Successful treatment of bifenthrin toxicosis using therapeutic plasma exchange.

OBJECTIVE: To describe a case of bifenthrin toxicosis in a dog with a successful outcome following the use of therapeutic plasma exchange (TPE) and intralipid therapy. CASE SUMMARY: An 8-month-old female neutered poodle mix dog ingested an unknown amount of powered bifenthrin, which resulted in acutely altered mentation, cranial nerve deficits, and intractable tremors that persisted in severity despite aggressive medical management to include intravenous fluids, intravenous lipid emulsion, anticonvulsant medications, and methocarbamol. TPE was initiated after lack of significant clinical improvement 12 hours after initial presentation. The dog underwent cardiopulmonary arrest (CPA) following approximately 1 plasma volume equivalent exchange. The dog was successfully resuscitated and showed marked improvement 12 hours postarrest and post-TPE treatment. Serum bifenthrin concentrations were analyzed prior to TPE (445.38 ng/mL) and ∼10 hours after TPE (51.18 ng/mL), which resulted in an 89% reduction in serum bifenthrin concentration. NEW INFORMATION: TPE may be a promising adjunctive therapeutic modality for bifenthrin toxicosis in dogs.

A Fatal Case of Chlorfenapyr Poisoning and the Therapeutic Implications of Serum Chlorfenapyr and Tralopyril Levels.

Chlorfenapyr is a new contact and stomach insecticide derived from natural pyrroles secreted by Streptomyces spp. It is a pro-insecticide and acts after metabolic transformation to its active metabolite tralopyril. Tralopyril is an uncoupler of oxidative phosphorylation in the mitochondria of the target insects and of experiment animals, leading to the disruption of adenosine triphosphate synthesis and death. Several fatal human poisonings had been reported and no blood chlorfenapyr or tralopyril measurements were available. The treatment remains supportive. A 32-year-old healthy man ingested 200 mL of 10% chlorfenapyr as a suicide attempt. Unfortunately, he succumbed at 157 h post-ingestion, shortly after having fever and seizures. His serum level of chlorfenapyr at 4 h post-exposure was 77.4 ng/mL, and was undetectable at 113 and 156 h, respectively. The serum levels of tralopyril were 723.6, 14,179, and 9654.2 ng/mL at 4, 113, and 156 h post-ingestion, respectively. The delay in the rise of serum tralopyril levels was noticeable, which seems to correlate with the patient's signs and symptoms. The information may have therapeutic implications in the management of this deadly poisoning.

Investigation of Cytotoxicity and Oxidative Stress Induced by the Pyrethroid Bioallethrin in Human Glioblastoma Cells: The Protective Effect of Vitamin E (VE) and Its Underlying Mechanism.

Bioallethrin belongs to the family of pyrethroid insecticides. Previous studies have shown that bioallethrin affected the function of muscarinic receptor and subsequently induced neurotoxicity in different brain models. Reactive oxygen species (ROS) are generated in the metabolic course of the human body, which can cause human damage when overactivated. However, whether bioallethrin evokes cytotoxicity through ROS signaling and whether the antioxidant Vitamin E (VE) protects these cytotoxic responses in human glial cell model are still elusive. This study investigated the effect of bioallethrin on cytotoxicity through ROS signaling and evaluated the protective effect of the antioxidant VE in DBTRG-05MG human glioblastoma cells. The cell counting kit-8 (CCK-8) was used to measure cell viability. Intracellular ROS and glutathione (GSH) levels were measured by a cellular assay kit. The levels of apoptosis- and antioxidant-related protein were analyzed by Western blotting. In DBTRG-05MG cells, bioallethrin (25-75 µM) concentration-dependently induced cytotoxicity by increasing ROS productions, decreasing GSH contents, and regulating protein expressions related to apoptosis or antioxidation. Furthermore, these cytotoxic effects were partially reversed by VE (20 µM) pretreatment. Together, VE partially lessened bioallethrin-induced apoptosis through oxidative stress in DBTRG-05MG cells. The data assist us in identifying the toxicological mechanism of bioallethrin and offer future development of the antioxidant VE to reduce brain damage caused by bioallethrin.

Comparison of Novel Sandfly Control Interventions: A Pilot Study in Bangladesh.

