Chapter 6

Arthropods and Mollusks

of Medical Importance
Introduction to Arthropods of Medical Importance
Lillian A. de las Llagas

O f all the major divisions or phyla

which make up the animal kingdom,
Phylum Arthropoda is certainly one of the
There are two types of metamorphoses:
• Gradual or incomplete metamorphosis.
In this type of metamorphosis, an
most important. Eighty-five percent of all
arthropod undergoes three stages:
known animals are arthropods. These are
egg, nymph, and adult. The young
bilaterally symmetrical invertebrate animals
resembles the adult except for the
with segmented bodies, jointed appendages,
smaller size and sexual immaturity.
and hard outer coverings or exoskeletons. No
Examples of arthropods exhibiting
other animal group demonstrates such a great
this include cockroaches, grasshoppers,
diversity in structure, life cycle, and habits. The
lice, and bugs.
arthropods range in size from the Atlas moth
• Complete metamorphosis. In this type
with a wingspread of 12 inches, to the small
of metamorphosis, an arthropod
follicle mite, less than l/250 of an inch long.
undergoes four stages: egg, larva, pupa,
Some arthropods are parasitic, while most
and adult. There is a great difference
are non-parasitic. Some prefer to live in highly
between the immature stages and
organized and complex environments in which
the adults. Examples of these are
each member contributes something to others
mosquitoes, flies, butterflies, moths,
in a symbiotic relationship.
ants, bees, wasps, fleas, and beetles.
Many arthropods have complicated life
histories. In some, the entire life cycle is not Arthropods are found everywhere, whether
completely known. Some demonstrate little it is in mountains, swamps, deserts, cities, or
change in morphology throughout the different countryside. Their presence in any environment
life stages, while others pass through a complete reflects their capability to adapt, propagate, and
metamorphosis having egg, larval, pupal, and establish colonies.
adult stages. Arthropods are provided with special
Metamorphosis refers to the change in form mechanisms which they use against their
or structure of an arthropod that occurs during enemies: the chitinized exoskeleton, primarily
the period of development. A few primitive a nitrogenous polysaccharide which makes the
insects develop without metamorphosis. In integument impervious to water; appendages
these insects, the young is the exact replica of which may be lost and later regenerated; hairs,
the adult differing only in size. scales or spines; and body fluids which may be
used effectively for their survival.

278
 Chapter 6: Arthropods and Mollusks of Medical Importance 279

Classification of Arthropods

Phylum Arthropoda comprises at least

740,000 species. The majority of medically
important arthropods can be grouped into two
classes: Insecta and Arachnida. Other classes,
which are also important, are Chilopoda,
Diplopoda, Crustacea, and Pentastomida
(Table 6.1).

Table 6.1. List of immediate diagnostic features

of arthropods
Figure 6.1. A generalized diagram of an adult
Class Antennae Legs
Cyclorraphan fly (From Baltazar CR, Salazar NP.
I. Crustacea 2 pairs 5 or more Philippine insects: an introduction. Quezon City:
(crabs, lobster, pairs of
University of the Philippines Press; 1979.)
shrimps, walking
copepods) legs
II. Arachnida 0 4 pairs (adult A. Head
(mites, ticks, stage)
scorpions, spiders) The head bears the eyes, antennae, and the
III. Hexapoda/Insecta 1 pair 3 pairs (adult mouthparts. The antennae are located in the
(mosquitoes, flies, lice, stage)
bugs, etc.)
front portion of the head between the eyes. They
IV. Chilopoda 1 pair 1 pair per
are greatly modified, often having characteristic
(centipedes) body shapes, and are provided with chemoreceptors
segment
(Figure 6.2).
V. Diplopoda 1 pair 2 pairs per
(millipedes) body
segment
VI. Pentastomida 0 0
(tongue worms)

Class Insecta (flies, mosquitoes, bees,

wasps, butterflies, bugs, etc.) is considered the
largest, representing approximately 70% of the
phylum. It also typifies the arthropod’s external
and internal structures. Class Insecta is the
most important group of arthropods from the
medical viewpoint. It includes many species that
directly and indirectly affect humans.
Figure 6.2. Parts of an insect head
External Anatomy (From Baltazar CR, Salazar NP. Philippine insects:
an introduction. Quezon City: University of the
The body of an insect is divided into Philippines Press; 1979.)
three major regions: the head, thorax, and
abdomen (Figure 6.1). In many insects, these Two types of eyes occur in insects: simple
parts are clearly well-differentiated, as in flies and compound. Simple eyes or ocelli consist of
and mosquitoes, whereas in some, they are less single eye units or facets. Compound eyes are
distinct as in fleas. usually very large and maybe round, oval, or
280 Medical Parasitology in the Philippines

kidney-shaped. The outer face of the compound soluble foods. The mandibles are absent, and
eye is composed of many small six-sided lenses the maxillae are represented only by the palps.
called facets. In general, the active flying insects The labrum and labium fuse to form a proboscis
have large eyes with many facets, while the with a spongy tip called the labellum. The insect
walking types have fewer facets. Some parasitic regurgitates saliva to dissolve the food. Then,
insects have poorly developed eyes, as in some the capillary grooves at the base of the labellum
fleas. carry the liquefied food to the food canal inside
Insects have an upper lip or labrum, a lower the proboscis (Figure 6.4).
lip or labium, a pair of maxillae or upper jaw,
and a pair of mandibles or lower jaw. The shapes
and sizes of these structures vary according
to the insects’ feeding habits. There are four
principal types of mouthparts:
1. Chewing mouthparts

These are exemplified by cockroaches and

silverfish, which use their mouthparts to grind
solid food. The mandibles are useful in cutting
or tearing food apart. The maxillae, labrum, and
labium are used in handling food before it is
swallowed. The palpi are used to feel, smell, and Figure 6.4. Sponging type of mouthparts
taste food. These appendages are provided with (From Baltazar CR, Salazar NP. Philippine insects:
hairs where the various senses are concentrated an introduction. Quezon City: University of the
(Figure 6.3). Philippines Press; 1979.)

3. Piercing-sucking mouthparts

These are exemplified by mosquitoes,

biting flies, sucking lice, fleas, and kissing bugs.
The mandibles, labrum, and maxillae are long
and slender. The labium forms a stout sheath,
which holds these structures, and the entire
structure is called the proboscis (Figure 6.5).

Figure 6.3. Chewing type of mouthparts

(From Baltazar CR, Salazar NP. Philippine insects:
an introduction. Quezon City: University of the
Philippines Press; 1979.)

2. Sponging mouthparts Figure 6.5. Piercing-sucking type of mouthparts

(From Baltazar CR, Salazar NP. Philippine insects:
This type, as exemplified by houseflies, an introduction. Quezon City: University of the
is adapted for sucking up liquid or readily Philippines Press; 1979.)
 Chapter 6: Arthropods and Mollusks of Medical Importance 281

4. Chewing-lapping mouthparts Wing veins running from the base to the

apex of the wings are called longitudinal veins.
An example of an insect having this type
Cross veins connect the longitudinal veins. The
of mouthparts is the honeybee. Mandibles and
arrangement and number of these veins are
maxillae are of the chewing type and are used
important in the classification of insects. Areas
for grasping prey or for molding wax or nest
in between veins are called cells. Some veins
material (Figure 6.6).
may be closed. Each vein contains a nerve cord,
trachea, and hemolymph. The leading edge is
called the costa, and short subcostal veins are
numbered 1, 2, 3 and so on.
2. Leg

The leg is divided into the coxa, trochanter,

femur, tibia, tarsus, and pretarsus (Figure 6.7).
The femur and tibia correspond to the human
thigh and shin, and the tarsus has a function
similar to that of the foot. The last tarsal
segment usually terminates into a pair of claws
or pulvilli, which help the insects in walking on
smooth surfaces.

Figure 6.6. Chewing-lapping type of mouthparts

(From Baltazar CR, Salazar NP. Philippine insects:
an introduction. Quezon City: University of the
Philippines Press; 1979.)

B. Thorax

This is the second main body region which

is connected to the head by a membranous
region, called the neck or cervix. This part bears
three segments, namely: prothorax, mesothorax,
and metathorax. Each segment bears a pair of
walking legs. Wings, when present, are attached
to the mesothorax and metathorax.
1. Wings

These are membranous extensions of the

body wall and consist of an upper and lower
Figure 6.7. Walking leg of an insect
layer. These layers are supported by reinforcing (From Baltazar CR, Salazar NP. Philippine insects:
structures, which appear as distinct lines called an introduction. Quezon City: University of the
veins. Philippines Press; 1979.)
282 Medical Parasitology in the Philippines

C. Abdomen Internal Anatomy

The third body region, which bears the A. Circulatory System

spiracles and the external reproductive organs,
Insect blood is usually colorless and is called
is made up of 11 segments. The spiracles (Figure
hemolymph. It contains hemocytes, which are
6.8) are the external openings of the respiratory
blood cells that are mainly phagocytic. Blood
system, and some insects have a pair on each
circulation is maintained by the hemolymph
abdominal segment. The 8th and 9th segments
which flows through small valve-like openings
bear the external sex organs used for copulation
called ostia (Figure 6.10). The heart is located
in the male and serve as an egg-laying device or
dorsally and blood from the heart is forced
ovipositor for the female. Some bear a pair of
forward through the aorta to the brain. The
finger-like processes called cerci (Figure 6.9) on
main function of the heart is to carry nutrients
the 11th segment which are more conspicuous
to the tissues, and waste products to the
in females.
Malphigian tubules for excretion (excretory
organ). The entire body cavity is called the
hemocoel.

Figure 6.8. Spiracle

(Courtesy of Dr. Lilian de las Llagas)

Figure 6.10. Diagram of an insect showing the

arrangement of the circulatory system
(From Baltazar CR, Salazar NP. Philippine insects:
an introduction. Quezon City: University of the
Philippines Press; 1979.)

