF is fatal if not treated.

Yes, it can be cured.

CCHF is also known as Congo Fever, Central Asian Haemorrhagic Fever, Hungribta (blood taking), Khunymuny (nose bleeding), Karakhalak (black death).

The incubation period for CCHF is the time from exposure to the time on starts showing symptoms, which is 2-14 days.

Some of the severe symptoms include bleeding from mucous membranes, hematomas, ecchymosis, melena, haematuria, nose bleeding, vaginal bleeding, bradycardia, thrombocytopenia, and leukopenia.

On birds and small-medium-sized wild mammals, ticks congregate around the head, in particular in and around the ears. On ruminant animals, ticks congregate around the hind quarters, in particular the udder, scrotum, inguinal area and perineum.

Ticks live in the ground vegetation and move mainly by climbing up and walking on the ground.

Hyalomma ticks prefer low to moderate levels of humidity and a long dry season during the summer months.

Hyalomma ticks are of a medium to large size, i.e., engorged adult females reach up to 2 cm in length with quite prominent mouthparts and are a brownish colour. In general Larvae: 0.5- 1mm, Nymph: 2-3.5 mm and Adult: 7- 15mm in size.

A. Safe way to remove tick includes:
• Use fine-tipped tweezers
• Grab the tick as close as possible to the skin
• Do not twist or jerk the tick
• Gently pull straight up until all parts of the ticks are removed
• Never crush ticks with your finger
• After removing ticks wash hands with soap and water and clean the tick bite area with soap and water.

The virus is transmitted within tick populations through:
• non-viraemic transmission: infected to uninfected ticks feeding on the same host
• transstadial transmission: larvae to nymphs to adults
• transovarial transmission: adult females to their eggs
• venereal transmission: male ticks to female ticks during reproduction

Below mentioned are steps to reduce the risk of tick to human transmission:
• wear protective clothing (long sleeves, long trousers)
• use approved acaricides (chemicals intended to kill ticks) on clothing
• use approved repellent on the skin and clothing
• regularly examine clothing and skin for ticks; if found, remove them safely
• eliminate or control tick infestations on animals or in stables and barns
• avoid areas where ticks are abundant and seasons when they are most active

Animal to human transmission can be reduced by following steps:
• Wear gloves and other protective clothing while handling animals or their tissues in endemic areas, notably during slaughtering, butchering and culling procedures in slaughterhouses or at home.
• Separate or restrict movements of animals (quarantine) before they enter slaughterhouses or routinely treat animals with pesticides two weeks before slaughter.

Ways to reduce risk of human-to-human transmission:
• avoid close physical contact with CCHF-infected people
• wear gloves and protective equipment when taking care of ill people
• wash hands regularly after caring for or visiting ill people.

Scrub typhus is a mite borne acute, febrile, infectious disease. Term scrub means the “type of vegetation that harbours the vector” and typhus means “fever with stupor”.

Orientia tsutsugamushi is an obligate intracellular bacterium and the causative agent of scrub typhus. In Japanese “tsutsuga” means something small and dangerous and “mushi” means insect or mite.

The ‘chigger mite’ Leptotrombidium deliense and L. akamushi are the vectors of scrub typhus. Mite is very small and ranges from 0.2-0.4 mm size.

Mammals, birds and small rodents, particularly wild rats of subgenus Rattus are natural hosts for scrub typhus.

Endemic countries include Japan, Taiwan, China, South Korea, India, Nepal, Indonesia and Australia.

It is a geographical area of Scrub typhus extending from northern Japan in the east to Pakistan and Afghanistan in the west and northern Australia in south. This distribution forms a geographical triangle which is then named as “tsutsugamushi triangle”.

In India, Scrub typhus is present in whole of Shivalik ranges from Kashmir to Assam, Eastern and Western Ghats, Vindhya and Satpura hill ranges north eastern Rajasthan and Eastern UP.

Yes, the occurrence of L. deliense mite is influenced by rainfall, with more chiggers attached to the rodents in rainy months of the year.

A. Common signs & symptoms of scrub typhus are Fever with chills & Headache, Body ache and muscle pain, Rash, Enlarged lymph nodes, Mental changes, ranging from confusion to coma, and Dark, scab region at the site of the chigger bite-‘Eschar’.

Incubation period is the time when the mite bites to the time when symptoms appear, it is around 10 days in the case of scrub typhus.