In this pilot comparative study, we investigated and compared the effects of existing vector control tools on sandfly densities and mortality to inform and support the National Kala-azar Elimination Program (NKEP). The interventions included insecticidal wall painting (IWP), reduced-coverage insecticidal durable wall lining (DWL), insecticide-impregnated bednets (ITN), and indoor residual spraying with deltamethrin (IRS). Sakhua union with seven villages was the study area, which was the most highly endemic visceral leishmaniasis union in Trishal upazila, Bangladesh. Each cluster containing the different interventions included approximately 50 households. Study methods included random selection of clusters, collection of sandfly by CDC light trap and manual aspirator to determine sandfly density, and sandfly mortality determined by WHO cone bioassay test. Trained field research assistants interviewed household heads using structured questionnaires for sociodemographic information, as well as safety and acceptability of the interventions. Descriptive and analytical statistical methods measured interventions' effect and its duration on sandfly density reduction and mortality. We measured the relative efficacy of IWP on sandfly control against DWL, ITN, and IRS by the difference-in-difference regression model. We found that existing interventions were effective and safe for sandfly control with different duration of effect and acceptability. The relative efficacy of IWP for sandfly reduction varied by -59% to -91%, -75% to -81%, and -30% to -104% compared with DWL, ITN, and IRS, respectively, at different time points during the 12-month follow-up. These study results will guide the NKEP for selection of sandfly control tool(s) in its subsequent consolidation and maintenance phases.

An 80-Year-Old Woman with Alzheimer Disease and Accidental Poisoning with Pyrethroid Pesticide Successfully Treated with Intravenous Lipid Emulsion.

BACKGROUND Pesticides are commonly used in the agricultural industry. Overdose can be lethal due to its effects generating closure of the voltage-gated sodium channels in the axonal membranes. Most case reports of toxicity refer to skin exposure and there are very few that refer to effects due to its oral intake. CASE REPORT We report the case of an elderly woman with Alzheimer disease who accidentally swallowed 50 g of Lambda Cyhalothrin (GOLPE 5 M E®), a pyrethroid of medium toxicity containing a cyano group. It severely harmed the woman's health, causing severe central nervous system depression and refractory vasodilated shock requiring the use of vasopressors. Its management was challenging, requiring orotracheal intubation, vasopressors, and admission to the Intensive Care Unit (ICU). The emergency care team decided to use intravenous lipid emulsion, which clearly helped with the recovery and successful discharge of the patient. CONCLUSIONS The use of intravenous lipid emulsion for the treatment of pyrethroid poisoning can lead to successful outcomes, as described in this case report.

Review of Issues on Residual Malaria Transmission.

Residual malaria transmission is the actual maintained inoculation of Plasmodium, in spite of a well-designed and implemented vector control programs, and is of great concern for malaria elimination. Residual malaria transmission occurs under several possible circumstances, among which the presence of exophilic vector species, such as Anopheles dirus, or indoor- and outdoor-biting vectors, such as Anopheles nili, or specific behavior, such as feeding on humans indoors, then resting or leaving the house the same night (such as Anopheles moucheti) or also changes in behavior induced by insecticides applied inside houses, such as the well-known deterrent effect of permethrin-treated nets or the irritant effect of DDT. The use of insecticides may change the composition of local Anopheles populations, such as A. arabiensis taking up the place of A. gambiae in Senegal, A. aquasalis replacing A. darlingi in Guyana, or A. harrisoni superseding A. minimus in Vietnam. The change in behavior, such as biting activity earlier than usually reported-for example, Anopheles funestus after a large-scale distribution of long-lasting insecticidal nets-or insecticide resistance, in particular the current spread of pyrethroid resistance, could hamper the efficacy of classic pyrethroid-treated long-lasting insecticidal nets and maintained transmission. These issues must be well documented in every situation to elaborate, implement, monitor, and evaluate tailored vector control programs, keeping in mind that they must be conceived as integrated programs with several well and appropriately coordinated approaches, combining entomological but also parasitological, clinical, and social methods and analyses. A successful integrated vector control program must then be designed to reduce transmission and incidence rates of malaria morbidity and overall mortality.

A clinical review and history of pubic lice.

