SPEAK YOUR MIND If you would like to respond to an article in this issue, please submit an article or letter to the editor. Contributions may be sent to editor @ glms. org or may be submitted online at www. glms. org. The GLMS Editorial Board reserves the right to choose what will be published. Please note that the views expressed in Doctors’ Lounge or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine.
GET THEE BEHIND ME, AEDES
Mary G. Barry, MD
Louisville Medicine Editor editor @ glms. org
I
’ m looking at you, kid. Aedes aegypti: get thee gone. Abracadabra, sisboombah, scram!
I so wish that magic worked, but life has taught us otherwise. However, science does work. If we could disappear, not Disapparate, all Aedes from the planet, what would happen?
Aedes aegypti are lethal. They are literally bloodsucking. They are feared and hated villains. They carry the viruses that cause Zika, Dengue fever, Chikungunya, and Yellow fever. Together with their mafia, Aedes albopictus( which causes West Nile) and Anopheles gambiae sp.( Malaria), they kill at least a million people per year, mostly from malaria. Some African countries are unable to report reliable numbers, and some estimates go up to several million deaths per year.( Ebola is not spread via insect bites.) Zika cases are vastly under-reported since the great majority of people may not know what bit them, or even that they had Zika, since up to 80 percent notice none to few mild, nonspecific symptoms. As of Sept. 7, inside the US we have had about 3,000 laboratory confirmed cases of Zika, and the majority were travel-acquired. In contrast, nearly 16,000 cases of locally acquired Zika have been lab-confirmed in Puerto Rico, and 200 or so in the US Virgin Islands. Since these numbers represent only 20 percent or so of the people infected, we will need to test
the blood supply for Zika, since so many donors would not be able to remember or report infection.
Obviously mosquitoes have some evolutionary function( even if you believe in the Ark, they must have been on the damn thing). As near as I can tell, either as adults or larvae, they form part of the food chain for migratory birds, bats, dragonflies, frogs, spiders, lizards, salamanders and fish. That’ s their sum total of usefulness. The ones that live way up north in the Arctic are the ones that seem to be most needed in the food chain, since they form great flying clouds of food for birds. In various climates they help to pollinate some plants, including orchids.
What female mosquitoes eat, is us: entomologically referred to as“ a blood meal,” it’ s necessary for having mosquito offspring. These females can smell us. They hunt us. They can track our chemical signatures from hundreds of feet away. Their eggs can survive in a cool dry place, hatch and attack us in the middle of March, without warning. They are worse than vampires, since they are real.
About the only really good thing they do, according to some, is to preserve the rainforest. Some humans would instantly pave over the rainforest for profit, if it were not for the 70 trillion mosquito bites it would cost them.
There are over 3,500 species of mosquito, and scientific opinion seems to be divided about the extermination-to-extinction consequences of getting rid of some or all of the 80-100 species that kill people. Proper pond and wetlands management keeps mosquito counts down by keeping water moving and minnows mating, since they eat larvae. Household mosquito control programs, that do not include pesticide, center on public education about the removal of standing water and shrub-trimming. Potted plant saucers, bottle lids, toys, recycling bins, rainwater barrels and gutters hold water and are prime offenders. Charlatans will sell people any number of useless mosquito repellents including pesticide misting systems, bug zappers and“ environmentally friendly” plant oils. Deet and permethrin do work, but leave one centimeter of skin uncovered and see what happens, if your pheromones are siren calls to mosquitoes.
Pesticide on a mass scale is deadly to the innocent. In early September, at least three million bees were wiped out in South Carolina – and also the livelihoods of their keepers – when Dorchester County authorities sprayed Trumpet insecticide from the air. The bees could have been saved if the keepers had known. Website posts, phone calls and email warnings for those on the mosquito control registry were apparently not enough notice for many, noted CNN,
( continued on page 34)
OCTOBER 2016 33