Travellers undertaking outdoor activities such as visiting farms, camping, archaeological digs etc., are at risk of getting bitten by chiggers, and the risk is being enhanced due to increasing deforestation and urbanisation.

Infection is transmitted to the hosts by infective mites, which feeds on lymph and tissue fluid of small mammals, including rodents. They maintain infection throughout their life stages and as adults they pass infection through ‘transovarial’ transmission and through ‘transstadial’ transmission.

Adult trombiculid mites are about 1-2 mm in length, bright red or reddish-brown in colour with velvety appearance. The larvae, also called ‘chiggers’, are very small, being only 0.15-0.3 mm in length. The nymph is similar but smaller in size.

The mite larva is the only feeding stage, natural ‘ectoparasite’ of rodents & birds, feed on lymph & tissue fluids. They do not actually bite, they inject digestive enzymes onto the skin that break down skin cells to form a hole in the skin.

Transovarial transmission: Once mite is infected by feeding, they maintain infection throughout their life and adults pass the infection on to next generation through eggs.
Transstadial transmission: It is the sequential passage of infection acquired during one life stage or stadium, to the next stage or stadium through the molt.

The life cycle of chigger comprises of egg, larva, nymph and adult,adult mite resembles the nymph, but is larger.

Scrub typhus is most often detected from blood serum using Weil–Felix test. IIFA is regarded as the gold standard test, as it gives a reliable result. Rapid ICT, ELISA, PCR detect O.tsutsugamushi-specific proteins so that they are highly specific and sensitive.

No effective vaccine is available for prevention of scrub typhus.

Following are some of the ways to reduce the risk of scrub typhus:
• Clearing or burning the vegetation and then to scrape or plough the top-soil where larval mites live.
• Bites can be prevented by avoiding infested terrain and applying repellents to skin and clothing.
• When the removal of vegetation is not possible mite island can be sprayed with residual insecticide.
• Chiggers typically takes several hours to settle down and begin feeding, so scrub yourself well while taking bath after you think you might have been exposed.

Following are some of the preventive methods:
• Using miticides / acaricides in mite islands.
• Apply mite repellent on the skin under clothing.
• Dress your clothing that covers arms and legs or use personal protection equipment.

Chandipura Virus (CHPV) infection is an arthropod-borne viral fever caused by a virus of the Rhabdoviridae family and genus Vesiculovirus called as chandipura virus.

High grade fever, vomiting, altered sensorium, generalised convulsions, decerebrate posture leading to grade 4 coma and acute encephalopathy.

Chandipura virus is transmitted by sandfiles belonging to species Phelobotomus papatasi.

In India it is reported from Gujarat, Maharatra, Andhra Pradesh and Odisha state.

Following the strategy for control of sandflys i.e IRS against Kala Azar may be used and avoid sandfly bites moreover early diagnosis and treartment of chanipura patient.

The virus most commonly affects children below the age group of 15 years

Nearly 30 species of Phlebotomine sandflies have been recorded for transmission of the virus.

Incubation period lasts for 1 to 2 days.

Chandipura virus looks like bullet shape

Integrated Vector and Pest Management (IVPM) is a combination of Integrated Vector Management (IVM) as well as Integrated Pest Management (IPM) techniques which are beneficial to reduce vector and pest population.

The basis of IVPM is to widen the scope of awareness on vectors and pest management and integrate the judicious use of chemicals (pesticides/insecticides).

The goal of IVPM is to reduce risk of vector-borne disease and raise agricultural productivity.

IVM is defined as a rational decision-making process to optimize the use of resources for vector control. It is evidence based and integrated management, promoting the use of a range of interventions alone or in combination, selected on the basis of local knowledge about the vectors, diseases and disease determinants.

The aim of the IVM is to improve the efficiency, cost effectiveness, ecological soundness and sustainable disease-vector management.

Key elements of IVM includes...
a. Advocacy, social mobilization and legislation
b. Collaboration within the health and other sectors
c. Integrated approach
d. Capacity building
e. Evidence-based decision making

The strategies under IVM being advocated for major VBDs like Malaria, Dengue, Chikungunya, JE, LF and VL are environmental management / modification / manipulation, chemical management and biological management.

Yes, IVM requires the integration of various control methods covering numerous diseases with many partners in order to attain its objectives by using resources efficiently and safely for VBD managment.

In IVM strategy inter-sectorial collaboration between the Health, Agriculture, Urban development, Education & other allied other sectors and Civil Societies etc., is of utmost important to achieve the objective.