The ectoparasite Pthirus pubis (PtP), commonly known as the crab or pubic louse, has plagued primates from prehistoric apes to Homo sapiens. We combed the literature from antiquity to the present day, reviewing the pubic louse's origins, its evolution with mankind, and its presentation and management. MEDLINE and EMBASE provided the greatest yield of literature compared with other databases. Estimates for PtP incidence range from 0.3% to 4.6% and for prevalence around 2% in adults. War, disasters and overcrowding support lice transmission, but modern pubic hair grooming has reduced the incidence of PtP in recent years. PtP, is usually found on pubic hair, but may infest scalp and body hair, eyebrows and eyelashes. Reports suggest the possibility of PtP as a vector for Bartonella spp. and Acinetobacter spp., which require further study. Transmission of PtP is via close contact, so sexual abuse and concomitant sexually transmitted infections should be considered. Symptoms and signs of infestation include pruritus, red papules and rust/brown deposits from feeding or faecal matter. Visualization of live lice confirms the diagnosis. Traditional treatments include hand-picking and combing, but in modern times pediculicidal products may generate faster resolution. Permethrin or pyrethrins are the first-line recommendations. Resistance to pediculicides is common with head lice and is presumed likely with PtP, although data are lacking. Pseudoresistance occurs as a result of poor compliance, incorrect or ineffective dosing, and reinfestation. In true resistance, a different pediculicide class should be used, e.g. second-line agents such as phenothrin, malathion or ivermectin. Lice have existed long before humans and given their adaptability, despite habitat challenges from fashion trends in body hair removal, are likely to continue to survive.

Control of Rhipicephalus annulatus resistant to deltamethrin by spraying infested cattle with synergistic eucalyptus essential oil-thymol-deltamethrin combination.

The current study investigated the synergistic effect of combinations containing deltamethrin (D), Eucalyptus essential oil (E), and the thyme essential oil component thymol (T), against a field population of Rhipicephalus annulatus in Egypt that was characterized to be resistant to D. Solutions of T, E, or TE at concentrations of 1.25-5% were combined with 5% deltamethrin at different dilutions (0.25-2 mL/L). Results of the adult immersion test used to estimate the in vitro acaricidal activity of these combinations at 5% yielded LC50 values for D, E-D, T-D, and TE-D of 3.87 mL/L, 3.89 mL/L, 0.14 mL/L, and 0.05 mL/L, respectively. Biochemical analyses using whole-body homogenate of ticks from the in vitro tests revealed that the lowest acetylcholinesterase and glutathione peroxidase activity, and the maximum lipid peroxidation were recorded in ticks treated with 5% TE-D. Glutathione content significantly decreased (p ≤ 0.05) in all treated ticks. Three groups, each containing five cross breed cattle naturally infested with R. annulatus from the same area where resistance to D was detected, were sprayed twice at two-week intervals using 1 mL/L of 5% solutions of D, T-D, or TE-D. Overall efficacy of the D, T-D, and TE-D sprays by day 30 post-treatment was 21.6, 88.3, and 95 %, respectively. Ticks collected from infested cattle three days after treatment with the D spray deposited egg masses that were able to hatch, deposited small masses of eggs unable to hatch when exposed to the T-D spray, and laid few eggs that didn't hatch when sprayed with the TE-D combination. Values for liver and kidney function parameters were comparable in cattle before and after treatment with the combination sprays tested. The TE-D spray overcame the insensitivity to D of this R. annulatus population in Egypt, which also highlighted the significant synergistic effect of thymol on the acaricidal activity of deltamethrin observed in vitro. Acaricidal activity of the TE-D combination apparently has deleterious effects on multiple tick systems involving inhibition of acetylcholinesterase, increased lipid peroxidation, and oxidative stress. These findings document that combinations of natural and synthetic products can be part of integrated management solutions to the problem with widespread resistance to pyrethroids like deltamethrin in populations of cattle ticks, including R. annulatus, around the world.

Surface distribution of pyrethroids following topical application to veterinary species: Implications for lateral transport.

Pyrethroids like permethrin have been used as topical formulations for their ectoparasiticidal effects since the 1970s. There are numerous efficacy studies in dogs and livestock animals that indicate a fast spread of pyrethroids after topical administration onto rather confined areas of the skin. Some studies correlate the efficacy against ticks, fleas or lice with concentrations of pyrethroids in hair and, less frequently, stratum corneum samples. It is often stated that lateral transport is responsible for the distribution of the pyrethroids over the body surface. With this review, we attempt to demonstrate evidence for lateral transport of pyrethroids after topical administration in dogs, cattle and sheep and to present data gaps that should be addressed in follow-up studies.

Ctenocephalides felis (cat flea) infestation in neonatal dairy calves managed with deltamethrin pour-on in Australia.