B. Respiratory System

Oxygen reaches the tissues by direct gaseous

exchange. The spiracles, which are circular
openings in the cuticle, allow air to enter the
body (Figure 6.11). Spiracles are located on
the mesothorax, the metathorax, and the first
eight abdominal segments. Air passes through
Figure 6.9. Cercus
(From Baltazar CR, Salazar NP. Philippine insects: a small tube called the trachea. Oxygen diffuses
an introduction. Quezon City: University of the across the tracheoles into the cells, while carbon
Philippines Press; 1979.) dioxide from the cells enters the tracheoles and
 Chapter 6: Arthropods and Mollusks of Medical Importance 283

the body, especially sensory organs like the

compound eyes, ocelli, antennae, halteres, palpi,
and hairs, serving as sensory receptors.
D. Digestive System

The foregut starts with the mouth

and includes the pharynx, esophagus, and
proventriculus (Figure 6.13). The posterior
part of the esophagus, called the crop, serves
as an area for temporary storage of food
before it is passed to the midgut for digestion.
The muscular proventriculus acts as a valve
preventing the food from being regurgitated
and may have teeth or spines to aid in the
disintegration of food particles. A pair of
Figure 6.11. Diagram showing an insect spiracle
and trachea (From Baltazar CR, Salazar NP.
salivary glands is situated in the thorax. The
Philippine insects: an introduction. Quezon City: composition of saliva varies according to the
University of the Philippines Press; 1979.) type of insect. In blood-sucking ones, it often
contains anticoagulins, which may be allergenic.
goes out via spiracles. This tracheal system also The midgut or stomach serves as an area
regulates water. for food storage in the process of digestion
and may become greatly distended. It secretes
C. Nervous System
enzymes necessary for insect meal digestion.
The central nervous system consists of a The beginning of the hindgut is marked by the
brain connected to a nerve cord, with ganglia presence of opaque tubules called Malphigian
occurring at intervals, often one ganglion per tubules. The anterior part is called the ileum,
body segment (Figure 6.12). Nerves arising while the more distal part is called the rectum,
from these ganglia reach various parts of which terminates in the anus.
E. Excretory System

Malphigian tubules act as excretory filters

and discharge waste products (Figure 6.13).

Figure 6.12. Diagram of an insect showing

the arrangement of the nerve cord Figure 6.13. The digestive and excretory systems
(From Baltazar CR, Salazar NP. Philippine insects: (From Baltazar CR, Salazar NP. Philippine insects:
an introduction. Quezon City: University of the an introduction. Quezon City: University of the
Philippines Press; 1979.) Philippines Press; 1979.)
284 Medical Parasitology in the Philippines

They are milky white to opaque in appearance Because of the chitinized cuticle, the
due to deposition of waste products within insect’s skin is not sensitive to contact. The
their cells. sense of touch is made possible by sensory
hairs connected to a nerve (sensory nerve cell),
F. Reproductive System
which is stimulated if hairs are disturbed.
Insects are dioecious; the male and female Nerve endings are usually concentrated in the
must mate before eggs are produced. Insects mouthparts, antennae, and tarsi.
which lay eggs are called oviparous, while those Taste is usually perceived by the mouth and
which deposit larvae are called viviparous. mouthparts, by the palpi or even by the protarsi.
The reproductive organs of the female Palps also bear olfactory organs. The sense of
(Figure 6.14A) consist of a pair of ovaries which smell is highly developed in insects and is used
produce eggs and pass them into the oviduct, for locating food, finding a mate, and locating
where they may be fertilized by sperm cells a suitable oviposition site.
stored in the spermatheca. Some species have Insects generally respond only to specific
accessory glands which secrete an adhesive noises, such as the sound made by the wings of
coating for the eggs. a female mosquito. Sound waves may be picked
The male reproductive organs (Figure up by fine sensory hairs or by an auditory drum
6.14B) consist of a pair of testes in which sperm located on the lower part of the insects’ front
cells are developed. The seminal vesicle serves legs. Only some insects, like grasshoppers,
as storage for spermatozoa until mating occurs. cicadas, crickets, and other species of moths
The accessory glands secrete a liquid substance have “ears” or tympanic membrane. Flies and
to serve as a vehicle for the sperm cells, which mosquitoes are believed to hear by means of a
are then passed into the vas deferens and into cup-like organ on the second antennal segment,
the penis or ejaculatory organ. which responds to sound waves picked up by
the rest of the antennae.
The principal organs of sight are the
compound eyes and ocelli. Insects cannot move
nor focus their eyes. It is not possible for insects
to see a sharp clear image, and they are only able
to see blurred images. These eyes are provided
with nerves, which transmit stimuli to the brain.
Because of these different senses, insects
are able to react to their environment. Their
responses arise from simple stimuli, such as
Figure 6.14. Reproductive systems of an insect
light, heat, gravity, hunger, and smell. Their
(From Baltazar CR, Salazar NP. Philippine insects:
an introduction. Quezon City: University of the reactions consist of more or less fixed behavioral
Philippines Press; 1979.) patterns and they react similarly to the same
stimulus. This is called automatic behavior,
G. The Senses
which does not involve reasoning. With insects,
behavioral reactions are usually immediate.
Insects also possess the senses of touch, Although the brain is located in its head, each
taste, smell, hearing, and sight. They also of the body regions act independently, or in
possess other auxiliary senses such as the sense a semi-autonomous manner, because pairs of
of balance, and possibly orientation. nerve centers called ganglia are located along
 Chapter 6: Arthropods and Mollusks of Medical Importance 285

the bottom side of the insect’s body and are D. Class Chilopoda (centipedes or hundred-
connected to the brain by a nerve cord. legged worms)
Arthropods can cause direct and indirect These arthropods are terrestrial, elongated,
injuries to humans. Below is the list of medically and have many segments. The body is
important classes and orders under Phylum dorsoventrally flattened with a pair of legs on
Arthropoda. Discussion of their important each body segment. The appendages of the first
features and roles in human disease are given body segment are modified to serve as poison
in the next two sections. claws.
A. Class Insecta
E. Class Diplopoda (millipedes or thousand-
Order Diptera (mosquitoes and flies) legged worms)
Order Siphonaptera (fleas) These are terrestrial, elongated and have
Order Hymenoptera (bees, wasps, and ants) many segments. The body is cylindrical with
Order Lepidoptera (moths and butterflies) two pairs of legs per body segment. There are
Order Hemiptera (bed bugs and kissing no poison claws. They do not bite humans, but
bugs) secrete substances that are irritants to human
Order Anoplura (sucking lice) skin.
Order Coleoptera (beetles)
F. Class Pentastomida (tongue worms)
B. Class Crustacea
Adults have elongated bodies which are
These arthropods are aquatic in nature. either flattened (e.g., Linguatula in dogs) or
Their bodies are divided into two: cephalothorax cylindrical (e.g., Armillifer in pythons). In
(head and thorax fused together) and abdomen. Armillifer, the body is divided into a series of
Respiration is either by means of true gills or unusually conspicuous rings, which are not true
directly through the body wall. segments. This characteristic raises questions
There are two orders of medical importance: on whether this class should be under Phylum
Order Copepoda (cyclops) Arthropoda. The larval stage, however, is
Order Decapoda (macrocrustaceans, e.g., segmented. The adults usually live in the lungs
crabs, lobsters, and shrimps) or air passages of their hosts, while larvae live
free or encysted in the viscera of some other
C. Class Arachnida hosts.
These arthropods are both aquatic and References
terrestrial in nature. Their bodies are divided
into a cephalothorax and abdomen. The Baltazar CR, Salazar NP. Philippine insects: an
cephalothorax bears six pairs of appendages: introduction. Quezon City: University of
anterior chelicerae, pedipalps, and four pairs the Philippines Press; 1979.
of walking legs. de las Llagas LA. Study guide in medical
There are three orders of arachnids which entomology. 1987. Located at: College of
are of medical importance: Public Health Library, University of the
Philippines Manila.
Order Scorpionida (scorpions) de las Llagas LA, Abong J. Identification and
Order Araneida (spiders) characterization of local house dust mites:
Order Acarina (mites and ticks) potential for native allergen production for
286 Medical Parasitology in the Philippines

experimental, diagnostic, and therapeutic Philippine Islands. San Francisco: USAF

use in the local setting. 2003. Located Fifth Epidemiological Flight, PACAF,
at: College of Public Health Library, technical report 70-l; 1970.
University of the Philippines Manila. Service MW. A guide to medical entomology.
Borror DJ, Delong DM, Triplehorn CA. An 1st ed. Hongkong: The MacMillan Press
introduction to the study of insects. 4th ed. Ltd.; 1980.
USA: Holt, Rinehart and Winston; 1976. Taboada O. Manual of medical entomology.
Cagampang-Ramos A, Darsie RF Jr. Illustrated USA: US Government Printing Office;
keys to the Anopheles mosquito of the 1968.
 Chapter 6: Arthropods and Mollusks of Medical Importance 287

Arthropods as Direct Causes of Injury

Lilian A. de las Llagas

Ways by which Arthropods Affect Humans follow repeated exposure to various venomous
arthropods. Arthropods that cause direct injury
T he direct effects of arthropods on humans are
generally classified as: (a) envenomization;
(b) ectoparasitism; (c) ingestant and inhalant
through envenomization are described below.
A. Order Hymenoptera (bees, wasps, and
allergens; (d) food, water, and house pests; (e) ants)
myiasis; and (f ) entomophobia and delusory The name of the order comes from the
parasitoses (Table 6.2). Greek word hymen meaning membrane and
ptery meaning wing. These are, therefore,
Table 6.2. Specific injuries and their causative membranous-winged arthropods. Their
agents mouthparts have strong jaws, which are
adapted for biting. Typically, there are two
Injury Agents
pairs of wings, with the hind pair being smaller
Envenomization Venomous arthropods: bees,
wasps, kissing bugs, ants, than the front pair. The wings are folded back
caterpillar, centipede over the abdomen when at rest. The body is
spider and scorpion
divided into three segments: head, thorax, and
Ectoparasitism Non-venomous arthropods:
mosquito, flea, lice, mite
abdomen. The abdomen is further divided into
and ticks abdominal segments, but usually only six or
Inhalant allergens Dead/decomposing bodies of eight are evident. The last abdominal segment
insects: cockroach feces,
hairs and spines, house dust
is a modified ovipositor, the stinging apparatus
mites (HDM) of a female hymenopteran. This modification
Ingestant allergens Mites, cockroach feces, larval of the egg-laying tube enables it to function as
stages of small beetles a very efficient weapon for both offense and
Contact allergens Urticating caterpillar hair, blister defense. The sting is withdrawn into the body
beetle, millipede
when not in use. The presence of an ovipositor
Food and water pests Moth, beetle, mites,
chironomids, maggots serves to identify the female since the sting is
House pests Mosquitoes, flies, cockroaches absent in the male.
Myiasis Fly maggots feeding on
The stinging hymenopterans are divided
human wounds into two distinct groups: those that kill their
prey by stinging, and those that sting only to
paralyze their prey.
Envenomization
Formic acid, which causes the paralysis,
Venoms are poisonous substances, which can be found at the base of the stinger of
certain animals secrete and introduce by biting some hymenopterans. The apparatus of the
or stinging. Arthropod venoms are usually hymenopteran that kills has an acid gland
poisonous when they are injected through the opening directly into the poison sac, and an
integument, or come in contact with injured alkaline gland, which is comparatively small.
skin. The toxic effect of the injected venom It is the combination of these acid and alkaline
depends upon its chemical composition and fluids that results in the death of the prey or
the amount injected. Allergic reactions may causes extreme pain.
288 Medical Parasitology in the Philippines