Integrated Pest Management (IPM) is an ecosystem-based strategy that focuses on long- term prevention of pests or their damage in Agriculture, Horticulture, Aquaculture etc,.

The techniques for IPM is a combination of control measure are such as biological control, habitat manipulation, modification of cultural practices and use of pest resistant varieties.

IPM is useful as it offers the opportunity to eliminate or drastically reduce the use of pesticides and to minimize the toxicity and pesticide pollution.

Under IPM integrated pest control measure are biological control, cultural control, mechanical/physical control and chemical control. It focus on long term prevention of pest or their damage by managing the ecosystem.

There are four basic elements of IPM: natural control, sampling economic levels, insect biology and ecology.

Important control methods of IVM are,
a. Environmental management
b. Personal Protection
c. Chemical control
d. Biological control

Environment management involves any change that prevents or minimizes vector breeding thereby reducing human-vector contact. The major environmental management methods are used for the modification and manipulation of environment.

Environmental modification includes permanent or long-lasting physical transformation of land, water and vegetation to prevent, eliminate or reduce the breeding without causing undue adverse effects on the quality of human habitats.

Environmental manipulation consists of planned recurrent activity so that temporary breeding conditions are made unfavourable for breeding of vectors.

Some biological species like bacteria and larvivorus fishes used to control against disease vectors are known as biological control.

Total four chemical groups are used in vector control are as follow:
a. Organochlorines
b. Organophosphates
c. Carbamates
d. Synthetic Pyrethroids

Behaviour Change Communication (BCC) is based on the information, education and communication strategies, with components of inter-personal communication between community and health workers.

BCC changes human behaviour to reduce vector population and disease transmission, increasing compliance with interventions and motivation for vector control activities and removing incorrect and wrong guided methods of vector control.

There are four tools of BCC such as media information; education and communication; communication for behavioural impact; and Farmer Field Schools.

Farmer Field Schools (FFSs) are to educate the farmers about IPM, farmers learn to adapt the practices of IPM and contemporary conditions such as crop cycle.

In FFS groups of farmers meet weekly to observe the agro-ecosystem and to discuss the results of the methods adopted. Based on the findings through observations and analysis, FFS adopt appropriate methods of vector control suitable to the conditions of that particular area.

A mosquito is a slender, long-legged insect with “two wings” belonging to the Order: Diptera. What distinguish a mosquito from other types of insects are its proboscis with piercing and sucking type mouthparts, hair-like scales on its body and their wing venation.

There are about 112 genera with over 3,500 mosquito species are reported worldwide. Around 400 species of 6 genera mosquitoes commonly present in India, they are Anopheles, Culex, Aedes, Mansonia, Armigeres and Toxorhychites are main genera to which mosquitoes of public health importance belongs

The word "mosquito" (formed by mosca and diminutive –ito) is Spanish and Portuguese for "little fly".

Yes, mosquitoes are in fact most dangerous invertebrate on earth. They transmit several pathogens through their bites and subsequently cause morbidity and mortality.

No, only certain genera and female mosquitoes only bite. Female mosquitoes require ‘protein’ from blood for development of eggs, therefore, they take blood meal. Males feed on plant nectar and juices of decaying fruits.

Mosquitoes can transmit diverse infectious pathogens and parasites that cause number of diseases such as Malaria, Dengue, Chikungunya, Zika, Japanese Encephalitis, Lymphatic Filariasis etc,. Therefore, mosquitoes are called vectors of important diseases.

Mosquitoes have 6 senses to find their target. Smell, Temperature, Movement, Light, Touch and Sound. They have receptors on their antennae that detect these senses.

The bumps due to mosquito bite are actually an allergic reaction to mosquito saliva. The reaction can vary from person to person, but usually last not more than 24 hours. The mosquito abdominal diverticula get completely full between 0.001 to 0.01 millilitres, depending on the species.

Mosquitoes can smell human breath and sense plumes of carbon dioxide from human breath at several hundred feet. At less than 100 feet, it can smell the odour of human skin, then land and locate the best capillaries for tapping.

Male mosquitoes find females by the sound of their wing beats. The females can beat their wings up to 500 times per minute and the males perceive the frequency when seeking for a mate.

People who produce more body odours and more carbon-di-oxide are more susceptible to mosquito bites. They also prefer the scent of cholesterol, folic acid and bacteria from drying sweat.

