Methods of Disease Transmission. There are many insects that are the primary or intermediate hosts or carriers of human diseases. Pathogens that are capable of being transmitted by insects include protozoa, bacteria, viruses, and such helminths as tapeworms, flukes, and roundworms. There are two methods of transmission of a pathogen by insects: mechanical and biological.

The frequency of the diseases mentioned is continuously changing. Some of these have become rare as a result of progress in hygiene and vaccinations measures (yellow fever, Japanese encephalitis, typhus, plague). Others, after having virtually disappeared, are re-emerging (trypanosomiasis). Finally, others are spreading, notably due to possible changes in climate and the changes that this brings about in the ecology of the vectors (dengue fever, chikungunya virus, Lyme disease, etc.). We will briefly present the most common diseases.

Mosquito-borne diseases or mosquito-borne illnesses are diseases caused by bacteria, viruses or parasites transmitted by mosquitoes. They can transmit disease without being affected themselves. Nearly 700 million people get a mosquito-borne illness each year resulting in over one million deaths.

Diseases transmitted by mosquitoes include: malaria, dengue, West Nile virus, chikungunya, yellow fever,^] filariasis, tularemia, dirofilariasis, Japanese encephalitis, Saint Louis encephalitis, Western equine encephalitis, Eastern equine encephalitis, Venezuelan equine encephalitis, Ross River fever, Barmah Forest fever, La Crosse encephalitis, and Zika fever, as well as newly detected Keystone virus and Rift Valley fever.

Diseases transmitted onto humans by insects:

Rat Lung Worm.

Angiostrongyliasis, also known as rat lungworm, is a disease that affects the brain and spinal cord. It is caused by a parasitic nematode (roundworm parasite) called Angiostrongylus cantonensis. The adult form of A. cantonensis is only found in rodents, particularly the rat. The rat worm lung life cycle is the adult worm lies it’s eggs in the lung of a rat, the eggs turn into larvae, the larvae are coughed up from the rat’s lungs and swallowed back into it’s stomach.  Than they are expelled in the rat’s feces and are eaten by a second host, a slug or a snail. The slug is than eaten by a rat and the process it repeated.  The nfected rodents pass larvae of the worm in their feces. Snails, slugs, and certain other animals (including freshwater shrimp, land crabs, and frogs) can become infected by ingesting this larvae; these are considered intermediate hosts. Humans can become infected with A. cantonensis if they eat (intentionally or otherwise) a raw or undercooked infected intermediate host, thereby ingesting the parasite. For more information on the life-cycle of A. cantonensis, visit the CDC website.  Areas noted for this disease are  Hawaii, these larval worms can be found in raw or undercooked snails or slugs. Sometimes people can become infected by eating raw produce that contains a small infected snail or slug, or part of one. It is not known for certain whether the slime left by infected snails and slugs are able to cause infection.  There is no specific treatment for the disease but our medical team has method treatments to get rid of it.  However, the Governor’s Joint Task Force on Rat Lungworm Disease recently published preliminary evidence-based clinical guidelines for the diagnosis and treatment of neuroangiostrongyliasis. Their are preventative measures to prevent getting this.  The parasites cannot grow or reproduce in humans and will die eventually, causing inflammation.  The parasitic lung worm get digested in out GI tract than absorbed in our bloodstream sent to the surface of the brain and they burrough in the brain spreading out into our nervous system.  This causes a terribly inflammatory response in the brain and the auto immune system is trying to fight this infection causing more inflammation to the body.  2 ways the rat lung worm is damaging the body; 1-First the worms are borrowing through the body first that causes bleeding, hemmoraging and tissue damage 2=The auto immune response causing swelling can be damaging to the organs like the brain since its increasing pressure more putting it at risk to be deadly (increased pressure in the brain).  This increase pressure in the lining of the skull that can go into meningitis being deadly.

