Middle East DVEP - Armed Forces Pest Management Board

The biology of the Cx. pipiens complex is discussed under West Nile fever on page 86.The bionomics of Ae. aegypti is summarized under dengue page 61.Anopheles arabiensis larvae occur in slightly brackish water in coastal areas. Culexbitaeniorhynchus larvae inhabit stagnant pools with high algae content. Anophelesarabiensis readily feeds on man and other animals. Culex bitaeniorhynchus feeds on manbut prefers birds. These two species are nocturnal feeders. Culex bitaeniorhynchus andAn. arabiensis, while moderately strong fliers, travel shorter distances than members ofthe Cx. pipiens group.Vector Surveillance and Suppression. Mosquitoes can be individually dissected andexamined for filarial infection. Large numbers of mosquitoes can be processed morequickly by crushing them in a saline solution and removing filarial worms with a finesieve. The parasites can then be concentrated by centrifugation. Careful identification isrequired so as not to confuse medically important species of filarial worms with speciesthat infect only mammals and birds.Adult mosquito populations can be reduced temporarily by dispersal of ULV aerosols,especially at dusk. Larviciding or source reduction is more effective when mosquitolarvae are concentrated in breeding sites. Application of residual insecticides to interiorwalls of buildings can be effective against night-biting mosquitoes that rest and feedindoors. The most feasible long-term control strategies involve reducing vector breedingby environmental management techniques. Personal protective measures to preventmosquito bites are the most practical means of avoiding infection with mosquito-bornediseases. Consult TIM 13, Ultra Low Volume Dispersal of Insecticides by GroundEquipment, and TIM 24, Contingency Pest Management Pocket Guide. Also see vectorsurveillance and suppression for malaria on page 55.E. Lyme Disease.Lyme disease is also called Lyme borreliosis, tick-borne meningopolyneuritis, erythemachronicum migrans, Lyme arthritis, and Barnwart's syndrome. The causative agent is thespirochete bacterium Borrelia burgdorferi. Like syphilis, the clinical disease manifestsitself in three distinct stages. Initially there is a highly characteristic expanding skin lesion(erythema migrans) that develops in about 60% of cases. Flu-like symptoms usuallyoccur about the same time. Weeks to months after initial infection, cardiac, neurologicalor arthritic symptoms and other joint abnormalities may occur. Treatment in the latestages of the disease can be difficult. Chronic Lyme disease can be very debilitating.Early recognition and treatment are critical.Military Impact and Historical Perspective. Lyme disease is an emerging infection ofpublic health importance in many parts of the world. Since its discovery in Connecticutduring the 1970s, Lyme disease has been reported from 48 states. Since 1995, about 100cases of Lyme disease have been reported in US Army personnel worldwide. Theprevalence of Lyme borreliosis in the Middle East in unclear. It is suspected only in Israeland Turkey, where sporadic cases in military personnel might occur.Disease Distribution. Lyme disease is the most common tick-borne infection of humans127