Stinging hymenopterans, which have 1. The Stinging Apparatus (modified ovipositor)

been found responsible for adverse reactions in
The venom apparatus consists of three
humans, are members of superfamilies Apoidea
parts: the piercing apparatus, the lateral plate
(bees) (Plate 6.1), Vespoidea (wasps, hornets,
and appendages, and the poison sac and glands.
and yellow jackets) (Plate 6.2), and Formicoidea
If the ovipositor stinger stays in the wound, one
(ants).
can be sure it is from a honeybee. The stinger of
the honeybee is barbed; when it is pulled from
the insect, the honeybee dies. The honeybee,
therefore, is not capable of multiple stings,
unlike the hornets, wasps, and bumblebees,
which all have unbarbed stingers (Plate 6.3).

Plate 6.1. Bee (Bombus sp.)

(Courtesy of Dr. Lilian de las Llagas)

Plate 6.3. Bee stinger

(Courtesy of Dr. Lilian de las Llagas)

Among ants, the bite may be supplemented

by the sting. Formic acid of the formicine ants
may reach intra- or sub-dermal tissues only
through wounds made by the mandibles. Some
ants bite and sting simultaneously. The bite is
a necessary mechanical advantage for inserting
the sting. Salivary secretions are not introduced.
2. The Nature and Action of the Venom

Venom secretion in worker honeybees

begins just prior to emergence and increases
slowly toward a maximum amount between
the 10th and 16th day. This amounts to 0.3
mg of liquid or 110 pg of venom. Secretions
cease after 20 days. Protein food, mostly pollen,
Plate 6.2. Wasp is required for the full production of venom.
(Courtesy of Dr. Lilian de las Llagas) Electrophoretic and chromatographic studies
 Chapter 6: Arthropods and Mollusks of Medical Importance 289

have shown that bee venom contains histamine,

which is released in the tissues. Histamine,
however, is not the major pharmacological
component. Bee venom appears to contain no
cholinesterase or 5-hydroxytryptamine, but it
does contain low molecular weight ninhydrin-
reacting compounds, the action of which is not
completely understood.
Toxic effects of bee venom result from the
combined actions of mellitin, phospholipase
A, and hyaluronidase. These account for
both the local and general reactions such as
pain, inflammation, swelling, and redness.
Phospholipase is also known to indirectly cause
hemolysis of red blood cells.
The initial response to the venom is a wheal
and flare at the site of the sting, then itching Plate 6.4. Kissing bug (Triatoma sp.)
and flushing follows. As the venom circulates (Courtesy of Dr. Lilian de las Llagas)
in the blood, more widespread symptoms
occur. Vascular effects (hypotension), and then bloodsuckers. Members include the genera
pulmonary effects, with asthma or angioedema Arilus and Reduvius.
in the airways, are observed. Triatomines are differentiated by the
The effects of stings are two-fold: the direct position of antennal insertion. In Rhodnius,
toxic effect, and the anaphylactic shock, which the insertion is at the top of the head. In
may develop in those who become sensitized Triatoma, the insertion is midway between
to it. Many beekeepers become desensitized the compound eyes and the tip of the head,
to bee venom as a result of repeated stings. while in Panstrongylus, the insertion is near the
The sera of beekeepers contain antibodies to compound eyes.
phospholipase A. Genus Triatoma has been reported to inflict
B. Order Hemiptera
painful bites (Plate 6.4). Triatoma rubrofasciata
bite was first reported in the Philippines by
Family Reduviidae consists of insects Africa in 1934. There have been periodic
described as “cone-nosed” because they have complaints from patients bitten by this bug.
narrow pointed, cone-shaped heads. They are Major complaints include swelling in the area of
known as “assassin” bugs or “cannibal” bugs the bite, nausea, vomiting, irritation, and pain.
which prey upon soft-bodied insects, and The extent of reaction to these bites appears to
“kissing” bugs because some biting species depend on the sensitivity of the host and on
attack the face. the amount of antigen injected. Symptomatic
Subfamily Triatominae feeds on the blood reactions are probably due to the phenomenon
of vertebrates, including humans. Members of sensitization rather than a response to a
of this subfamily include the genera Rhodnius, primary irritant. Bugs usually bite at night and
Triatoma, and Panstrongylus (Plate 6.4). the lesions are usually in the exposed parts of
Subfamily Haspactorinae also inflict the body. The venom is probably the same as
painful bites, but they are not necessarily the venom of bees and wasps.
290 Medical Parasitology in the Philippines

Arilus is called the wheel bug because of

a cog-like crest found on its thorax, which is
its distinct feature. The proboscis has three
long and stout joints. When not in use, the
proboscis is bent ventrally under the head. This
bug is usually found in vegetation, near rocks,
other outside debris, and inside buildings when
raining. This bug is known to feed on other
arthropods.
The wheel bug attacks humans as a form
of defense, particularly when its resting place is
disturbed. Its bite inflicts severe and immediate
pain.
C. Order Lepidoptera

The larvae of moths and butterflies are Plate 6.6. Caterpillar head and thorax, lateral
called caterpillars (Plates 6.5–6.6). They usually view (Courtesy of Dr. Lilian de las Llagas)
have a cylindrical, worm-like body which is
divided into 12 segments: the first three make mechanical effect, similar to that of glass fibers.
up the thorax, and the other nine the abdomen. The hairs are of several kinds and many of them
The well-developed head bears a mouth, 12 are barbed, so that they tend to stick to the skin.
tiny eyes and two very short antennae. The Upon contact, the susceptible individual may
mouthparts of the larvae consist of strong biting experience a burning sensation on the affected
jaws and mandibles adapted for biting. This skin, which may show redness or inflammation.
differs from the adults, which have sucking Other areas may show urticarial wheals.
mouthparts. Some larval species have spines If the hairs get into clothing, widespread
or hairs, which may contain toxin. In some dermatitis may occur. Wind-blown hairs in
instances, irritation seems to be largely due to a drinking water can also cause inflammation of
the mucous membrane of the mouth.
D. Class Chilopoda

Centipedes are terrestrial arthropods that

are dorsoventrally flattened, and have one
pair of legs per body segment (Plate 6.7). The
head bears a pair of long antennae, a pair of
mandibles, and two pairs of maxillae (Plate 6.8).
The first body segment bears a pair of
modified legs found just ventral and lateral to
the mouth. These modified legs form claws,
the terminal joints of which are curved, sharply
pointed, horn-like fangs that connect to the
venom glands.
Plate 6.5. Caterpillar, dorsal view Large species of centipedes can grow up to
(Courtesy of Dr. Lilian de las Llagas) 25 cm in length and are considered venomous.
 Chapter 6: Arthropods and Mollusks of Medical Importance 291

brain where marked congestion was observed

indicating the concentration effect of the
poison, and (b) thinness of the skin in the region
of the bite, which allowed the deep injection of a
large amount of poison and its rapid absorption.
E. Order Scorpionida (scorpions)

The body is divided into a cephalothorax

and an abdomen. The cephalothorax is
unsegmented and covered by a dorsal plate,
called a carapace which contains 2 to 12 eyes.
The abdomen is segmented with the terminal
five segments ending in a bulbous sac and a
conspicuous stinger. The sac contains two
poison glands which are connected to the
terminal stinger by ducts. Scorpions have no
Plate 6.7. Centipede
(Courtesy of Dr. Lilian de las Llagas)
antenna but their bodies and legs are covered
with sensory hairs (Plate 6.9).
Scorpions are nocturnal creatures. During
the day, they remain hidden under stones, logs,
piles of lumber, closets, shoes, folded blankets,
folded papers, and other debris. They come out

Plate 6.8. Centipede head

(Courtesy of Dr. Lilian de las Llagas)

Small types, about 2 to 5 cm long, are harmless,

since they do not have well-developed fangs
for biting. The amount of venom introduced
depends on the size of the centipede.
The bite is characterized by local pain at
the site of puncture, hardening of the skin,
formation of papules, rash, swelling, and
purple patches. However, each sign or symptom
subsides within 24 hours if the wound remains
uninfected.
Pineda, in 1934, reported a death due
to a centipede bite in the Philippines. The
immediate reactions noted after the bite were
pain, numbness of the affected area, and a
minute, reddish puncture wound. Noteworthy Plate 6.9. Scorpion
were the following: (a) proximity of bite to the (Courtesy of Dr. Lilian de las Llagas)
292 Medical Parasitology in the Philippines

of their hiding places at night to obtain food, and Loxosceles (brown widow/recluse spider).
consisting mainly of insects and other arachnids. The females of both spiders destroy or kill the
Although scorpions rarely sting humans, males after mating. Thus, they are called “widow
they are considered dangerous since they spiders.”
produce hemolytic and neurotoxic venom.
1. Latrodectus
Investigators have described the venom to be
protein in nature, and its toxicity is dependent The mature female black widow spider is
on sulfhydryl groups. Hemolytic venom causes deep black in color. It has red markings in the
painful swelling at the site of the sting, which form of an hourglass on the underside of its
diminishes within 30 minutes. Neurotoxic abdomen. It is approximately 1.2 to 5.1 cm in
venom may produce numbness at the sting size (Plate 6.10).
site, profuse sweating, salivation, nausea, and
paresthesia of the tongue. Drowsiness may
follow the immediate sharp pain. It has been
observed that if the victim is alive for three hours
after the sting, survival is probable. No other
arthropod produces these symptoms.
A. Order Araneida (spiders)