Plague

Fleas are the vector for the plague (or black death), which infects man as well as rats and other rodents. There are three forms of plague that occur in humans: bubonic, pneumonic, and septicemic. The bubonic type, in the form of the bacterium, Yersina pestis, is transmitted by fleas. The disease is passed as fleas regurgitate plague bacilli when biting, when flea feces are scratched into the skin, or when the host ingests an infected flea. The plague has killed millions of people in history, especially in the 14th and 17th centuries. In 14th century Europe, the great pandemic resulted in twenty-five million deaths. The plague is still a problem to society, with some 5,000 cases annually.

Enteric diseases. 

There are many bacterial diseases that are transmitted by some form of fecal contamination of food or water, either directly or indirectly. House flies are a primary agent in transmitting these diseases, and do so mechanically. Typhoid Fever (Salmonella typhi) is a well-known enteric disease, and affects humans worldwide. Cholera is another enteric disease of great importance. Shigella, causing dysentery and diarrhea, and Escherichia coli, causing urogenital and intestinal infections, are widespread enteric diseases.

Lyme disease.

This disease is caused by an arachnid, the deer tick, which carries a bacterium called Borrelia bugdorferi. When a person or warm-blooded mammal is bitten, the bacterium enters the bloodstream, and Lyme disease may occur. The disease was first described in New England and the mid-Atlantic states, but is now known from all of the Northern Hemisphere.  Mosquitoes can carry the disease also and transmit it via bites.

Sleeping Sickness. 

This disease is also known as African Trypanosomiasis. The disease is transmitted by the Tsetse Fly, in the genus Glossina. The causative agent of African trypanosomiasis is Trypanosoma brucei (two forms). The disease is known to have a high mortality rate, not only among people, but among cattle, which was one of the reasons that parts of Africa could not be settled. Wholesale destruction of habitat and reservoir hosts has had some positive impact on the distribution of the disease.

American Trypanosomiasis. 

This disease is also known as Chagas’ Disease. Trvpanosoma cruzi, a protozoan and causative agent of Chagas’ Disease, invades the muscle cells of the digestive tract and heart, and sometimes also the skeletal muscle. There the protozoa multiply. Adult trypanosomes may circulate in the blood, but they do not invade blood cells the way malaria parasites do. Transmission of the protozoa is by Conenose Bugs, also known as Kissing Bugs, and is by the bug’s feces, not the bite. Conenose Bugs feed at night on their sleeping victims.

Malaria

Malaria represents the primary health risk for travellers due to being very widespread in the tropical and subtropical regions around the globe and due to its potentially fatal outcome. The disease is caused by a unicellular blood-dwelling parasite of the genus Plasmodium, transmitted by a mosquito of the genus Anopheles. Different species exist. The study of this disease is the subject of a specific sheet.

The chikungunya virus

This is an emerging viral disease caused by an Alphavirus, the main reservoir of which consists of monkeys and other vertebrates including infected humans. The transmission to humans occurs as a result of the bite of the Aedes genus mosquito. This is essentially a diurnal vector. This disease affects Africa, Southeast Asia and the entire Indian subcontinent. The disease progresses in the form of epidemic outbreaks.

The disease can go unnoticed. In its usual form, it leads to a feverish state with intense joint and muscular pains. It is sometimes accompanied by mild haemorrhaging. The disease progression is normally favourable but complications and death can occur. There is a long recovery period with long-lasting residual asthenia. The signs are not very specific, in such a way that without a serology test, the diagnosis can be confused with other diseases causing fever and pain, such as dengue fever, malaria, etc.

No specific anti-viral treatment exists. The treatment is purely symptomatic (paracetamol-type non-salicylate analgesics). The disease confers long-lasting immunity. There is no vaccine; prevention consists of avoiding mosquito bites.

