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