The body is divided into a cephalothorax

and an abdomen joined by a slender “waist,”
called a pedicel or stalk. The cephalothorax
commonly has eight simple eyes and six pairs
of appendages. The first pair of appendages, the
chelicerae or fangs, are claw-like and utilized by
Plate 6.10. Black widow spider (Latrodectus
the spider to capture its prey. The second pair hasselti) (Courtesy of Dr. Lilian de las Llagas)
of appendages is a pair of six segmented palpi
or pedipalps, which are found in front of the A bite from the black widow spider is often
legs and are sometimes mistaken for legs. The inconspicuous. Slight local swelling and two
other four pairs of appendages are walking legs. tiny red spots may appear, with local redness
The chelicerae are segmented appendages usually evident at the point of attack. Within
and have hollowed tips, through which the a few minutes after the bite, latrodectism
venom is injected from the modified salivary develops, characterized by severe pain which
or poison glands. spreads throughout the extremities and the
The spinning organs are located near the trunk. Within a few hours, chills, vomiting,
back of the abdomen and on the underside. cramps, delirium, and spasms may occur.
There are usually six spinnerets used for Abdominal pains are frequently severe. These
spinning the web. symptoms may be mistaken for appendicitis,
Spiders are cosmopolitan in distribution colic, or food poisoning. In 1987, Grace and
and nocturnal in habit. They prefer quiet, cool DaÔgo reported a case of spider bite by a spider
shelters and dimly lit areas. popularly known as “gagambang gubat.” The
Most spiders are harmless. Few have patient exhibited contraction of leg muscles,
chelicerae that are strong enough to penetrate high fever, hemoglobinuria, and jaundice.
human skin. Among the dangerous species are The venom apparatus consists of two
Latrodectus (black widow spider or “katipo”) glands, located on the cephalothorax, which are
 Chapter 6: Arthropods and Mollusks of Medical Importance 293

connected by ducts to two curved fangs, located a. Family Culicidae (Mosquitoes)

on the distal segments of the chelicerae. The
Among the mosquitoes, only females bite,
venom is a complex protein with a neurotoxic
but both sexes feed on nectar and juices. The
lipoprotein fraction.
sexes can be easily differentiated by looking at
2. Loxosceles the antennae. The male has a hairy or plumose
antenna, while the female has pinnose antennae
This species may be distinguished from
with less hair.
other forms by its three pairs of eyes arranged
Mosquitoes have scaly wings, the third vein
in a semi-circle fashion on the forepart of
of which is simple, while the second and fourth
the head, and a dark violin-shaped marking
veins are branched. The mouthparts belong to
immediately behind the simple eyes. This is
the piercing-sucking type. Mosquitoes are about
more commonly found inside houses than the
4 to 6 mm in length. Some small-sized species
black widow spider.
measure about 2 to 3 mm in length, while the
Loxoscelism is caused by this spider’s bite.
larger-sized species can be as long as 10 mm.
Although symptoms are localized, it differs from
Mosquitoes have two compound eyes that are
the bite of the black widow in that the initial
made up of many facets. Just below the antennae
thick wheal may become necrotic. In 1987,
is a pair of palps, dilated or pointed at the tips,
Barrion reported two cases of loxoscelism. Two
depending on the species.
boys were bitten on their hands by a spider
The thorax is slightly humped and is
while climbing a mango tree. The immediate
covered dorsally and laterally with scales. The
reactions were localized swellings at the bite
abdomen is composed of 10 segments but
sites, high fever, and contractions of leg muscles.
only the first 8 are visible. The last abdominal
Later, necrosis and gangrene were observed on
segment of female mosquitoes terminates in
the bitten areas. The venom of Loxosceles may
a small pair of cerci, whereas, in the males, a
contain a spreading factor and this may be
prominent pair of claspers is present.
responsible for the necrotic effect.
Two major divisions of Family Culicidae
Ectoparasitism and lesions due to arthropod are Anophelinae and Culicinae. Anophelines
bites include the Anopheles mosquito, whereas Aedes,
A. Order Diptera (Class Insecta: mosquitoes Culex, Mansonia, and Armigeres mosquitoes are
and flies) culicines.

This order is characterized by the presence i. Mechanism of Bite Reaction

of a single pair of wings. The second pair is Some species bite during the day, while
reduced to small knob-like structures called others hide and become active at night, dusk
halteres, which are used during flight as or dawn. Bites are usually inflicted on exposed
balancers. There are three suborders of medical body surfaces. The reaction to these bites may
importance: either be immediate or delayed or sometimes
1. Suborder Nematocera (e.g., mosquitoes, both, depending on the frequency of contact.
blackflies, midges, and sandflies). There are three general types of reactions:
Insects under this suborder possess a pair of • Hemorrhagic macule. There is a
thread-like antennae of similar segments. There punctum seen at the site of the bite,
are about 11 to 15 segments for the long type of which may develop without symptoms
antennae. These antennae are longer than the of irritation; in the course of several
head and thorax combined. The mouthparts are days, these marks become darker and
adapted for sucking blood. eventually disappear.
294 Medical Parasitology in the Philippines

• Delayed reaction papule. This may c. Family Ceratopogonidae (Leptoconops,

be observed from a few hours up to 2 Culicoides, midges, “nik-nik”)
weeks after the bite; there is swelling These insects are small, about 1.5 to 5
accompanied by intense irritation. mm long. The antennae are long, consisting of
• Immediate reaction wheals. These about 15 segments. The wings are spotted and
appear within a few minutes of the covered with hairs. The mouthparts are short,
bite, but do not last long, usually less relatively inconspicuous, and are not projected
than an hour; these cause moderate forward (Plate 6.12). Males do not take blood
irritation. meals. Females stay around vegetation, cow
The reactions to mosquito bites are sheds, muddy debris, and shaded trees. The
associated with the trauma produced by the eggs are laid on the surface of mud, wet soil,
mechanical insertion of the proboscis by the cow dung, and other habitats that are moist or
mosquito. The initial cutaneous reaction is partially submerged in water. Midges usually
due to the sensitizing effect of the saliva. The swarm over the head, biting the face and neck,
saliva chemically consists of histamines and and exposed body parts. Lesions are usually in
5-hydroxytryptamine, or kinin. the form of multiple vesicles, which produce
intense itching.
b. Family Simulidae (Simulium or “black flies”)

These are humpback dipterans measuring

1.5 to 4.0 mm long. They are usually black in
color, but may sometimes be gray. They have
short legs and short antennae. The mouthparts
are short and relatively inconspicuous (Plate
6.11). Only the females bite, though their
mouthparts do not penetrate the host’s deeper
tissues. These dipterans usually stay near
vegetation. Its intermediate stages breed in fast
flowing streams.
Plate 6.12. Midge (Culicoides spp.)
The lesions produced are characterized (Courtesy of Dr. Lilian de las Llagas)
by localized swelling and inflammation,
accompanied by an intense irritation, which d. Family Psychodidae (Phlebotomus, sandfly,
lasts for several weeks. mothfly)

These flies are small, about 2 to 5 mm

long. The body and wings are entirely covered
with hairs, thereby giving them the appearance
of small moths. The wings are lanceolate in
shape and have simple wing venation. The
antennae have 12 to 16 segments. The legs are
long and slender. The mouthparts are short and
inconspicuous (Plate 6.13). Only the females
bite, feeding at night. They hide in dark corners
during the day. They usually attack the face and
the neck, and produce vesicles or wheals. Intense
Plate 6.11. Blackfly (Simulium sp.) itching, pain, heat, and swelling occur. A blue
(Courtesy of Dr. Lilian de las Llagas) scar often remains.
 Chapter 6: Arthropods and Mollusks of Medical Importance 295

Plate 6.13. Sandfly (Phlebotomus spp.) Plate 6.14. Horsefly (Tabanus spp.)
(Courtesy of Dr. Lilian de las Llagas) (Courtesy of Dr. Lilian de las Llagas)

Eggs require a moist environment with habitat, where the environment is moist. Most
high humidity, such as holes in the ground and species are aquatic or semi-aquatic.
leaf litters. Because of their mouthparts, these flies
inflict very painful bites, resulting in erythema
2. Suborder Brachycera (e.g., horseflies and
deerflies) and swelling. Their attacks are usually persistent,
producing multiple painful non-pruritic lesions
The antennae are shorter than the head on exposed areas.
and thorax combined, and is composed of
3. Suborder Cy clorrapha/Or thorapha
three segments. The third segment is enlarged
(e.g., houseflies, Stomoxys, “biting housefly,”
and bears a terminal bristle called the style. The and other biting flies)
mouthparts belong to the cutting-sponging
type. The antennae consist of three segments.
The third segment is enlarged and carries
a. Family Tabanidae (Tabanus and Chrysops)
a conspicuous bristle called the arista. The
These flies vary in size depending on the mouthparts are of the sponging and piercing
species. They can be smaller than a housefly, or types.
they can be very large, measuring 5 to 25 mm. This fly resembles the housefly (Musca)
Tabanus (horse fly) is uniformly black but has very closely, but differs from the housefly by
whitish markings on the thorax and abdomen. having a piercing-sucking type of mouthparts.
Its wings are clear (Plate 6.14). Chrysops (deer It has four brown-black longitudinal bands on
fly) is smaller than the horse fly and has a more its thorax, and its antennae are of the aristate
rounded head. The middle part of its wing is type. It breeds in moist, rotting, and fermenting
patterned with a brown coloration. Males of vegetable matter, such as grass, hay, or horse
these flies do not bite. Eggs are deposited on manure. Both males and females suck blood.
the underside of leaves, twigs, stems, stones, They are active at daytime and bite outdoors.
and rocks overhanging or adjacent to their larval They inflict very painful bites.
296 Medical Parasitology in the Philippines