Dengue fever

Dengue Fever is a viral disease caused by a Flavivirus. It is undergoing a strong resurgence. It is transmitted by the bite of a mosquito of the genus Aedes, which reproduces in stagnant water locations around habitations. The disease occurs in Southeast Asia, Australia, Oceania, the Indian Ocean, the Caribbean, America (from Southeastern USA to northern Argentina), and in sub-Saharan Africa. It is endemic in all the overseas French regional départements and territories. It follows an endemic-epidemic transmission pattern. There are 4 distinct serotypes of the disease.

After an incubation period of 7 days, the clinical picture is one of a fever and aches with a rash. After a remission with a drop in temperature, the established stage occurs with resumption of the symptomatology. The disease lasts for a week, the recovery period is long, and is marked by a long-lasting asthenia. There are subclinical forms and, on the contrary, severe forms resulting in death. The clinical picture is not very specific; it is shared by other arboviral infections that present Dengue fever-like syndromes. The definitive diagnosis of isolated cases depends on serology testing.

The treatment is purely symptomatic (paracetamol-type non-salicylate analgesics). A vaccine is under study. The disease resulting from a virus of a given group does not confer immunity with regard to the viruses of the other groups. On the contrary, the fact that a patient has already suffered dengue fever exposes them to a new, more severe illness in the event of a new infection by a virus from a different group.

Yellow fever

Yellow fever is a viral haemorrhagic fever caused by a Flavivirus: the yellow fever virus. It is transmitted by the bite of a mosquito of the Aedes genus. The natural host of the virus is a particular species of monkey living in forest regions. The virus can be transmitted, accidentally, to human communities. The disease follows an endemic-sporadic transmission pattern and gives rise to epidemics. It affects the tropical and subtropical regions of South America and Africa. The disease is absent from Asia, the Pacific and the Indian Ocean. It is currently highly present in Africa where small epidemics are regularly observed (Ivory Coast, Cameroon, Senegal).

The disease typically begins with a highly feverish state with headaches and lower back pain. It then progresses, in the typical forms, in 2 stages. A red stage with fever, congested appearance to the face, headaches. There is a remission in the 3rd-4th day, then a yellow stage with recurrence of the fever, deterioration of the general condition, jaundice, black vomit (vomitus containing blood), haemorrhaging, reduction in urine volume. The progression can be fatal. There are many milder or subclinical forms.

The treatment is purely symptomatic. There is a vaccination that is very effective. This vaccination is compulsory for travellers visiting countries where the disease is likely to exist. The vaccination is administered at the approved vaccination centres. It is subject to inclusion on the international vaccination record.

West Nile disease

It is an infection caused by a Flavivirus: the West Nile virus. The vector is a mosquito of the Culex genus. The reservoir of the virus consists of birds. The disease initially affected Africa, part of central and southern Europe, the Middle East, and India. A gradual expansion is being observed with a spread across the American continent from East to West, and to Eastern Europe and Russia. In France, the disease is present in Camargue where it affects horses, but also humans.

The disease is frequently asymptomatic but it can cause feverish states accompanied sometimes by neurological signs presenting a clinical picture of encephalitis or flaccid paralysis. There is a risk of death or serious sequelae.

The treatment is symptomatic. Vaccine trials are underway.

Japanese encephalitis

Japanese encephalitis (JE) is caused by a Flavivirus. It is transmitted to humans via the bite of a mosquito of the Culex genus. The reservoir of the virus consists of wild aquatic animals and pigs, from which the disease can spread to humans in rural areas. JE affects the far south-east of Russia, the whole of Asia, India and the far north of Australia. It is endemic in rural areas with rice fields and irrigation throughout the year. It is epidemic in rural and urban areas during the monsoon. There are 30,000 to 50,000 new cases per year, mainly among children, with 25,000 deaths. The risk of travellers contracting the disease is roughly 1/1,000,000.

There is one visible form (one case) for every 250 contaminations. The clinical picture formed by the visible forms is not specific. It can consist of an isolated feverish state, or a meningitis or meningoencephalitis clinical picture. It is estimated that the mortality rate is 30% and that 30% of patients will recover with sequelae.

