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Prevention of Mosquito-borne Diseases

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Title: Prevention of Mosquito-borne Diseases


1
Prevention of Mosquito-borne Diseases
Central Health Education Unit June 2007
2
Mosquito-borne diseases
  • Common mosquito-borne diseases
  • Prevention of mosquito-borne diseases
  • Work of the Government
  • Personal Protection
  • Elimination of Mosquitoes

3
Common mosquito-borne diseases
  • Dengue Fever
  • Japanese Encephalitis
  • Malaria

4
Dengue Fever
5
Dengue Fever statistical data
Note Dengue Fever became a notifiable disease
since March 1994
6
Dengue Fever - Introduction
  • Etiological agent
  • Dengue viruses (DEN-1, DEN-2, DEN-3 and DEN-4) -
    flaviviruses
  • Principal vector
  • Aedes albopictus
  • Aedes aegypti

Source of photo Food and Environmental
Department
7
Dengue Fever Habitual Behaviour of Aedes
Albopictus
  • Usually breed in stagnant water
  • Usually active in dark or shaded places outdoors,
    but indoor activity is also possible
  • Distance of flightless than 100 meter
  • Most active 2 hours before sunset (5-6pm) and
    morning (8-9am)

Source of photo Food and Environmental
Department
8
Dengue Fever Mode of Transmission
Infected person
Dengue fever is not spread by contact with
infected persons.
9
Dengue Fever - Symptoms
  • Fever continuous for 3 to 7 days
  • Severe headache
  • Joint pain, muscle pain, pain behind eyeballs
  • Nausea, vomiting, and rash
  • In very rare cases, the condition may worsen into
    dengue haemorrhagic fever, leading to internal
    bleeding, shock, or even death.

10
Dengue Fever - Treatment
  • At present, no specific drug that can treat
    dengue fever effectively.
  • Patient should be isolated in a mosquito-free
    environment to prevent the spread of disease

11
Treatment (1)
  • Patients infected with classical dengue usually
    recovers in 1 to 2 weeks
  • For serious cases, supportive treatments are
    provided by hospitals
  • If you suspect that you have dengue fever, you
    should seek medical treatment promptly

12
Treatment (2)
  • For high fever, wipe the body with warm water and
    proper use of anti-fever drugs can relieve the
    fever
  • Dont take aspirin-containing drugs because they
    worsen the haemorrhage

13
Dengue fever patients immunity
  • Immunity is gained against that serotype
    after recovery from its infection. However, no
    effective protection is conferred against
    infection by the other three serotypes.
  • If the patient is infected with the other three
    different serotypes, it will increase the risk of
    getting haemorrhagic fever.

14
Japanese Encephalitis
15
Japanese Encephalitis statistical data
Note Voluntary reporting before 2004, JE became
a notifiable disease since 16 July 2004
16
Japanese Encephalitis Introduction
  • Etiological agent
  • Japanese encephalitis virus
  • Principal vector
  • Culex tritaeniorhynchus

17
Japanese Encephalitis Mode of Transmission
  • Spread by Culex tritaeniorhynchus
  • The mosquitoes infected by feeding on pigs and
    wild birds infected with the Japanese
    encephalitis virus

within 4-14 days
  • The disease is not directly transmitted from
    person to person or from animal to human.

18
Japanese Encephalitis - Signs and symptoms
  • Majority are asymptomatic
  • Low grade fever with headache
  • More severe infectionquick onset of headache,
    high fever neck stiffness, impaired mental state,
    coma, tremors, occasional convulsions and
    paralysis.
  • Death rates may range from 5 to 35. Patients
    who survive may have neurological consequences.

19
Japanese Encephalitis - Treatment
  • Seek medical treatment promptly
  • The mainstay of treatment is supportive

20
Japanese Encephalitis - Vaccination
  • WHO recommendationvaccination for the whole
    country is indicated when there are 10 to 100
    cases for every 100,000 population.
  • Provide 80-100 immunity, but may have adverse
    reactions.
  • Immunity may last for about 3 years.
  • Should consult medical officer for vaccination.

