Mosquito-Borne Diseases
Mosquito-borne diseases are those that are transmitted to people through the bite of an infected mosquito.
The diseases spread by mosquitoes can be caused by a parasite, as in the case of malaria, or by viruses, as is the case for Zika fever and numerous others.
Some of these agents, like the parasite that causes malaria, have produced illness in humans for thousands of years, while others such as the chikungunya and Zika viruses have emerged only very recently.
Factors such as urbanization, global travel, and human population growth have increased the potential for mosquitoes to proliferate and hence cause disease on a wider scale.
Chikungunya virus causes a disease that, while rarely fatal, can cause debilitating joint pain that can last for weeks. Typical symptoms include fever and rash, as well as pain. The virus, which is classified as an alphavirus, is similar to dengue virus. The two viruses produce many of the same symptoms and both are carried by the Aedes mosquitoes, primarily Aedes aegypti. The chikungunya virus originated in tropical regions of Africa. It then spread east into Asia and north into Europe. The first reports of chikungunya in the Americas occurred in 2013 when the virus emerged in the Caribbean and rapidly expanded into Central America, South America, and North America. Chikungunya has now been identified in over 60 countries in Asia, Africa, Europe, and the Americas. By 2016 there were more than 1.7 million suspected cases of infection in the Americas. The virus is not spreading within the United States at this time, but there have been close to 800 cases of individuals in 44 states contracting the virus while traveling in areas where chikungunya was present in the local mosquito populations.
Dengue
Dengue virus causes dengue fever, a disease characterized by high fever, headache, joint pain, and rash. A more severe form, dengue hemorrhagic fever, can include bleeding and breathing difficulty and is fatal in some cases.
There are four types of dengue virus, and they belong to a class of viruses known as flaviviruses – the family that also includes the West Nile, yellow fever, and Zika viruses. Dengue, transmitted predominantly by Aedes aegypti mosquitoes, is found in more than 100 countries.
Dengue is the most common vector-borne viral disease in the world, causing an estimated 50 to 100 million infections globally each year and 25,000 deaths. In the tropics and subtropics, it is a leading cause of illness and death.
The incidence of dengue has jumped sharply in recent decades as the disease has spread into new geographic regions. While still rare in the United States, the frequency of dengue infection is on the rise and is largely associated with travel to regions in which dengue is circulating, but some cases have been acquired locally.
Yellow Fever
Yellow fever virus most commonly causes fever, headache, muscle pain, and nausea in those individuals who develop symptoms (many do not); these symptoms can initially be mistaken for malaria. However, a small percentage of symptomatic patients enter a more severe phase where they experience bleeding from the mouth, nose, and eyes and jaundice, a condition affecting the liver and kidneys that produces the yellowing of the skin and eyes for which the virus is named. For about half of the people who progress to this second phase, the disease will lead to death. The virus, classified as a flavivirus, is generally transmitted by Aedes aegypti mosquitoes, the reason that these mosquitoes are also known as yellow fever mosquitoes. While no longer a threat in the United States (although in the past it has caused devastating outbreaks), yellow fever is endemic in many countries in Africa and Central and South America. The greatest risk for a yellow fever outbreak occurs when the virus is introduced into heavily populated areas with high mosquito densities where the human population has little or no immunity, as is occurring currently in Africa. An outbreak of yellow fever was detected in the capital of Angola in December 2015 that has since spread to other regions within Angola and to the neighboring Democratic Republic of Congo. As of June 2016, there have been nearly 1000 cases confirmed in these two countries (mostly in Angola), with many more suspected, and over 300 people have died. A separate outbreak was reported in Brazil in January of 2017. Unlike many other mosquito-borne viruses, a safe and effective vaccine exists to safeguard against yellow fever. The challenge is to vaccinate people in the affected regions swiftly enough to contain the spread and to maintain sufficient stockpiles of the vaccine so that enough is available during an outbreak; it takes about 12 months to produce additional doses.
Malaria
Malaria is caused by Plasmodium parasites. Four Plasmodium species (Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae) give disease in humans, and humans are their only relevant reservoir. Once the Plasmodia multiply inside the red blood cells, fever and multi-organ disease may ensue, which can be life-threatening when P. falciparum is involved. Malaria is characterised by fever and influenza-like symptoms, including chills, headache, myalgia, and malaise.
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