Mosquitoes can live in environments where warm blooded animal live. Some mosquitoes like living near human habitation, while others prefer forests, marshes, or tall grasses and vegetation.

Different species of mosquitoes have different breeding habits but the majority of them prefer to lay their eggs in or near water. All mosquitoes like water because mosquito larvae and pupae live in the water with little or no flow.

Prime biting hours are between dusk and dawn, but some species are active during the day and night too.

Mosquito population fluctuations depend mostly on rainfall, temperature and relative humidity. Frequent rains create more standing water and therefore, more mosquitoes during monsoon and post-monsoon seasons.

The bumps & itching we feel from a mosquito bite is our body's reaction to the anticoagulant injected with the female mosquito's saliva as she takes blood. The reaction can vary from person to person, but usually last not more than 24 hours.

Mosquito lifespans depend on temperature, humidity and their ability to successfully obtain a blood meal while avoiding host defences and predators.

Though they don’t gather pollen like bees, they fly from flower to flower to feed and along they carry pollen from one blossom to the other. Mosquitoes serve as food sources for a variety of organisms such as bats, birds, anurans, fishes etc.. They also purify the water sources by eating debris and detritus suspended solids.

Mosquito bites lead to a variety of mild, serious and rarely life-threatening allergic reactions. These include ordinary wheal and flare reactions and mosquito bite allergies (MBA), also excessive reactions caused by the non-toxic allergenic proteins contained in the mosquito's saliva called hypersensitivity to mosquito bites (HMB).

Adult mosquitoes have a slender segmented body of head, thorax and abdomen. A pair of palpi, a pair antenna and elongated mouthparts covered under proboscis, one pair of wings, one pair of halters, three pairs of long legs on the thorax.

Adult mosquitoes usually mate within a few days after emerging from the pupal stage. In most species, the males form large swarms, usually around dusk and the females fly into the swarms to mate.

The mosquito life cycle consists of 4 stages. Namely egg, larva, pupa and adult. Out of which the first three being largely aquatic and the rest is being terrestrial or ariel.

There 4 larval instars in mosquito life cycle, the larvae feed mostly on algae, bacteria, dead & detritus material and other microbes in the surface micro-layer.

A mosquito has a proboscis, which is a long, pointed mouth part used to pierce the skin and suck the blood. It contains two tubes; one for injecting saliva and one for drawing blood.

A mosquito has 6 legs(3 pairs ). The mosquito has one pair of wings and second pair modified in halters, small club-shaped organs that provide information about body rotations during flight.

Mosquito life span depends on species, sex and weather condition, a potential adult male mosquito lifespan ranges as short as a week and female mosquitoes live up to 3-4 weeks.

Generally, Anopheles females just fly over the water, bobbing up and down to the water surface and dropping eggs more or less singly. Culex females deposit eggs on water surface in rafts with the help of hind legs. Aedes mosquitoes attach their eggs to the water containers.

Mosquito larva is known as ‘wrigglers’ by their jerky movements. The mosquito larva has a well-developed head with mouth brushes used for feeding, a large thorax with no legs and a segmented abdomen. Larvae breathe through spiracles located on their eighth abdominal segments or through a siphon tube.

At the end of each instar, the larvae moult, shedding their skins to allow for further growth and metamorphosis. The larvae develop through 4 stages or instars, after which they metamorphose into pupae.

Mosquito pupa is called as ‘tumbler’ by their tumbling/flipping movements. The mosquito pupa is comma-shaped, the head and thorax are merged into a cephalothorax with the abdomen curving around underneath.

The pupa must come to the surface frequently to breath, which they do through a pair of respiratory trumpets on their cephalothorax. The pupa do not feed.

After a few days or longer, depending on the temperature and other circumstances, the dorsal surface of the pupal cephalothorax splits at ‘ptilinum’ and the adult emerges.

Mosquito has a pair of compound eyes, each of which contains thousands of six-sided lenses that point in all different directions and move independently. The eyes stay open to help them detect quick movements.

No. Mosquitoes cannot transmit HIV. This is because, HIV is unable to replicate in the mosquito gut and is digested there, so it cannot be transmitted through saliva.

Mosquitoes are called Mashakah in Sanskrit, Machchar/Dans/Masak in Hindi, Moh in Kashmiri, Mashak in Assamese, Masha in Bengali & Oriya, Daas in Marathi & Gujarati, Machaad in Punjabi, Solle in Kannada, Koshu in Tamil, Doma in Telugu and Kothuku in Malayalam.