The treatment is symptomatic. There is a preventive vaccination. There are two types of vaccines on the market: a cell culture vaccine in Western countries and a suckling mouse brain vaccine. This vaccination is only available at approved vaccination centres.

Vaccination is recommended for :

• Adults who are expatriates or who need to reside for more than 30 days in Asia;
• Adults who are visiting these regions, undertaking significant outdoor activity, in particular in rice fields or marsh areas, during the virus transmission period, in particular during the rainy season, regardless of the duration of the stay. The following activities are considered to present a risk: sleeping outdoors without a mosquito net, camping, working outdoors, cycling, hiking, etc.; especially in areas where flood irrigation is practised.The vaccine marketed in France is currently reserved for persons aged 18 and over.

Filariasis

Filariasis is a group of tropical diseases linked by the development, within the body, of adult worms (filariae) and their lavae or microfilariae. These diseases constitute a real public health problem for the local populations, but infection is rare among travellers. They are transmitted by specific insects acting as vectors, which explains their presence in certain specific areas. A distinction can be made between lymphatic filariasis and cutaneous filariasis depending on whether the adult worms live in the lymphatic system or beneath the skin.

Lymphatic filariasis :

• There are three species: Wuchereria bancrofti (cosmopolitan), Brugia malayi and Brugia timori (Southeast Asia). Each species is transmitted by a specific mosquito (Culex, Anopheles, Aedes, Mansonia) and has a well-defined geographical distribution. The disease is endemic in tropical regions where 120 million people are infected.
• The symptoms are linked with the disruption of the lymphatic drainage caused by the adult worms, giving rise to oedema of the limbs, lymphangitis and superinfections. They are also allergenic in nature due to the microfilariae. Without treatment, the oedema progress to a chronic state, causing a thickening of the tissues and resulting in a clinical presentation of elephantiasis.
• Treatment uses anti-parasitic drugs. The WHO launched a mass treatment program in 2000 aiming to stop the transmission of the disease.

Loa loa filariasis :

• This is a cutaneous filariasis found in the forest regions of central Africa. It is caused by the Loa-loa. It is transmitted by the bite of a horse fly: the Chrysops. The microfilariae live in the blood circulation.
• The symptomatology is characterised by itching, urticarial episodes, migrating oedema of the limbs. The movement of the adult worm beneath the skin is the cause of the tortuous cords; they move at a speed of roughly 1 cm per minute. The passage of the worm beneath the conjunctiva of the eye causes tearing, red eye and foreign body sensation. This occurrence is dramatic but relatively benign. The disease progresses over a long period of time. Later stage complications can be observed, particularly affecting the heart.
• Treatment uses anti-parasitic drugs. They must be used carefully.

Other types of filariasis :

There are other types of filariasis transmitted by specific vectors: Onchocerciasis, filarial pleural effusion. They are rarer.

Sleeping sickness

Human African typanosomiasis or sleeping sickness is a parasite disease caused by the Trypanosoma protozoa (unicellular blood-dwelling parasites), several different species of which exist. This disease, which virtually disappeared during the 1960s as a result of the actions of the major disease mobile teams founded by Jamot, is in full resurgence due to troubles disrupting the various health systems. It is transmitted by the bite of a fly: Glossina or tsetse fly. It is found only in Africa. It is found in homes in the tropical and subtropical regions. The disease affects rural populations; the risk to travellers is limited.

The disease progresses in two stages: a lymphatic/blood stage during which the parasite is found in the lymphatic system, then a stage called the “neurological phase” where the central nervous system is affected. The progression occurs over a long period of time. Without treatment, the disease is invariably fatal.

The disease is treated with anti-parasite drugs; the treatment is very well codified but relatively hard to undergo. It is very effective.

The leishmaniases

The leishmaniases are parasite diseases caused by Leishmania (unicellular parasites that infect the reticulohistiocytic system) transmitted by a species of sand fly (subfamily Phlebotominae). A distinction can be made, according to the type of parasite, between the cutaneous, mucocutaneous and visceral forms.

