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Preface

The discipline of medical entomology encompasses insects and other arthropods that may negatively affect human health as well as the disease agents they transmit (vectorborne diseases). These vector-borne diseases are by no means abated. Maladies such as malaria and dengue affect almost a half billion people annually, and vaccines for these diseases are still not available. The advent of West Nile virus in the United States focused new light on the threat of introduced arthropod-borne disease agents in developed countries. Other threats such as Chikungunya and Rift Valley fever lurk on the horizon and could theoretically be introduced into this and other countries. Arthropod adaptability combined with ecological and environmental change and frequent air travel ensure that vector-borne diseases will continue to be a problem for humankind.

For most people living in the industrialized nations, the threat from insects, spiders, mites, and scorpions lies primarily with stings and bites of various species and the reactions, both allergic and nonallergic, to them. For example, due to the ubiquity of stinging wasps, ants, and bees, almost every person is occasionally stung. Allergic reactions resulting from these stings can be severe, resulting in death.

This book was written to provide physicians, other healthcare providers, and public health officials with a reference of these insects, mites, scorpions, and spiders of public health importance as well as various ancillary topics related to these organisms. Voluminous works could be developed on many of these topics; however, a deliberate effort has been made to keep extraneous information to a minimum. Also, as in all areas of science, entomology includes controversies over certain points and "facts." In many cases, these facts are constantly changing and being revised. Accordingly, I have tried to limit the references in this book and to provide views that represent a general consensus of the current status of each subject.

The primary focus of this arrangement is to provide easy, almost instant access to essential information concerning these topics. It is not the intent of this reference to make entomologists out of the readership. Specialists should be consulted whenever possible for definitive identification of an arthropod. Extensive technical jargon has been avoided as much as possible in the "General Description" sections, and a glossary is included to aid the reader in defining and locating descriptive terms and characters.

The volume begins with several chapters on the pathologic conditions caused by arthropods, and the principles of treating those conditions. These are provided because a physician may first have to identify the nature of an arthropod-caused problem (sting, bite, blistering, etc.). Chapter 1, Principles of Treatment for Arthropod Bites, Stings, and Other Exposure, includes the rationale behind the various treatment regimes. This should be helpful because, although specific recommendations may change through time, the underlying principles of controlling the immune response will not. When arthropods are mentioned in Part I, there is a parenthetical reference indicating where in Part III the reader can go for more detailed information. Part II consists of a chapter on identification principles of arthropods and a chapter on some common signs and symptoms of vector-borne disease.

The third major part of the book is an alphabetical arrangement of the arthropods of medical importance with clearly marked subheadings for easy information access. To find a topic or insect section, the reader should look for that name or topic alphabetically. Keep in mind that all flies are grouped together, as are all lice, all mites, etc. A person wishing to find the topic "screwworm fly" would consult the flies chapters. Also, it is important to remember that common names vary with locality. A "blue-tailed darner" may mean one thing to the author and something totally different to someone else. Part IV of the book contains discussion of the various personal protection measures that may be employed against insects and other arthropods, including repellents and bed nets. The index includes the various pathologic conditions and as many of the common names as possible to aid the reader in finding a particular topic or insect. Also, it is important to remember that, if a patient brings in to the clinic an insect, mite, or spider associated with a particular health problem, it is prudent not only to deal with the problem at hand (with the aid of this reference) but also to submit the specimen to a university or health department entomologist for definitive identification. This might be important for later follow-up, consultation, or legal matters.

The sixth edition of Physician's Guide to Arthropods of Medical Importance marks 20 years of this book being continuously in print, a testament to its usefulness. In this edition, the chapters have been updated with much of the latest information and current references. The mosquito chapter was revised with the help of Dr. Bruce Harrison at the North Carolina Department of Environment and Natural Resources, and the tick chapter by Dr. Andrea Varela-Stokes, a veterinary parasitologist at Mississippi State University. Finally, many of the older black-and-white photographs have been replaced with new, improved, or color ones. The CD-ROM, first included in the fifth edition, has been updated and revised. The CD-ROM contains helpful identification aids, additional reading materials, videos, useful links, and, perhaps most importantly, more photographs. I am very excited about this 20-year edition and wish to extend appreciation to my colleagues for their interest in this book through the years.

Finally, every effort has been made to ensure that the treatment recommendations herein are current and widely recognized as appropriate; however, it must be emphasized that treatment recommendations may change over time and should not be construed to be the sole specific treatment guidelines for any one case. Physicians should consult appropriate medical literature (Conn's Current Therapy, for example) and/or drug package inserts for the most up-to-date treatment recommendations.

Author: Goddard, Jerome