21
Japanese Encephalitis Do I need to have
vaccination?
  • WHO recommendation
  • Travellers going to endemic areas particularly in
    rural areas and
  • staying over 30 days are
  • recommended for vaccination.
  • Where can I get the vaccination?
  • Travel Health Centres of the Port Health Office
    of the Department of Health
  • Enquiry No2150 7235
  • www.travelhealth.gov.hk/cindex.html

22
Malaria
23
Malaria Statistical data
24
Malaria - Introduction
  • Etiological agent
  • A group of malaria parasites
  • Principle vector
  • female Anopheline mosquito

25
Malaria Mode of Transmission
  • When the mosquito bites a malaria patient, the
    mosquito
  • becomes infected and will pass on the disease
    when it
  • bites another person.
  • Malaria is not transmitted from person to person.
  • Malaria can be transmitted through contaminated
    blood
  • transfusion, organ transplant, or shared
    needles or
  • syringes.
  • It may also be transmitted from a mother to her
  • foetus/newborn baby before or during delivery.

7-30 days later
Infected mosquito
Healthy person
Infected person
26
Malaria Signs and symptoms
  • Intermittent fever, chills, sweating, headache,
    tiredness, poor appetite and muscle pain.
  • In typical cases, the fever comes, then subsides
    for 1 to 3 days and then comes again in a
    cyclical pattern.
  • Complications include anaemia, liver and kidney
    failure, seizures, mental confusion, coma, and
    death if the disease is not treated promptly.

27
Malaria Treatment
  • Consult a doctor for early diagnosis is crucial.
  • The doctor would prescribe a course of
    anti-malarial drugs with other supportive
    measures.
  • The patient should complete the whole course of
    medication to ensure clearance of the malaria
    parasites.

28
Malaria Prevention
  • Recommendation from WHO
  • If you travel to areas where malaria is
  • common, you should start taking the
  • anti-malarial drugs two to three weeks
  • before the trip, continue for four more
  • weeks after leaving the malarious area.
  • From where I can obtain the anti-malarial drugs?
  • Travel Health Centre, Department of Health
  • For Enquiries2150 7235
  • Websitewww.travelhealth.gov.hk/eindex.html

29
Malaria Vaccination
  • There are no vaccines against malaria.

30
Prevention of mosquito-borne diseases
  • Work of the Government
  • To prevent mosquito-borne diseases effectively
    relies on the support and co-operation of both
    public and private sectors with the government.

31
Work of the Government
  • Publicity and Health Education
  • Provide health education on personal protection
    against mosquito-borne diseases for general
    public.
  • Publicize personal protection against
    mosquito-borne diseases for travellers.
  • Latest updates on dengue fever for healthcare
    workers through periodicals, mails and internet.

32
Disease surveillance
  • Dengue fever, Japanese encephalitis and Malaria
    have been brought into one of the statutory
    notifiable diseases.
  • web-based Central Notification Office (CENO
    On-line)

33
Disease surveillance
  • Contact tracing, epidemiological investigations
    on disease outbreaks.
  • Liaise with relevant department, e.g. Food and
    Environmental Department for following up control
    measures.
  • Collaborate with other departments and Hospital
    Authority in formulating response measures to
    prevent local spread of Dengue fever.

34
Disease surveillance
  • Maintain close liaison with nearby regions and
    oversea countries.
  • Make announcement to general public on reported
    cases and disease situation of nearby regions and
    remind public of preventive measures.

35
Prevention of mosquito-borne diseases
  • Personal Protection

36
Personal Protection
  • The best protection is to avoid being
  • bitten by mosquitoes by paying
  • attention to the following
  • Avoid staying in dark, outdoor
  • places such as brushwood, pavilions,
  • or the shade of a tree during the
  • hours when Aedes albopictus is
  • active.

37
Personal Protection
  • Avoid going out in the hours when Aedes
    albopicuts feed or wear light-coloured,
    long-sleeves clothing and trousers.

38
Personal Protection
  • Install mosquito nets to doors and windows so
    that mosquitoes cant get in.

39
Personal Protection
  • Accommodation should have air-conditioners or
    mosquito nets
  • Hang mosquito screens around your bed
  • Use of mosquito coil

40
Personal Protection Choosing the insect
repellents
  • DEET containing products, such as repellents,
    anti-mosquito patches and spray are generally
    most effective to avoid mosquito bites.
  • Citronella, Soybean oil and 3-N-Butyl-N-acetyl-a
    minopropionic acid containing products also have
    mosquito repellent effects.
  • Portable ultrasonic devices are less reliable
    when compared with DEET.