B. Order Anoplura (sucking lice) further development. Severe infestations may

result in the hair becoming matted with eggs.
These are wingless permanent ectoparasites
Itching is usually the predominant symptom.
of mammals. They measure 1.5 to 3 mm in
The itching is attributed to the injection
length. The body is dorsoventrally flattened
of the saliva, and may also be a reaction to lice
and usually gray in color. Lice are strictly
feces. The intensity of itching varies from one
host-specific. Head lice and genital lice, for
person to another, and this is highly correlated
example, are seen only in humans. They do
with the degree of infestation.
not infest domestic household pets and other
Phthirus pubis (genital louse, pubic/crab
animals. Both species belong to the family
louse) has a crab-like body. It is nearly as broad
Pediculidae, having mouthparts adapted for
as it is long and measures about 1.5 to 2 mm.
piercing-sucking.
The middle and hind legs are stouter than the
Pediculus humanus capitis is also called the
first pair. Pubic lice infestation is more common
head louse. The male measures 2 to 3 mm and
in adults rather than in children (Plate 6.16).
the female 3 to 4 mm in length. Its head is
Transmission usually results from intimate
small compared to its body size. It is narrow and
contact. Ordinarily, the pubic louse confines its
pointed in front, and has antennae with four to
activities to pubic hairs, but it may also be found
five segments. Its legs are of the clinging type
in other parts of the body where hair is coarser,
and are of equal size. It is found on the scalp
such as axillary hair, eyebrows, or eyelashes.
(Plate 6.15).
Patients with pubic lice infestation
Head lice infestation is very common in
were found to be concomitantly infected
the Philippines. Children are most commonly
with sexually-transmitted infections (e.g.,
affected. This condition is very much associated
gonorrhea). Infestation with this louse is
with warm weather, as the lice require this for
commonly associated with complaints of
intense pruritus in the affected region due to
the presence of nits or eggs.
Other lice include Haematopinus (hog
louse), Trichodectes canis (dog biting louse),

Plate 6.15. Louse (Pediculus humanus capitis) Plate 6.16. Pubic louse (Phthirus pubis)
(Courtesy of Dr. Lilian de las Llagas) (Courtesy of Dr. Lilian de las Llagas)
 Chapter 6: Arthropods and Mollusks of Medical Importance 297

Linognathus (cattle louse), Menopon (chicken time. Any change in humidity, temperature, or
louse), and Columbicola (pigeon louse). These vibration stimulates the pupae to escape from
are lice of domestic animals, and they do not their cocoons and enable them to emerge as
attack or infest humans. adults. As fleas suck blood from their hosts, they
All lice have similar life histories. The adult inject saliva to prevent the host’s blood from
lays eggs, which are called nits. These appear as clotting. This secretion contains amino acids,
white or gray oval bodies which are glued to the peptides, ketones, low molecular weight sugars,
hair by the head, or by the gonopod, as seen polyhydric alcohols, phenols, aldehydes, and
in pubic lice. The young resemble the adults, phosphates, all of which are capable of inducing
except in size. They require at least 1 week to sensitivity in the host.
complete development. Bites appear as small punctures, which
represent areas probed by the fleas. Initially, the
C. Order Siphonaptera (fleas)
flea explores the exposed skin area completely,
These are wingless insects measuring less frequently stopping to probe the surface without
than 4 mm, usually l.4 to 2 mm in length. necessarily feeding at each probe site. Once a
The body is laterally compressed and covered suitable site is selected, the flea bites and remains
with spines which enable them to move freely. attached. It then moves along, biting and feeding
The antennae are short, three-segmented, in a grouped but irregular pattern, resulting in
club-shaped, and embedded in a deep groove. multiple lesions. Grouping, therefore, is one
The legs are adapted for jumping, allowing of the most distinct descriptions of the lesions.
them to jump as far as 28 cm vertically or 32 Appearing immediately around the probe
cm horizontally. On smooth surfaces, they site is a wheal with or without accompanying
progress by means of short jumps and running. erythema. Aside from the presence of multiple
Both sexes feed on blood. The mouthparts are zigzag lesions, the diagnosis of flea bites is also
adapted for piercing and sucking. Compound confirmed by previous exposure to animal hosts.
eyes are lacking. Some species, however, possess
D. Order Hemiptera (bed bugs)
degenerate eyes without distinct facets, while
others are completely blind. In some species, Cimex hemipterus is common in tropical
a conspicuous row of spines or a “comb” climates. Bed bugs inflict very irritating and
is present. This is useful in recognizing the itchy bites. On examination, multiple bite
different species of fleas. lesions are found with erythematous wheals
The most common species are Ctenocephalides of uniform size with red punctate centers that
canis (dog flea), C. felis (cat flea), Pulex irritans persist for many days. The skin condition caused
(human flea), and Xenopsylla cheopis (rat flea). by a Cimex bite is called cimicosis. Bed bugs are
Although Ctenocephalides preferably feed on generally nocturnal feeders (Plate 6.17).
dogs and cats, they can also bite humans when The bug uses its beak-like proboscis,
their preferred hosts are not around. with its mandibles and maxillae, to pierce or
Fleas remain on their hosts less constantly puncture the skin of the host. It feeds directly
than lice do. Female fleas, after blood feeding, from the capillaries. The combination of initial
lay their eggs on the fur of the hosts, in dust, skin piercing, and the subsequent probing for
on debris, in floor cracks, and under rugs and blood, results in swelling and irritation. It is
carpets. The larvae feed on organic debris. They reported that the amount of saliva injected
usually avoid light. Pupae emerge after 10 to by the bed bug is around 0.16 µL. This saliva
12 days and may remain inactive for some contains an anticoagulant.
298 Medical Parasitology in the Philippines

1. Mites

a. Chigger infestation

Chigger infestation is caused by the larval

stage of Leptotrombidium species. The larvae
feed on the host’s epidermal cells. Infestation
usually occurs when one walks through long
grass, or when one sits or lies on infested
ground. Chigger bites cause intense pruritus
and severe reactions may also occur.
The larval chigger is very small, about 0.15
to 0.3 mm long depending on the species. The
larva may increase its size six-fold after feeding.
It is usually reddish-orange, but may be pale
or yellow. There are three pairs of legs covered
with fine hairs. It does not burrow into the host
Plate 6.17. Bedbug (Cimex sp.)
(Courtesy of Dr. Lilian de las Llagas) skin; but merely attaches itself using its large,
segmented palps and blade-like chelicerae. It
E. Order Acarina (mites and ticks) secretes powerful digestive enzymes, which
liquefy epidermal cells, and the resultant fluid
The majority of mites and ticks (Table serves as its main diet.
6.3) are round or oval, dorsoventrally depressed Although the chigger larva drops off the
forms with the head, thorax, and abdomen host soon after feeding, the host response may
fused together, lacking visible segmentation. persist for weeks. Itching begins a few hours
The anterior portion is modified to form a after the chigger has attached itself to the
capitulum, made up of a central hypostome, and skin, which transforms the affected area into
paired chelicerae and palpi, used for attachment a wheal. In heavy infestations, a patient may
and obtaining food. find it almost impossible to sleep because of the
intense pruritus, since the heat of a warm bed
Table 6.3. Principal differences between mites
and ticks
may intensify the itching. Pruritus gradually
decreases and resolves after 5 to 14 days. The
Parameter Mites Ticks chigger usually attacks the legs, or attaches itself
Body With long hair With short hair, or to skin in areas where skin meets clothing, such
may be bare as the edges of a brassiere, the waistband of
Hypostome Hidden and Exposed with teeth underwear, and the tops of socks.
unarmed
Diagnosis of chigger infestation can usually
Size Usually small Large (macroscopic)
(microscopic) be made on the basis of a history of previous
Body texture Membranous in Leathery in
outdoor exposure, and typical skin lesions in
appearance appearance areas where clothing is snug.
Pedipalps Almost lacking in Prominent and
segmentation distinctly b. Scabies
segmented
Scabies (“galis-aso”) is caused by Sarcoptes
Chelicerae Reduced to Heavily chitinized,
blades and bearing teeth at scabiei. It is a contagious skin infection.
rods their distal ends Infestation with this mite is seen in all age
 Chapter 6: Arthropods and Mollusks of Medical Importance 299

groups, and is very common in crowded stumpy legs, and the abdomen is annulated.
dwellings. The usual transfer of the mite is by Other than Demodex, infestation may also
direct contact. The variety of S. scabiei that be caused by Dermanyssus (red poultry mite),
causes sarcoptic mange in dogs can also burrow Ornithonyssus (tropical rat mite), Pyemotes (grain
in human skin but stays only for a limited itch mite), and Acarus (cheese mite).
duration. The mite causes intense pruritus
• Dermanyssus. This mite is known
that is more severe at night and may persist for
to attack humans, but is actually a
some time.
common parasite of wild birds. It
The female mite is 0.3 to 0.45 mm
feeds on blood, causing irritation
in length. It is whitish, disc-shaped, and
and discomfort. Its common name
flattened ventrally. The mite is covered with
is derived from its ability to thrive in
membranous, small, peg-like protuberances, has
poultry houses. The adult is about 1
a few bristles, both dorsally and ventrally. The
mm long and its red color is due to
mite has a few lines across the body, giving it a
ingested blood. The mouthparts are
striated appearance.
modified for piercing and sucking.
The female mite favors places on the body
• Ornithonyssus. This mite attacks people
where the skin is wrinkled, such as wrists,
living in rat-infested buildings, like
elbows, feet, penis, scrotum, breasts, axillae,
dormitories, restaurants, warehouses,
and in between fingers. Using its short, stout,
and granaries. It is capable of inflicting
sharp pincer-like chelicerae, the mite digs and
a bite that is irritating and painful.
eats its way through the surface of the stratum
Ornithonyssus generally resembles D.
corneum. It buries itself, excavates, and creates
gallinae, and is also red after a blood
a tunnel then feeds on liquids oozing from
meal.
dermal cells. During the mite’s progress along
• Pyemotes. People handling infested
the tunnel, it lays about four to six eggs and
grain, cotton, and hay may develop
sometimes defecates while feeding.
dermatitis due to this mite. The adult
Definitive diagnosis is by demonstration
is about 0.2 to 0.3 mm, and is whitish
of the female mite. Physical examination of the
or yellowish. The female has a pair of
patient reveals mite burrows. In chronic cases,
club-shaped setae between its first and
the skin becomes eczematoid.
second pair of legs. The male is about
c. Demodex folliculorum and Demodex brevis 0.16 mm, has a broader body, and has
no club-shaped setae on its thorax.
Demodex folliculorum (on face) and
• Glycyphagus, Acarus, Tyrophagus.
Demodex brevis (on face and trunk) cause
These stored product mites cause
follicle mite infestation. These mites are found
dermatitis in humans often called
in the hair follicles and sebaceous secretions of
miller’s, grocer’s, copra, or worker’s
humans. They are sometimes present on the skin
rash, depending on the material
and usually cause no severe symptoms. These
being handled. These parasites can
mites, especially D. folliculorum, are associated
also precipitate an attack of bronchial
with “black heads.” On rare occasions, the mites
asthma. These mites are about 0.4 to
produce an erythematous follicular eruption in
0.5 mm long. They are whitish or pale
the beard area of men.
yellow in color and resemble Pyemotes
The adult mite is usually less than 0.5 mm
mites, though their chelicerae are large,
in length, and is worm-like and elongated in
and the setae on their bodies are longer
appearance. The thorax bears eight very short,
and more conspicuous.
300 Medical Parasitology in the Philippines

