Did you know that mosquitos kill more humans than any other animal on the planet? (Forget sharks, who don’t even make the top fifteen killers on most lists.) From dengue to chikungunya, mosquitos are easy to hate and are a public health nightmare.
Nurses and Mosquitos
According to the National Library of Medicine website, there are over 3,500 mosquito species and approximately 110 trillion mosquitos worldwide, with only Antarctica being spared.
Since RNs are educated generalists who often serve as the healthcare systems’ first line of defense — with friends, family, and fellow community members turning to them for medical advice — it’s prudent for nurses to know a little about many things. With climate change, a warming planet, and a growing threat of mosquito-borne illnesses worldwide, nurses understanding these diseases is in everyone’s best interest.
Mosquito-Borne Illnesses of Concern
Mosquitoes cause many illnesses, but if we narrow the list to the top candidates American nurses are more likely to run into, we can focus on a small selection deserving of at least some familiarity.
Malaria
Malaria has strong name recognition. According to the World Health Organization, there were approximately 249 million cases and 608,00 deaths in 85 countries in 2022. The vast majority of cases are contracted in Africa, with 80% of African malaria deaths sadly occurring in children.
For Americans, increasingly popular safari vacations are one way to encounter the anopheles mosquito and destinations in Southeast Asia and Latin America.
Fever, headache, and chills are the most common early symptoms of malaria, with extreme fatigue, impaired consciousness, convulsions, difficulty breathing, and jaundice being more severe. Once contracted, malaria symptoms can haunt the individual for decades.
Antimalarial medications are powerful forms of prevention, and smart travelers visiting malaria zones throughout the world will seek medical advice and a prescription before leaving home.
Chikungunya
The chikungunya virus is occurring increasingly frequently in Africa, the Americas, and Asia and has been identified in over 100 countries. Infected travelers can spread the virus to unaffected areas. The most common mosquito species are Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus, which also transmit dengue and Zika.
The most common chikungunya symptoms are fever, joint pain, headache, muscle pain, swelling, and rash.
Protecting from mosquito bites is crucial, as there are no medications to treat or prevent chikungunya. In 2023, the FDA approved a new vaccine for use in the United States, and vaccination is recommended for some travelers.
Japanese Encephalitis
Japanese encephalitis (JE) is transmitted by the Culex tritaeniorhynchus mosquito. The risk of infection with JE is low for most travelers. It can be found throughout Asia, Southeast Asia, and the Pacific West regions, including New Zealand and Australia.
Most individuals who contract Japanese encephalitis have mild or no symptoms, but a small percentage develop encephalitis, including fever, headache, seizures, weakness, disorientation, and coma. Of those who develop encephalitis, there is a 20–30% mortality rate.
Japanese encephalitis is vaccine-preventable, with some travelers encouraged to be vaccinated based on their destination and planned activities.
Zika
Aedes mosquitoes mainly transmit Zika. While most infected people have no symptoms, those who do will experience rash, fever, conjunctivitis, Guillain-Barré, neuropathy, muscle and joint pain, malaise, and headache. It is most common worldwide in tropical and subtropical regions and is currently not common in the U.S.
Zika can also be transmitted between sexual partners, and infection of a woman with Zika during pregnancy can lead to congenital disabilities, including microcephaly, as well as premature birth and miscarriage.
Dengue
Dengue is an illness caused by four different virus types: dengue-1, dengue-2, dengue-3, and dengue-4. The most common symptoms are muscle and joint pain, eye pain, nausea and vomiting, and rash. It is found in the Caribbean, Central and South America, Southeast Asia, and the Pacific Islands.
Puerto Rico has declared a dengue-related public health emergency. In the first half of 2024, dengue cases were reported in New York, Massachusetts, California, Colorado, Arizona, the District of Columbia, and other locations.
While dengue’s joint and muscle pain is said to be potentially severe, most dengue patients recover completely within several weeks. Rest, NSAIDs, and fluids are the recommended treatment.
The only vaccine currently approved in the U.S. is reserved for children 9 to 16 years old with a previous dengue infection confirmed in a laboratory.
As a nationally notifiable disease, clinicians are advised to suspect dengue infection in patients with fever who have traveled to areas with common dengue transmission within several weeks before the onset of symptoms.
The Nurse on the Alert
The illnesses outlined above are a small slice of the mosquito-borne illnesses that haunt humanity. However, nurses who maintain awareness of the symptoms of malaria, chikungunya, dengue, Zika, and Japanese encephalitis are ahead of the game.
It is prudent to maintain a high level of suspicion in patients with various combinations of fever, joint and muscle pain, rash, headache, and recent travel to one of the aforementioned regions.
While RNs are not trained diagnosticians, they are often the healthcare system’s first line of defense, as noted above. Meanwhile, nurse practitioners are indeed trained in physical assessment and diagnosis and can play an enormous role in the identification of mosquito-borne infections.
Unfortunately, mosquitoes aren’t going away anytime soon. Therefore, we must maintain awareness that these and many other diseases can be caused by these miniature-flying pests that buzz in our ears, swarm around our heads, and plague humans worldwide.
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