The cutaneous and mucocutaneous forms have a different aspects on the American continent compared with Asia. The various forms of the disease have as a common feature, the creation of chronic ulcers, more or less hollow, without a tendency to heal.

The visceral forms or Kala-azar are observed in the Mediterranean basin. They are characterised by a severe deterioration of the general condition of the patient with an increase in the size of the lymph nodes and of the spleen, and a drop in blood cell numbers.

These diseases have specific treatments, which need to be followed over long periods of time in order to achieve a cure.

Lyme disease

Lyme disease is an infection caused by a a species of bacteria of the Borrelia genus: Borrelia burgdorferi transmitted by the bite of a tick of the Ixodes genus. 10 to 15% of them carry the Borrelia bacteria. The risk of contamination by tick bite varies between 1 and 6% depending on the region. The disease is found in the northern hemisphere, in America and in Eurasia during the active phase of the ticks, between May and October. It is not uncommon in France.

The disease begins with a red skin lesion centred around the tick bite that gradually spreads out and ends up disappearing within a few days or a few weeks. A few weeks or a few months later, other signs may appear, involving the joints, the nervous system (paralysis and pain), heart rhythm abnormalities and, more rarely, other symptoms. The expression of the disease is usually more severe in Northern America than in Europe.

The treatment relies on antibiotics. Admission to hospital can be necessary.

Tick-borne meningoencephalitis

Tick-borne meningoencephalitis is a disease of the central nervous system caused by a Flavivirus (Tick Born Encephalitis Virus). It is transmitted by the bite of a tick of genus Ixode, in spring and summer. In the past, a distinction was made between the European forms (Central Europe and Eastern Europe) and the Asian forms (from Russia to Japan), but in fact it consists of the same disease transmitted by different tick species. In the areas affected, the disease is restricted to limited territories. It has been expanding continuously over the last few years. The disease is present in Alsace.

After an incubation period of 7 days, the symptomatology progresses in two stages. A first stage that lasts 2 to 4 days is characterised by a flu-like state. The second stage does not always occur, and if it does, appears 10 days later. It is characterised by neurological signs of varying severity: meningitis, meningoencephalitis, meningo-encephalo-radiculitis. In general the disease progresses towards recovery. Sequelae can be observed. The mortality rate is 1%.

The treatment is purely symptomatic; there is no medicine that acts on the virus itself. A preventive vaccine is available. The vaccination against tick-borne encephalitis is recommended for travellers staying in endemic rural and forest regions in central, eastern and northern Europe, between spring and autumn.

The tick-borne spotted fevers

The tick-borne spotted fevers are diseases caused by bacteria of the Rickettsia genus. They are transmitted by tick bites. More than 20 species of the Rickettsia genus are pathogenic for humans. Besides the various spotted fevers, they are responsible for typhus (epidemic typhus, endemic typhus, scrub typhus).

The spotted fevers are found in Europe, on the North American continent and in sub-Saharan Africa (especially southern). Various types of the disease have been described: Mediterranean spotted fever, Israeli tick typhus, Indian tick typhus, Rocky Mountain spotted fever, African tick bite fever.

These various diseases present a common symptomatology. After an incubation period of 5 days, the following signs appear: fever, an eschar at the point of the tick bite with satellite lymphadenopathy (lymph glands) and, not systematically, skin rash with blisters. Progression can be severe for Mediterranean spotted fever and especially Rocky Mountain spotted fever. For the other types of the disease, progression is benign.

The severe forms are treated with antibiotics.

“Insects are ectothermic, which means that their body temperature tracks the temperature of their environment. Thus, the air temperature affects oxygen consumption, caloric requirements, and other metabolic rates.”

Futurity (Furity.com)

Body Lice                                                         Head Lice 

Bed Bugs and the bed bug bites on the human body.