2. Ticks Inhalant Allergens

Two types of ticks bite humans: soft Decomposed and pulverized arthropods,
or Argasid, and hard or Ixodid ticks. Hard cast skin, scales, hairs, spines, cocoons, and webs
ticks, which are difficult to remove, are more permeate the air via upward air streams and
frequently encountered. Ticks are readily convection currents, and are thus considered
distinguished from insects by their strongly inhalant allergens of humans (Plate 6.18). Their
fused thorax and abdomen. The body is ovoidal relationship to inhalant-respiratory allergic
and is capable of great expansion, particularly in disease has been the subject of interest of many
females. There are six legs in the larval stage, and workers in the field of allergology.
eight in the nymphal and adult stages. Ticks are
bigger than mites and are usually more than 1
mm in length. The head bears the mouthparts,
which consist of two small, retractile mandibles
or chelicerae, a pair of short palpi, and a well-
developed hypostome armed with teeth.
Generally, ticks pass through the egg, larval,
nymphal, and adult stages over months or years.
Eggs are usually laid on the ground in batches
of 100 to 18,000. The larvae emerge and climb
up any available object in order to reach passing
hosts. Ticks of some species remain on the same
host until they reach maturity, but others find
two or more hosts for their blood meal. Females
take prolonged blood meals lasting for 8 to 10
days. Males, however, remain attached to the
host only for a few hours in order to mate with
females.
Once the tick comes in contact with a host, Plate 6.18. Butterfly scales
(Courtesy of Dr. Lilian de las Llagas)
the hypostome and chelicerae are inserted into
the skin. Using their recurved teeth, a firm
hold is maintained, reinforced by a cement-like Despite the close association between
secretion. The tick can detach quickly once it arthropods and respiratory allergy, there is
is fully engorged without the host noticing still no direct evidence available to justify this.
it. Forceful removal of the tick may result in Evidence has stemmed from positive skin tests
granuloma formation which may persist for days utilizing arthropod extracts, the inability to find
or even months after the bite. This granuloma other etiological factors to explain respiratory
may be due to either a reaction to mouthparts, symptoms, and the presence or abundance
or to injected salivary secretions. The granuloma of arthropods in the immediate environment
measures 0.5 to 2 cm. coinciding with the patients’ allergic symptoms.
Tick paralysis is an acute disorder of the The work of Agbayani et al. in 1989 showed
central nervous system, and is believed to be this relationship.
caused by a neurotoxin secreted by the salivary House dust mites (Dermatophagoides) have
gland of many species of ticks in the process of also been implicated as a source of allergens
prolonged feeding. by some investigators. A study on house dust
 Chapter 6: Arthropods and Mollusks of Medical Importance 301

mites (HDM) by de las Llagas and Abong spp., Cheyletus malaccensis, and Suidasia
(2002) on the association between mites and pontifica (Plates 6.19–6.22).
respiratory allergy showed the presence of six Wi n g e d i n s e c t s s u c h a s m a y f l i e s
species of HDM in dust samples collected from (Order Ephemeroptera), caddisflies (Order
houses of patients with a history of bronchial Trichoptera), moths and butterflies (Order
asthma and allergic rhinitis. These mites Lepidoptera), and aphids (Order Hemiptera),
are Dermatophagoides pteronyssinus, Blomia have been observed to be the most common
tropicalis, Glycyphagus spp., Austroglycyphagus arthropods inducing respiratory allergy.

Plate 6.19. Dust mite (Blomia tropicalis) Plate 6.20. Dust mite (Glycyphagus sp.)
(Courtesy of Dr. Lilian de las Llagas) (Courtesy of Dr. Lilian de las Llagas)

Plate 6.21. Dust mite (Dermatophagoides Plate 6.22. Dust mite (Cheyletus malaccensis)
pteronyssinus) (Courtesy of Dr. Lilian de las Llagas) (Courtesy of Dr. Lilian de las Llagas)

Ingestants pathogenic to humans. Diarrheal diseases have

long been associated with these arthropods.
The feces of cockroaches and the vomitus of
Various mites and their eggs, either living
non-biting flies are the best examples of harmful
or dead, have been found in various parts of the
ingestants of man. These ingestants are highly
human body, such as the alimentary canal and
contaminated with microorganisms, which are
urinary tract. The presence of mites has been
302 Medical Parasitology in the Philippines

found to be contributory to various conditions

including enteritis, nocturnal enuresis, and
hematuria. The evidence, however, is not direct
because in many cases, the mites are quite
harmless.
The most common mites present on food
include species in the genera Tyrophagus, Acarus,
and Glycyphagus.
Food and Water Pests

Food and water adulteration/contamination

due to insects and mites may be incurred in any
of six stages: storage, transport, preparation,
processing, packaging, and serving. The insects Plate 6.23. Maggots
and mites discussed in this chapter are classified (Courtesy of Dr. Lilian de las Llagas)
as pests because of the damage done on food and
water and the potential risk to humans upon this occurs accidentally, but for some species,
consumption (Table 6.4). parasitism is necessary. Obligatory myiasis is
the condition wherein larvae need a host to
Table 6.4 Arthropods as pests of stored products, complete their development. Facultative myiasis
food and water sources identified at the
Medical Entomology Laboratory, UP-CPH
occurs when free-living larvae become parasitic.
Clinically, myiasis may be classified
Food products/water according to the part of the body invaded.
Arthropods
sources/places infested Aural, nasal, ophthalmic, cutaneous, and
Chironomid larva or blood Water tanks, hospital intestinal myiases have been reported. In the
worm faucet
Philippines, myiasis is caused by the following
Moth caterpillar Chocolate candies
species of fly larvae.
Moth pupa Chocolate bars
Moth adult Chocolate rice crispies • Obligatory
(Plodia interpunctella) (Chrysomya, Boopunus, Stomoxys,
Beetle adult Hospital bed Lyperosia)
Beetle (grain) adult Raisins
Animals primarily affected include
Mites Pancake mix
Bakery products carabaos, cattle, and other domestic
Fly larvae Stuffed milkfish animals.
(Sarcophaga spp.)
Phorid fly Bread with sugar coating
• Facultative
Centipede adult Pancit
Phaenicia
(Scolopendra spp.) Lucilia
Cockroach adult Dimsum from a Chinese
(Blatella germanica) restaurant • Accidental
Sarcophaga
Pericoma
Myiasis
Identification of Myiasis-Producing Larvae
Myiasis is the infestation or invasion of
tissues or organs of humans and animals by The identification of fly larvae is important
dipterous larvae (Plate 6.23). Sometimes, for prevention and control. In forensic medicine,
 Chapter 6: Arthropods and Mollusks of Medical Importance 303

identification of the species and age of the References

larvae can help establish the time of death of a
Baltazar CR, Salazar NP. Philippine insects: an
victim. Identification is done by examining the
introduction. Quezon City: University of
morphology of the posterior spiracles and the
the Philippines Press; 1979.
cephalo-pharyngeal skeletons.
de las Llagas LA, Abong J. Identification and
Maggots, the larvae of muscoid diptera, are
characterization of local house dust mites:
legless, worm-like and more or less cylindrical.
potential for native allergen production for
They are usually tapered anteriorly and broad
experimental, diagnostic, and therapeutic
posteriorly. The spiracles are situated on the
use in the local setting. 2003. Located
posterior end (Table 6.5).
at: College of Public Health Library,
University of the Philippines Manila.
Table 6.5. Identifying characteristics of some
myiasis-producing larva Borror DJ, Delong DM, Triplehorn CA. An
introduction to the study of insects. 4th ed.
Larva Characteristics USA: Holt, Rinehart and Winston; 1976.
Musca Posterior spiracles: D-shaped, Cagampang-Ramos A, Darsie RF Jr. Illustrated
with spiral slits and a keys to the Anopheles mosquito of the
complete peritreme
Philippine Islands. San Francisco: USAF
Chrysomya Body: with bands of spines
Fifth Epidemiological Flight, PACAF,
Stomoxys Posterior spiracles: with a black
peritreme and a spiral slit technical report 70–1; 1970.
Lucilia and Phaenicia Posterior spiracles: lower Jueco N, de Leon W. A case of aural myiasis.
spiracular slits oriented Acta Med Philipp. 1984;20(2):18–20.
upward and not horizontal
Service MW. A guide to medical entomology.
Sarcophaga Posterior spiracles: lie in a
deep slit, slits not pointing
1st ed. Hongkong: The MacMillan Press
towards the opening of the Ltd.; 1980.
peritreme
Anterior spiracles: with 12
Taboada O. Manual of medical entomology.
processes, accessory oral USA: US Government Printing Office;
hook absent
1968.
304 Medical Parasitology in the Philippines

Arthropods as Vectors of Disease

Lillian de las Llagas

Arthropods as Transmitters of Pathogenic their bodies. Some vectors (e.g., fleas, beetles,
Agents crabs, and copepods) serve as intermediate hosts
to some parasites.
A rthropods which are capable of acquiring
and transmitting pathogens that cause
diseases are called vectors. There are two types
Most of the arthropods which are classified
as vectors of diseases belong to Class Insecta,
subclass Pterygota (winged insects such as
of vectors: biological vectors and mechanical
mosquitoes, flies, and cockroaches) and Order
or passive vectors. Biological vectors, (e.g.,
Acarina (mites and ticks).
mosquitoes and biting flies), acquire pathogenic
Several arthropod-associated diseases in
agents in the act of blood-feeding. These
the Philippines are summarized in Table 6.6.
agents undergo multiplication, propagation,
The diseases listed have varying degrees of
and development inside the arthropod’s body.
importance. Based on morbidity and mortality,
After some time, the pathogens assume their
the most important diseases are the mosquito-
infective form and are then transmitted from
borne diseases. Others do not rank high among
one host to another. Mechanical vectors, on
national health care priorities, but they have
the other hand, transmit pathogens by way of
significant public health implications. Diseases
their oral secretions (vomitus of flies) and the
associated with cockroaches and non-biting flies
contaminated external surfaces of their body
(e.g., diarrhea and amebiasis) are important,
(feet, wings, etc.). Mechanical vectors serve
although evidence linking diseases to the
as mere contaminators; the pathogens do not
filthy behavior of these arthropods is purely
undergo multiplication or development inside
circumstantial.

