Mosquitoes are aquatic breeding arthropods found in all parts of the world. Like other members of this group, they possess one pair of wings, the second pair having evolved into smaller structures used as stabilizers.
Mosquitoes penetrate skin with a piercing motion of a bayonet-like proboscis. The actual puncturing of the skin surface causes minimal trauma and is frequently not felt by the host. A type of local anesthetic is injected into the wound that causes local tissue damage and local hypersensitivity. Bites can lead to both immediate and delayed reactions. An immediate skin reaction includes redness, a wheal, and itching. A delayed reaction usually consists of edema and a burning pruritus. The immediate reaction tends to be of short duration, whereas a delayed reaction may persist for hours, days, and even weeks. Severe local reactions with skin necrosis occur occasionally. The history of an allergy to mosquito saliva constituents consists of an increasing reaction to seasonal exposures with more and more pronounced edematous and pruritic lesions, accompanied sometimes by complications such as fever, malaise, generalized edema, severe nausea and vomiting, and necrosis with resulting scarring. Treatment is symptomatic, with antihistamines and NSAIDs.
The greatest dangers from mosquitos in other countries is their function as disease vectors. Even with extensive pest control programs, arboviruses and malaria are epidemic in some parts of the world. Japanese B encephalitis, yellow fever, dengue hemorrhagic fever, and various types of equine encephalitis are among the many viruses transmitted by mosquitos. Malaria is encountered frequently in patients in the United States after travel and in immigrant populations from areas where malaria is endemic.
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