TYPES OF INSECTS THAT CAN TRANMIT DISEASE:

Mosquitoes

There are different species of mosquitoes (Anopheles, Aedes, Culex) and these have completely different preferred habitats, times when they are active and types of bite. The lavae that produce the adults develop in areas of stagnant water (receptacles, reservoirs, ponds, lakes, etc.). They transmit certain specific diseases according to the specific species, climate and habitat: malaria (Anopheles), chikungunya virus, dengue fever, yellow fever, Japanese encephalitis, lymphatic filariasis.

Their flight can be more or less noisy; their bite is not always painful. Half of all mosquito bites occur through clothing.

Flies, midges

The Chrysops (horse flies) are the vector for loa loa filariasis. Simuliidae (black flies) transmit onchocerciasis. Certain members of the glossina genus (tsetse flies) transmit African trypanosomiasis (sleeping sickness). Certain of the phlebotominae (sand flies) transmit leishmaniasis. Their bites are not always felt.

Besides their direct role in the transmission of microorganisms, flies can be the cause of conditions linked to the development and to the migration of their lavae beneath the skin (the Cayor worm is linked to the passage through the skin of the lavae of Condylobia anthropophaga which lays its eggs on the ground but also on linen). The contamination occurs either by lying down on ground contaminated by the eggs laid by the fly, or via clothes on which the flies have laid their eggs while drying. Prevention is achieved by not lying down in the ground and by avoiding drying one’s clothes in the open air. It is also recommended that one irons one’s clothes after they are washed in order to destroy, with the heat from the iron, any lavae present.

Bed bugs

On the South American continent, the triatomines or reduviidae (bed bugs) transmit Chagas disease (American trypanosomiasis). They live in the walls of damp houses and are only active at night.

Lice, fleas

Lice transmit different bacterial infections: bartonellosis (Trench fever), borrelliosis (relapsing fever), and certain types of rickettsiosis (typhus). Rat fleas are a vector for the plague.

Ticks

There are numerous species of ticks, each one having a relatively specific habitat. They are the vector for numerous diseases: Lyme disease, tick-borne meningoencephalitis, Crimean–Congo hemorrhagic fever, tick-borne relapsing fever, Q fever, the tick-borne spotted fevers, babesiosis, ehrlichiosis, tularemia.

Tick bites result from contact with grassland. This risk is generally restricted to certain well-defined regions. Once the ticks are on the skin, they migrate towards the major skin folds (groin, armpits) where they implant themselves. They do not begin to feed until 12 to 24 hours have passed and so the risk of infection is low if they are quickly removed.

Besides the transmission of various diseases, a tick bite can, in its own right, be the cause of a local inflammation reaction that can sometimes be highly pronounced.

Now learn the diseases they and more insects can transmit, especially in the warmer weather since they increase in population during that temperature as opposed to cold in Part III.

“Insects are cold blooded. This means the hotter it is outside, the more energy they have to search for food which generally leads them into our kitchens, garages and bathrooms. Maryland, Virginia and DC summers are a volatile combination of heat and moisture that bring annoying bugs out like no other.  While there is little you can do about the heat, being aware of increased pest activity can let you nip it in the bud when the six-legged adversaries enter your living areas.  A warm winter preceding a hot summer means that more insects were able to survive the mild temperatures instead of freezing as many normally do. This combination means more bugs in more places.”

American Pest

TICS BEES

ANTS

You may have noticed that when the temperatures begin to rise, so does the chance of an insect encounter. In fact, summer is well known for its many different infestations, from mosquitoes to bees to ants and beyond. So what’s the reason for this apparent insurgence of annoying critters?

For the most part, many bugs and insects go into some form of hibernation during the colder months. Other insects migrate someplace warm to wait out the colder months. Still others decide the best way to stay out of the cold is to camp out in your home. You may see more bugs in your house in the winter months, although many of them make their homes inside walls and attics where you are unlikely to encounter them.

No matter the method, these insects simply pass the time until they can return with a vengeance. The minute it starts warming up, the bugs of summer will begin to flock to your area.