Table 6.6. List of arthropod-associated diseases and their corresponding agents and vectors

Disease Agent Vector

Malaria Plasmodium Mosquito
Filariasis Wuchereria and Brugia Mosquito
Dengue/Dengue Hemorrhagic Fever Dengue virus Mosquito
Japanese Encephalitis JE virus Mosquito
Scrub typhus Rickettsia Chigger Mite
Babesiosis Babesia Tick
Paragonimiasis Paragonimus Crab
Diphyllobothriasis Diphyllobothrium Copepod
Dracunculiasis Dracunculus Copepod
Hymenolepiasis Hymenolepis Flea
Dipylidiasis Dipylidium Flea
Raillietiniasis Railletina Flour or Rice Beetle
Amebiasis Entamoeba Flies and Cockroaches
Diarrheal Disease Enteric pathogens Flies and Cockroaches
Miscellaneous Intestinal Parasitoses Ascaris, Trichuris Flies and Cockroaches
 Chapter 6: Arthropods and Mollusks of Medical Importance 305

The succeeding topics describe the most organ called the siphon, which extends from
important vectors of tropical diseases in the the eighth abdominal segment. The culicine
Philippines: mosquitoes, flies, and cockroaches. larva therefore hangs down from the surface of
the water by the tip of the siphon in order to
Mosquitoes
breathe. The Culex larva has a long and slender
There are two important divisions or siphon, with many ventral hair tufts. Aedes has
tribes of mosquito vectors. The anopheline a short and stout siphon with only one pair of
mosquitoes, consisting of Genus Anopheles, hair tufts. Mansonia breathes through a siphon
which are vectors of human malaria and human modified for piercing and adhering to stems of
filariasis; and the culicine mosquitoes, vectors aquatic plants.
of dengue, Japanese encephalitis, and human C. Pupa
filariasis, which includes the genera Aedes,
Culex, and Mansonia. Mosquitoes undergo a This is the non-feeding stage, found on the
complete type of metamorphosis. Fertilized surface of the water sources. The pupa is mobile
eggs go through four larval stages, develop into and is able to dive rapidly when disturbed. It
the comma-shaped pupae, and then emerge as breathes through a pair of respiratory trumpets.
adults. The immature stages require an aquatic Culicine pupae have longer trumpets than
environment, while the adult, an aerial and anophelines.
terrestrial one. D. Adult
A. Egg
Generally, the wings of anophelines have
Anophelines lay their boat-shaped eggs dark and pale areas, whereas culicines have
individually over the surface of water, each unpatterned wings. Another visual distinction is
having lateral air floats to keep it buoyant. that, at rest, the body of an anopheline mosquito
Culex lay their eggs in rafts. Each Culex egg is forms an angle nearly vertical with the surface
cigar-shaped, and is provided with a corolla at (i.e., the head, thorax, and abdomen are in a
the end. Mansonia lay their eggs under leaves of straight line). The culicine mosquito, on the
aquatic plants. Aedes eggs are laid individually, other hand, lies almost parallel to the surface,
often in artificial containers, and dry hollows, sometimes appearing as “hump-backed.”
which become flooded after the rain. These The abdominal tip is pointed in the
“dry-laid” eggs are able to retain their viability female Aedes, and blunt in Culex. Mansonia has
for long periods without water. speckled legs with asymmetrical brown, yellow,
and gold scales.
B. Larva
Palpi of female Anopheles are as long as the
Eggs of mosquitoes generally hatch after 2 proboscis. Palpi of its males are club-shaped,
to 3 days of contact with water. They are about each with rounded scutellum. Palpi of female
1 to 1.5 mm long when newly hatched and grow culicines are not as long as the proboscis (usually
to a full length of about 8 mm. The larva casts a quarter of the proboscis); male culicine palpi
its skin four times. The stages between molts are are not clubbed, and the scutellum is trilobed.
known as instars. The mosquito larva breathes E. Mosquito Bionomics
through two openings called spiracles. The
spiracles of the anopheline larvae are situated Bionomics deals with the relationship
on the eighth abdominal segment so that in between a species and its environment. An
order to breathe, the larva rests in a horizontal understanding of mosquito bionomics is
position at the surface of the water. In culicines, important in the epidemiology of mosquito
the spiracles are situated at the end of a tubular borne diseases, and in planning methods of
306 Medical Parasitology in the Philippines

mosquito control. The environment consists F. Seasonal Prevalence

of the climate, the water habitat of immature
In tropical countries, such as the
stages, and the hosts for the adults. The
Philippines, where there are no extreme
environment of immature and adult mosquitoes
fluctuations in temperature and humidity,
is interdependent, because the female mosquito
rainfall is the most important factor affecting
must have access to water for egg-laying.
the mosquito population. The rise and fall of the
The adult environment is largely aerial and
mosquito density, called seasonal fluctuation,
terrestrial, the former for mating and dispersal,
is dependent on the availability of suitable
and the latter for feeding and resting.
aquatic environments, which can support the
The Environment and Habits of the Adult multiplication of the mosquito.
Mosquito The Philippines has four types of climate
A. Mating based on monthly rainfall. Type I areas have two
pronounced seasons, dry and wet; Type II areas
Mating usually occurs within 24 to 48 have no dry season, but with a very pronounced
hours after emergence. In some species, the rainfall; Type III areas have seasons not very
males form a swarm, usually at dawn or in the pronounced; and Type IV, where rainfall is more
evening. Females entering the swarm are seized, or less evenly distributed throughout the year.
and the resulting pairs drop out of the swarm. With these types of climate, it is possible
Insemination then follows. to expect the following:
B. Dispersal • In Type I areas, it is possible to
The male is a much weaker flyer than the have two density peaks: one during
female. Most mosquitoes fly within a range of 1 intermittent rains and the other before
to 2 km. Strong winds carry mosquitoes along the onset of heavy rains.
greater distances. • In Type II areas, more breeding
grounds are expected
C. Biting Habits • In Types III and IV areas, there will
Host seeking and feeding generally take be no peak months; thus, mosquito
place in a warm, humid environment. Biting populations are maintained at certain
hours vary from one species to another. Culex, levels.
Mansonia, and Anopheles prefer to bite at night G. Extrinsic Incubation Period and Longevity
while Aedes during daytime. Mosquitoes which
feed while inside human dwellings are described The climate in which the mosquito lives
as endophagic, while those that feed outdoors dictates its capability for disease transmission.
are called exophagic. The climate influences the rate of development
of the parasite within the vector, and the
D. Resting Habits longevity of the mosquito.
After feeding, adult mosquitoes may rest The period between the mosquito’s
inside dwellings, referred to as endophily or may infected blood meal and its transmission of
rest outdoors, referred to as exophily. the infective agent in a subsequent feeding is
called the extrinsic incubation period. It varies
E. Host Preference in length in response to the temperature of the
Mosquitoes that feed on humans are called host mosquito’s environment. For example,
anthrophilic, whereas those that feed on animals the development of the malaria parasite,
are zoophilic. Plasmodium is retarded at 19°C down to 15°C
 Chapter 6: Arthropods and Mollusks of Medical Importance 307

and below, but completed at 20 to 30°C. Also, outside human dwellings. This may indicate
the growth of the filarial parasite Wuchereria that An. flavirostris exhibits certain degrees of
in Culex quinquefasciatus is inhibited at mean exophily and exophagy. These observations
temperatures below 24°C and above 34°C. deserve serious attention, as the current indoor
Temperature and humidity affect the residual spraying of insecticide may no longer
survival of mosquitoes. At extremely high or low be effective.
humidities, mosquitoes are unable to regulate Deviations in the characteristics of this
their water loss. They thrive best at 70 to 80% mosquito have been observed, and this may
relative humidity and at a temperature of 20 disqualify the claim that Anopheles flavirostris
to 30°C. is made up of one or two species.
Major Mosquito-Borne Diseases 2. Anopheles litoralis

A. Malaria This small- to medium-sized mosquito

is a secondary vector (supplementary role in
The vectors of malaria in the Philippines
transmission but would be unable to maintain
include: Anopheles flavirostris, the primary
an epidemic in the absence of primary vector) of
vector of malaria; Anopheles litoralis and
malaria. It has palps with three pale bands: the
Anopheles balabacensis. Anopheles flavirostris is
pale band at the tip is broad, the next is narrow,
found in the entire national territory, except
and the third very narrow. Its legs are speckled,
in areas with elevations of more than 4,000 ft.
the hind tarsi possessing apical distinct narrow
Anopheles litoralis has been described in Basilan,
pale bands. They prefer to breed in water with
various Luzon provinces, Southern Samar, Sulu,
a salinity of 2.5 to 3.0%.
Surigao, and Zamboanga. Anopheles balabacensis
has been reported only in Palawan. 3. Anopheles balbacensis

Morphological Characteristics, Breeding This is also a secondary vector of malaria.