Ctenocephalides felis infestations outbreak is documented as a welfare and production limiting disease in neonatal calves in eastern New South Wales, Australia. Due to the calves' discomfort, the first objective was to relieve the calves from the large burden of fleas. The affected neonatal 0-4 week old calves showed dull and quiet demeanour, with the geometric mean of body condition score (BCS) 2.67 (2-4) and geometric mean burden 41.51 (15-75) of fleas collected over 3 min. Deltamethrin pour-on (Arrest Easy-Dose, Virbac Animal Health, Australia) registered for treatment of lice and flies on cattle in Australia was evaluated for control effect of the cat flea (C. felis) on cattle. The fleas were identified morphologically as being C. felis which was confirmed by sequencing cytochrome c oxidase I gene (cox1). We report successful improvement of welfare and reduction of flea counts post application of pour-on deltamethrin on the property. In the absence of registered flea product for cattle in Australia, deltamethrin pour-on product is a suitable option, because of its registration for control of lice and flies on cattle.

The safety and applicability of synthetic pyrethroid insecticides for aircraft disinsection: A systematic review.

BACKGROUND: Air travel contributes to the global spread of vectors and vector-borne infections. Although WHO provides guidance on methods for disinsection of aircraft, there is currently no harmonized or standardized decision-making process to decide when disinsection of an aircraft should be conducted. It is however compulsory for flights arriving in certain countries. Concerns have been expressed about the usefulness of disinsection for preventing the international spread of vectors and vector-borne diseases via air travel and possible toxicity for passengers and flight crew. METHODS: We performed a systematic literature review using the databases PubMed, Embase, Medline, Scopus and CINAHL to evaluate all research findings about the applicability and safety of chemical-based, aircraft disinsection. Official reports from the WHO were also screened. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and meta-analysis (PRISMA) statement. The literature search strategy included "disinsection, airplane/plane/aviation/aircraft" and several other search items including d-phenothrin, permethrin, insecticide. Papers in English, French and German were reviewed. Reports of adverse events attributed to the disinsection of aircraft were also searched. AMP and PS screened all papers of relevance and agreed on a final selection. RESULTS: Our search resulted in 440 papers of possible relevance. After screening, we included a total of 25 papers in this systematic review. Ten papers reported possible human toxicity and 17 papers addressed the applicability of disinsection and 2 papers addressed both topics. Chemical disinsection at recommended insecticide concentrations was found to be highly effective against a broad range of arthropods. Three papers reported passenger or crew illness possibly associated with insecticide spraying in passenger cabins - one describing a single passenger, the other two papers describing occupational illness of 12 and 33 aircrew members respectively, possibly due to aircraft disinsection. Another paper evaluating exposure of flight attendants to permethrin found higher levels of urinary metabolites in those working in planes that had recently been sprayed but this could not be linked to adverse health outcomes. CONCLUSION: Our analysis confirmed that disease vectors are carried on international flights and can pose a threat particularly to island populations and certain airport hub areas. Disinsection with permethrin or d-phenothrin was shown to be highly effective against vectors. Despite several hundred million passenger and crew exposures to chemical disinsection, very few proven cases of toxicity have been reported. There is limited evidence linking exposure to insecticide spraying with negative health impact.

In vitro and in vivo effects of chlorpyrifos and cypermethrin on blood cholinesterases in sheep.

The combination of the organophosphate (OP) chlorpyrifos (CPF) and the pyrethroid cypermethrin (CPM) is commonly marketed as pour-on formulations for the control of sheep lice, ked, and blowflies. CPF irreversibly inhibits acetylcholinesterases (AChE), while pyrethroids are not AChE inhibitors. However, combinations of pyrethroids with OPs showed a highly synergistic effect on AChE inhibition. Thus, the aim of the current work was to evaluate in vitro and in vivo the inhibitory potency of both pesticides, alone and in combination with AChE and butyrylcholinesterase (BChE) activities in sheep blood. In vitro, IC50 values were similar after CPF or CPF plus CPM incubations. The pour-on coadministration of recommended doses of CPF and CPM did not cause a significant inhibition of AChE and BChE in sheep blood. Only slight percentages of inhibition of their catalytic activities were observed when both drugs were given at 4-fold higher dose rates. The lower systemic availability of topical administration of OPs in sheep may help to explain the lower degree of inhibition of blood AChE and BChE in vivo. The results emerged from this research are a further contribution to the knowledge of the risks of implementing higher dosage regimens of OPs-containing antiparasitic formulations.