It’s important to be aware of the common bugs that you are sure to see in summer months, as some of them may actually pose a threat to you or your loved ones. Mosquitoes, which are certainly some of the most annoying insects out there, can actually be quite dangerous. These pesky creatures are known to spread diseases, some of which may actually be deadly. West Nile Virus spread by mosquitoes has become a serious threat in the United States in recent years. Other diseases that one may suffer from after a mosquito bite include malaria, dengue fever and chikungunya.

In order to dodge mosquito bites this summer, avoid going outside at dawn and dusk, as this is when you are most likely to run into a mosquito swarm. Anytime you know you will be spending time outdoors, spray yourself down with a mosquito repellent that contains a small percentage of DEET (a brand of diethyltoluamide, a colorless oily liquid with a mild odor, used as an insect repellent.). Avoid areas with standing water, and be aware that after significant rainfall mosquitoes are more likely to be out and about.

Other common summer insects include bees and wasps. While for many people a bee or wasp sting is simply a painful annoyance, for others it can be quite dangerous – or even deadly. Since these flying creatures are sure to be around this summer, there are a few things you can do to avoid an encounter. Skip out on the perfume when you know you will be spending time outdoors, as the scent may attract nectar-seeking bees. Avoid eating sugary food and drinks when you are outdoors, and clean up well anytime you decide to have a quick snack in your backyard. If a bee or wasp happens to fly into your direct proximity, stay still. Swatting at them or running may simply draw attention or agitate them to the point that they will sting. Stay still enough to let them discover that you aren’t a flower, which is what they are hunting for, and then they will be on their way.

Ants are yet another common bug of summer, and these pesky things can be downright hazardous. Fire ants create colonies of hundreds or thousands of ants, and if you happen to encounter one of their large mounds, you may soon regret it. Fire ants latch on and sting, injecting a toxic alkaloid venom into their victim. They have even been known to gang up and attack and kill small animals. While their sting is quite painful, to most it poses no real harm. But if a sensitive individual is stung, the aftereffect of the sting could potentially be deadly.

We also have the tics, worms who are vectors sending infections to even the the rodent family that can further transmit infections to humans putting us at health hazard risks.

“SCD is a genetic disorder. Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has SCD, the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle”. The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems such infection, acute chest syndrome and stroke.”

CDC Centers for Disease Control and Prevention

SCD is the most commonly inherited blood disorder in the United States, affecting 100,000 people, and millions more worldwide. The disease primarily affects people of African, Hispanic, Mediterranean, Middle Eastern and South Asian ancestry.

What is sickle cell disease actually?

The term sickle cell disease (SCD) describes a group of inherited red blood cell disorders. People with SCD have abnormal hemoglobin, called hemoglobin S or sickle hemoglobin, in their red blood cells.

Hemoglobin is a protein in red blood cells that carries oxygen throughout the body.

“Inherited” means that the disease is passed by genes from parents to their children. SCD is not contagious. A person cannot catch it, like a cold or infection, from someone else.

People who have SCD inherit two abnormal hemoglobin genes, one from each parent. In all forms of SCD, at least one of the two abnormal genes causes a person’s body to make hemoglobin S. When a person has two hemoglobin S genes, Hemoglobin SS, the disease is called sickle cell anemia. This is the most common and often most severe kind of SCD.

Hemoglobin SC disease and hemoglobin Sβ thalassemia (thal-uh-SEE-me-uh) are two other common forms of SCD.

Cells in tissues need a steady supply of oxygen to work well. Normally, hemoglobin in red blood cells takes up oxygen in the lungs and carries it to all the tissues of the body.

Red blood cells that contain normal hemoglobin are disc shaped (like a doughnut without a hole). This shape allows the cells to be flexible so that they can move through large and small blood vessels to deliver oxygen.

Sickle hemoglobin is not like normal hemoglobin. It can form stiff rods within the red cell, changing it into a crescent, or sickle shape.