Places, and Habits of Vectors of Malaria It is a small- to medium-sized mosquito having
1. Anopheles flavirostris palps with narrow pale bands. It has a dark
proboscis and wings with multiple dark spots.
This is the most important vector of It also has speckled legs, with wide bands on the
malaria in the Philippines. It is a small- to tibiotarsal joint of the hind legs. This mosquito
medium-sized mosquito, measuring 2 to 6 mm breeds in clear ponds and pools in deep forests
in length. It has a proboscis with a pale golden and jungles.
patch that is usually confined to its apical half.
The basal third of its costal vein is usually dark B. Filariasis
or has a single pale spot. The vectors of Bancroftian filariasis in
An. flavirostris usually breeds in slow the Philippines include Aedes poecilus, which
flowing, clear, partially shaded streams with breeds in abaca-raising areas, and Anopheles
vegetation. It also breeds in foothills and in flavirostris, which breeds in clear mountain
wells. During the rainy season, it is possible to streams. The vectors of Malayan filariasis in
collect the larvae from rice fields and trapped the Philippines include Mansonia bonneae and
waters. Mansonia uniformis, which breed in swampy
This mosquito is widespread in and forested areas.
distribution. It has been reported to be Aedes poecilus has been reported in the Bicol
endophagic, endophilic, and anthrophilic. region, Masbate, areas of Mindanao, Mindoro,
Recent observations by field entomologists Quezon and Sulu. Anopheles flavirostris has been
showed that female mosquitoes prefer to rest shown to transmit the parasite in Mt. Province
308 Medical Parasitology in the Philippines

(Bontoc), Palawan and Sulu. Mansonia has to golden in color. Its legs have many pale
been found in Agusan del Sur. Eastern Samar, markings, and its wings have white and dark
Palawan, and Sulu. broad scales, many of which are asymmetrical.
Morphological Characteristics, Breeding C. Dengue/Dengue Hemorrhagic Fever
Places, and Habits of Vectors at Filariasis
The vectors of dengue in the Philippines
1. Aedes poecilus include Aedes aegypti, which is associated with
This mosquito is associated with urban dengue, and Aedes albopictus, which
Bancroftian filariasis. It breeds in the axils is associated with rural dengue. There is a
of plants like abaca (Musa textiles), banana widespread distribution of these vectors in the
(Musa sapientum), pandanus, gabi (Colocasia Philippines.
esculentum), and biga (Alocasia macrorrhiza). Morphological Characteristics, Breeding
The adult Aedes poecilus has scutellar scales Places, and Habits of Vectors of Dengue
that are mostly broad and white. The dark scales
1. Aedes aegypti
are found on the mid-lobe and form a distinct
dark central patch. A variable number of white This is primarily known as the “tiger
scales are also present at the base of the first four mosquito.” It is black in color, and small to
tarsal segments. medium in size. It has characteristic lyre-shaped,
This mosquito is a nocturnal feeder. silvery markings on its mesonotum. The fore-
However, it is possible to find it seeking a blood and mid-pairs of legs have white narrow bands
meal during the day. It is highly anthrophilic but at the base of the tarsi. The hind pair of legs has
it may feed on animals like birds, bovids, and five broad white bands, hence the name “tiger
dogs. The highest density of these mosquitoes mosquito” (Plate 6.24).
is observed from 10 p.m. to 12 a.m., which This mosquito breeds in clear water
coincides with W. bancrofti periodicity. The collecting in indoor and outdoor containers
density of these mosquitoes is also related such as old tires, vases, jars, and bottles.
to rainfall patterns in endemic areas. This
mosquito is endophilic and partially exophilic.
2. Mansonia

A vector of the Malayan type of filariasis,

Ma. bonneoe, is a forest swamp mosquito. It
prefers fresh water swamps with an extensive
growth of giant pandanus. Ma. uniformis also
breeds in swamps containing other aquatic
plants.
These mosquitoes are exophagic and
exophilic. The peak of biting is observed at 1:00
a.m. to 2:00 a.m.
The population density of Aedes mosquitoes
and Mansonia is related to rainfall patterns.
3. Adult Mansonia

It is a medium-sized, robust-built mosquito, Plate 6.24. Aedes aegypti mosquito

usually light to dark brown, or light yellow (Courtesy of Dr. Lilian de las Llagas)
 Chapter 6: Arthropods and Mollusks of Medical Importance 309

2. Aedes albopictus human food. Anatomically, these flies are well

adapted to carry and disseminate pathogenic
The most important diagnostic
agents because of the following structures:
characteristic of this mosquito is the presence
of a single, longitudinal, silvery stripe on 1. Sponging mouthparts. The expanded
the mesonotum. This mosquito breeds in labellum has hairs that are capable of
clear water collecting in indoor and outdoor sweeping or picking up the agents.
containers such as bamboo stumps, empty 2. Manner of ingesting food. A drop of
coconut shells, some artificial containers, and saliva is regurgitated in the process and
tree holes. It is not unusual, therefore, to see this contaminates the food.
both Aedes species sharing a common habitat. 3. Hairy body and appendages.
D. Japanese Encephalitis (JE)
4. Foot pads. These are also contributory
to their pathogen-carrying potential
The proven vector of Japanese encephalitis because of their sticky secretion.
in the Philippines is Culex tritaeniorynchus.
Potential vectors include Culex vishnui, Culex Pathogenic agents acquired and carried
gelidus, and Culex fuscocephalus. The vectors are by these flies include Ascaris, Trichuris
widely distributed in ricefields. Most cases of JE and hookworm ova. The extent of disease
are from Luzon, particularly from Nueva Ecija. transmission by adult flies under natural
conditions is difficult to determine. The larvae
Morphological Characteristics, Breeding Places of flies may also affect humans. These larvae
and Habits of Vectors of Japanese Encephalitis or maggots invade living tissues, producing a
1. Culex tritaeniorynchus condition called myiasis.
This is a small mosquito. The mesonotum A. Musca domestica (The common housefly)
is uniformly covered with dense, very small, This fly is dark gray in color and measures
brown to dark brown scales, which are curved about 6 to 9 mm in length. It has four
and narrow. Its proboscis has a pale band. This conspicuous longitudinal black bands or stripes
mosquito is usually associated with rice fields. on its thorax. The arista has dorsal and ventral
Activity is greatest from 6:00 p.m. to 7:00 hairs. The wing venation is characterized by
p.m. The mosquito feeds on man and animals, Vein 4 (V4) bending sharply at the end of Vein
specifically pigs. Pigs serve as amplifying hosts. 3 (V3). The two veins are therefore very close
Flies at the edge of the wing.
The eggs of the common housefly are laid
There are different species of non- in masses of about 75 to 150 eggs. A single
bloodsucking flies that are commonly female is able to lay as many as 21 batches
encountered in our environment. These flies within a month after emergence. Hatching
that coexist with humans over an extended takes place in about 20 to 24 hours under warm
period of time are described as synantrophic conditions, and the resulting legless, headless,
species. The most common representative is the and eyeless larva, or the maggot, undergoes three
common housefly (Musca domestica). stages of development. The maggot completes
Synantrophic flies are associated with its development in about 5 to 9 days then it
gastrointestinal diseases such as amebiasis, migrates to drier habitats and changes into a
salmonellosis, and shigellosis. This association pupa. The pupal state requires 4 to 7 days before
stems from their filthy habits; they feed on an adult emerges, making a total of about 10
human and animal excreta, then freely feed on to 17 days of development from egg to adult.
310 Medical Parasitology in the Philippines

Other species of synantrophic flies include: Cockroaches

Sarcophaga (flesh fly), Calliphora (blue-bottle
Cockroaches, like non-blood sucking flies,
fly), Lucilia (green-bottle fly), Muscina (non-
are also carriers of some pathogenic organisms.
biting stable fly), and Fannia (latrine fly).
The best example of their filthy habits is feeding
B. Sarcophaga on human feces and then on human food.
At least 16 species of cockroaches are
The adult fly measures 11 to 15 mm long
considered carriers of pathogenic agents. The
and is gray in color. It has three prominent black
three most common are Periplaneta Americana,
longitudinal stripes on the dorsum of its thorax.
Blatella germanica, and Blatta orientalis.
The abdomen is distinctly marked with squarish
Cockroaches are nocturnally active, but they
dark patches on a gray background, giving it a
may be seen crawling at daytime. Cockroaches
“chess-board” appearance. Adults do not lay
are much bigger than flies and thus enabling
eggs. Larval development is about 3 to 4 days,
them to carry more pathogens. Transmission of
while stage lasts about 7 to l4 days.
pathogens is facilitated by their hairy chewing
C. Calliphora mouthparts, which enable them to pick up
pathogens easily, and their habit of dropping
The face or genae of the adult is covered
their feces while walking or feeding. A study
with yellow hairs. The fly is bluish in color, and
conducted in the University of the Philippines
its thoracic hairs are well-developed. The life
Manila-College of Public Health in 1981
cycle of this fly requires 16 to 35 days, usually
recovered the following parasites and pathogens
22 days.
from Periplaneta americana: Ascaris, Trichuris,
D. Lucilia and parasites under Family Thelastomatidae and
Superfamilies Spiruroidea and Tylenchoidea.
This fly is greenish in color and has white
Other pathogens include Proteus, Escherichia,
genae. Its thoracic bristles are well developed,
Salmonella, and Citrobacter.
and there are two pairs of acrostichal bristles on
The extent of disease transmission by
its mesothorax. The life cycle of this fly is similar
cockroaches under natural conditions is not
to that of Calliphora. A very similar species is
clearly known.
Phaenicia (bronze-bottle fly).
A. Periplaneta americana (American
E. Muscina
cockroach)
This fly is slightly larger and more robust This cockroach is chestnut brown to dark
than the housefly. It is dark gray to almost black reddish-brown in color. It is the largest species
in color. It has four longitudinal black bands on among the three most commonly encountered
the thorax, and its arista bears setae. Vein 4 (V4) domestic cockroaches. It measures up to 40
is not much angled, and is clearly separated from mm in length, and both male and female adults
Vein 3 (V3) at the wing margin. have fully developed wings. The female, in her
F. Fannia lifetime, lays about 50 egg capsules or ootheca,
each containing about 15 eggs. The length of
This fly resembles Musca domestica very the life cycle is from 6 months to a year (Plate
closely but it is smaller and more slender. The 6.25).
arista is bare; V3 and V4 are broadly open.
 Chapter 6: Arthropods and Mollusks of Medical Importance 311

Plate 6.25. American cockroach (Periplaneta Plate 6.27. Oriental cockroach (Blatta orientalis)
americana) (Courtesy of Dr. Lilian de las Llagas) (Courtesy of Dr. Lilian de las Llagas)

B. Blatella germanica (German cockroach) The Oriental cockroach measures 22 to 27

mm long. It is dark brown to black in color, and
The German cockroach measures 10 to
both sexes show wings that are very short. The
15 mm in length. It is pale yellowish-brown in
length of its life cycle is l2 months (Plate 6.27).
color. It has two prominent longitudinal dark
bands on its pronotum. The female carries the References
ootheca, which protrudes from the tip of the
Borror DJ, Delong DM, Triplehorn CA. An
abdomen, until hatching time. Its life cycle takes
introduction to the study of insects. 4th ed.
from 2 to 3 months (Plate 6.26).
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1968.

Plate 6.26. German cockroach (Blatella

germanica) (Courtesy of Dr. Lilian de las Llagas)