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Insect reactions related to sports.

Only the rare practicing physician does not see at least a few patients during the warm summer months who have come off second best in an encounter with a member of Hymenoptera or one or the other of the various species of the phylum Arthropoda. Next to children and certain occupational groups such as farmers, it is probable that the outdoor sports enthusiast is the most frequent victim of insect stings and bites. Often the victim is not sure just what attacked him, and the physician may have to make an educated guess based on the appearance and grouping of the wounds and on the nature of the patient's symptoms. Usually, secondary infection is the most frequent possibility after these attacks. However, the hypersensitive patient who suffers immediate or delayed allergic reaction poses the greater, if rarer problem.

Adult

Domiciliary biting frequency and blood ingestion of the Chagas's disease vector Rhodnius prolixus Ståhl (Hemiptera: Reduviidae), in Venezuela.

Demolition of a rural house in the State of Cojedes, Venezuela, provided a collection of 7.934 Rhodnius prolixus of which a random sample of 1,415 was weighed within 48 hours. The field weights, coupled with laboratory information of weight loss (in %) with time, average blood ingestion and meal size sufficient to promote moulting, were used to estimate biting rate under domiciliary conditions. The results show that in this particularly highly infested house, the R. prolixus population bites, on the average, at a rate of 58 times/person/day, draining blood at a rate of about 100 cm3/person/month; this meant a total of 1.2 litres/month from the 11 people inhabiting the house. It was found that the more advanced R. prolixus is in its development, the more aggressive it is in securing its meal: 15, 25, 30, 59 and 77% of fed insects of instar 1 through 5, respectively, were able to achieve moulting with only one meal. Applying the estimated biting rate to R. prolixus collections of other 13 demolished houses, with more typical insect population densities, an average biting rate of 9 bites/person/day was obtained; this value was, however, extremely variable, ranging from 0.2 bites/person/day (once every five days) to 33 bites/person/day.

Animals

Correlation between mosquito repellent protection time and insensible water loss from the skin.

Insensible water loss and mosquito repellent protection time have been found to be relatively characteristic of any given individual. In a population having a biologic distribution of repellent protection period against mosquitoes, an inverse linear correlation was observed between repellent duration and insensible water loss. Doubling of insensible water loss was associated with a 20% decrease in repellent duration. Repellent penetration or evaporation but not attractiveness to mosquitoes are explanations for the observed relationship.

Adult

An allergist looks at urticaria.

Some etiologic possibilities which must be considered are foods, drugs, infection, inhalant sensitivity, psychic factors, physical agents, underlying connective tissue disease or neoplasm, insect bite or stings and genetic abnormalities. A painstaking history and a complete physical examination are, of course, mandatory. These are followed by appropriate studies for whatever etiologic factors are suggested by the history and physical examination. Certain routine or more sophisticated studies might be indicated including a complete blood count, urinalysis, stools for ova and parasites, antinuclear antibody titer, complete complement, sedimentation rate, sinus, chest and dental X rays and any other specified test depending on where the clues lead. O'Loughlin described a practical approach in the use of laboratory studies for the diagnosis of chronic urticaria. Skin tests can be helpful especially for inhalants, but food tests are usually not reliable in the diagnosis of chronic urticaria. The acute urticaria reaction to a food is clinically obvious and this type of patient does not usually seek medical attention or need extensive investigation. Treatment includes a few basic medications. Hydroxyzine (Atarax, Vistaril), which combines tranquilizer and antihistamine action, is frequently effective. Cyproheptadine HCL (Periactin) both a serotonin and histamine antagonist with anticholinergic effect, is also helpful--especially in combination with hydroxyzine. Antihistamines, ephedrine, epinephrine, aminophyllin and occasionally corticosteroids are helpful. Immunotherapy with inhalants is occasionally indicated. Eliminating possible offending foods, dyes or drugs has been previously discussed. Anti-candidal therapy and low yeast diet is effective when indicated. The final aspect of the investigation and treatment process might best be described as "patient support"--patience on the part of the physician. It should be realized that in 75% of the cases of chronic urticaria, no convincing etiology is found. It should also be realized that urticaria all too frequently "settles down" due as much to the natural course as to the careful ministrations of the physician.

Dermatitis, Atopic

Dynamics and intensity of Wuchereria bancrofti transmission in the savannah and forest regions of Liberia.

In four villages in the savannah and in the rain forest of Liberia, regular assessment of the biting activity and infection rates of anthropophilic mosquitoes have been carried out through full annual cycles. The microfilaremia rates in the localities in the savannah were 18.3% and 20.0% and in those of the forest 10.3% and 12.5%. The all-night catches were performed inside ordinary inhibited houses at monthly or fortnightly intervals. Presence of infective larvae of Wuchereria bancrofti proved Anopheles gambiae, A. funestus and A. nili to be the local vectors. Biting densities were high in the savannah, and low in the forest. From the mosquito catches and the results of their dissections for filarial larvae it could be estimated, that during the observation year a person in the savannah villages would be bitten annually by 18,165 and 36,450 vector mosquitoes respectively, and would receive 236 and 536 infective bites with 570 and 1211 infective larvae. In the two forest villages the number of vector bites per person per year was calculated to be in the order of 6120 and 1102 of which 64 and 8 would be infective bites transmitting 101 and 8 larvae. The findings of considerable differences in transmission intensities between villages of the same bioclimatic zone and of comparable microfilaremia rates indicates instable epidemiological conditions in at least some of the localities investigated.

Animals