Sickle-shaped cells are not flexible and can stick to vessel walls, causing a blockage that slows or stops the flow of blood. When this happens, oxygen can’t reach nearby tissues.

The lack of tissue oxygen can cause attacks of sudden, severe pain, called pain crisis. These pain attacks can occur without warning, and a person often needs to go to the hospital for effective treatment.

Most children with SCD are pain free between painful crises, but adolescents and adults may also suffer with chronic ongoing pain.

The red cell sickling and poor oxygen delivery can also cause organ damage. Over a lifetime, SCD can harm a person’s spleen, brain, eyes, lungs, liver, heart, kidneys, penis, joints, bones, or skin.

Sickle cells can’t change shape easily, so they tend to burst apart or hemolyze. Normal red blood cells live about 90 to 120 days, but sickle cells last only 10 to 20 days.

The body is always making new red blood cells to replace the old cells; however, in SCD the body may have trouble keeping up with how fast the cells are being destroyed. Because of this, the number of red blood cells is usually lower than normal. This condition, called anemia, can make a person have less energy.  Anemia ending line is lack of oxygen to the tissue body parts all over.

“Sickle cell disease is devastating for patients and their families,” said Jeffrey Glassberg, MD, MA, Assistant Professor of Emergency Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai. “It’s a chronic disorder causing pain in the extremities and back, infections, organ failure and other tissue damage, skin infections, loss of eyesight, severe blood clots and strokes. Patients learn to function in a constant state of pain and when that pain becomes debilitating, they often end up in the emergency room,” said Dr. Glassberg, also Associate Director of the Comprehensive Sickle Cell Program at The Mount Sinai Hospital.

“Patients with SCD are more likely to live full lives if they undergo regular checkups, prevent infections and develop healthy habits,” said Jena Simon, MS, FNP-BC, RN, also of the Comprehensive Sickle Cell Program.

Tips to Staying Healthy

• Get regular checkups. Regular health checkups can help prevent some serious problems.
• Prevent infections. Common illnesses, like influenza quickly can become dangerous for both children and adults with SCD. The best defense is to get a flu shot every fall and to stay up-to-date on other immunizations.
• People with SCD should drink 8 to 10 glasses of water every day and eat healthy food. They also should try not to get too hot, too cold, or too tired.
• Look for clinical studies. New clinical research studies are beginning all the time at Mount Sinai and elsewhere, with the goal of finding better treatments for SCD. Study participants gain early access to experimental medicines and treatments.
• Get support. People with SCD should find a patient support group or other organization in the community that can provide information, assistance, and support.

Sickle Cell Disease Facts & Figures:

• SCD is an inherited blood disorder that can cause severe pain and permanent damage to the brain, heart, lungs, kidneys, liver, bones and spleen.
• SCD is most common in Africans and African-Americans. It is also found in other ethnic and racial groups, including people from South and Central America, the Caribbean, Mediterranean countries, and India.
• More than 2 million people carry the sickle cell gene that allows them potentially to pass the disease on to their children. People of African, Hispanic, Mediterranean, Middle Eastern, and Indian descent may want to be tested for the gene before having children. You can carry the gene and not have any signs or symptoms of SCD. Both parents have to have the gene to have a child with SCD.

“Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.”

MAYO CLINIC

“Safe blood saves lives and improves health. Blood transfusion is needed for:

• women with complications of pregnancy, such as ectopic pregnancies and haemorrhage before, during or after childbirth;
• children with severe anemia often resulting from malaria or malnutrition;
• people with severe trauma following man-made and natural disasters; and
• many complex medical and surgical procedures and cancer patients.”

World Health Organization (WHO)

“Bursitis is most often caused by repetitive motions (i.e., overuse); or direct, minor impact on the area (such as from such activities as repeated bumping or prolonged pressure from kneeling). Less often, bursitis is caused from a sudden, more serious injury.”

Cleveland Clinic