41
Safety tips on using repellents that contain DEET
(1)
  • Avoid applying high DEET
  • concentration products (i.e. gt35)
  • Always read and follow the
  • instruction label carefully
  • before using repellents.

42
Safety tips on using repellents that contain
DEET (2)
  • As rare reports about application of repellents
    with DEET associated with seizures in young
    children, therefore the low concentration product
    (10 DEET) should be used on children.
  • DEET is not recommended for use on infants less
    than 2 months of age. They should use mosquito
    net for health protection (e.g. infant carrier
    draped with elastic edge mosquito net).

43
Safety tips on using repellents that contain DEET
(3)
  • Never use repellents over wounds or irritated
    skin.
  • Apply the repellent on exposed skin surfaces
    only
  • or on top of clothing. Do not use under
    clothing.
  • Do not attach the anti-mosquito patches
    directly
  • on the skin if it is specifically for clothing.
  • Wash repellent-treated skin with soap and water
  • when you come indoors.
  • When using sprays, do not spray directly on face
  • spray on hands first and then apply to face. Do
  • not apply to eyes or mouth.

44
Prevention of mosquito-borne diseases
Elimination of Mosquitoes
  • The most effective way to eliminate mosquitoes
    is to
  • Keep the environment clean.
  • Remove stagnant water so that mosquitoes cant
    breed.

45
Possible Breeding Grounds of Aedes Albopictus (1)
Artificial containers Vases, saucers
underneath flower pots, trays underneath
air-conditioners, buckets jars and jugs of
earthenware, cement troughs, dumped tyres and
solid wastes such as cans, disposable cups and
bowls, and plastic bags.
46
Possible Breeding Grounds of Aedes Albopictus (2)
Natural containers The hollow space inside a
bamboo, hollows of a tree and the rachis of a
leaf.
47
Elimination of Mosquitoes
  • Cover water containers
  • tightly so that
  • mosquitoes cant get in
  • to lay eggs.

48
Elimination of Mosquitoes
  • Dispose of domestic wastes, empty bottles, cans
    and lunch boxes properly into a covered bin to
    prevent the accumulation of stagnant water.

49
Elimination of Mosquitoes
  • Change water for vases
  • and aquatic plants at
  • least once a week,
  • leaving no water under
  • the pots or in the
  • bottom saucers.
  • Scrub the container
  • surfaces thoroughly to
  • prevent mosquito eggs
  • sticking on them.

50
Elimination of Mosquitoes
  • Remove or puncture any dumped tyres to prevent
    the accumulation of stagnant water.

51
Elimination of Mosquitoes
Keep ditches free from blockage.
52
Elimination of Mosquitoes
Fill up uneven ground surfaces to prevent the
accumulation of stagnant water.
53
Elimination of Mosquitoes
  • Remove stagnant water immediately if mosquitoes
    are found to be breeding. Use environmentally
    friendly insecticides such as lavicidal oil if
    necessary.

54
Elimination of Mosquitoes
  • In cultivation ponds, water tanks or large
    containers, biological controls such as keeping
    fishes to eat mosquito larvae would be a good
    option.

55
Mosquito Elimination Checklist (1)
  • Are containers and other items where water could
    accumulate disposed of properly? (For example,
    throwing empty cans, foam rubber boxes, cups and
    bottles into a covered bin)
  • Are water containers covered properly?

56
Mosquito Elimination Checklist (2)
  • Are ditches free from blockage?
  • Are containers with stagnant water cleaned
    regularly?(For example, vases, saucers underneath
    flower pots, water storage device of an
    air-conditioner, water tanks and pools)
  • Are uneven ground surfaces filled to prevent the
    accumulation of stagnant water?

57
Seek medical consultation immediately
  • Having been bitten by a
  • mosquito and displaying
  • symptoms afterwards
  • Falling ill, especially having
  • a fever within one month
  • after you have returned
  • from abroad

58
Enquiries/Websites
  • Centre for Health Protection,
  • Department of Health (www.chp.gov.hk)
  • Hong Kong Travellers Health Service, Department
    of Health (www.travelhealth.gov.hk/eindex.html)
  • 24-Hour Health Education Hotline, Department of
    Health (2833 0111)
  • Food and Environmental Hygiene Department Hotline
    2868 0000
  • Website www.fehd.gov.hk

59
Elimination of mosquito is the most effective
prevention strategy
Lets remove stagnant water and eliminate
mosquitoes
60
Thank You!
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