Effects of Deltamethrin Treatment on Small Mammal and Ectoparasite Population Dynamics and Plague Prevalence in a North American Mixed-Grass Prairie System.

Sylvatic plague affects many species in North American prairie ecosystems. Deltamethrin is commonly used to manage fleas in potential outbreak areas. Understanding the role of small mammals and their ectoparasites in sylvatic plague maintenance is pertinent to understanding the ecology of plague and its persistence in nature. This study examined the effects of plague management using deltamethrin on communities of small mammals, their flea faunas, and Yersinia pestis prevalence. We trapped small mammals from 2014 to 2016 on the Lower Brule Indian Reservation (LOBR), South Dakota, and analyzed the effects of deltamethrin treatment on small mammal populations, flea loads, and Y. pestis prevalence. We collected higher flea loads from small mammals on sites not treated with deltamethrin (1.10 fleas per animal) than from deltamethrin-treated sites (1.03 fleas per animal). We observed significant negative trends in mean flea load per animal between pre- and post-treatment collections. We detected no significant effects of deltamethrin treatment on animal captures pre- and post-treatment, but observed significant differences in animal captures by experimental unit. We detected no serological evidence for the presence of Y. pestis antibodies in small mammals and 1.2% Y. pestis prevalence across all sampled fleas. Although there is little overlap in the species of fleas infesting small mammals and prairie dogs, the occurrence of flea spillover has been documented. In our study, treatment with deltamethrin reduced flea loads on small mammals by up to 49%. Our data suggest that although the efficacy of deltamethrin on the LOBR-a mixed-grass system-may not be as high as that found in a comparable study in a short-grass system, deltamethrin is still a useful tool in the management of plague.

Preventing ectoparasite infestations reduces glucocorticoid concentrations in the hair of cows - short communication.

The aim of this study was to compare hair corticosteroid concentrations in ectoparasiticide-treated (n = 10) and non-treated (n = 12) Holstein cows. Animals in the treated group received cyfluthrin three times, on days 0, 28 and 56 of the experiment. Hair samples were collected from all cows on days 0, 21, 42, 63, and 84 of the experiment for the determination of cortisol and corticosterone concentrations using immunoassays. The respective hair cortisol concentrations in the treated group averaged 209.78, 165.10, 260.78, 177.44 and 183.11 ng/g, while in the non-treated group hair cortisol concentrations averaged 172.58, 243.58, 309.73, 199.75 and 207.09 ng/g. These results indicate that the control of ectoparasites reduced hair cortisol levels in dairy cows. The respective hair corticosterone concentrations in the treated group averaged 19.06, 22.95, 21.95, 21.60 and 24.84 ng/g and in the non-treated group the hair corticosterone concentrations averaged 17.28, 21.94, 34.05, 26.27 and 26.91 ng/g. The results suggest that longterm stress can be estimated better by the determination of hair cortisol rather than corticosterone concentrations.

Lice Update: Management and Treatment in the Home.

Lice infestation is a common health issue affecting 6 to 12 million school-age children in the United States each year, impacting all members of the household. The home care nurse can be a valuable resource in the management of lice in the home and can assist the family in understanding the various myths and misconceptions about lice. This article provides an overview of lice management, including identification and treatment of a lice infestation as well as recommendations for environmental control strategies in the home. It includes an overview of the various over-the-counter and prescription treatment options and highlights the social stigma that is often associated with a lice infestation.

RESISTANCE TO DELTAMETHRIN IN PRAIRIE DOG ( CYNOMYS LUDOVICIANUS) FLEAS IN THE FIELD AND IN THE LABORATORY.

Sylvatic plague poses a substantial risk to black-tailed prairie dogs ( Cynomys ludovicianus) and their obligate predator, the black-footed ferret ( Mustela nigripes). The effects of plague on prairie dogs and ferrets are mitigated using a deltamethrin pulicide dust that reduces the spread of plague by killing fleas, the vector for the plague bacterium. In portions of Conata Basin, Buffalo Gap National Grassland, and Badlands National Park, South Dakota, US, 0.05% deltamethrin has been infused into prairie dog burrows on an annual basis since 2005. We aimed to determine if fleas ( Oropsylla hirsuta) in portions of the Conata Basin and Badlands National Park have evolved resistance to deltamethrin. We assessed flea prevalence, obtained by combing prairie dogs for fleas, as an indirect measure of resistance. Dusting was ineffective in two colonies treated with deltamethrin for >8 yr; flea prevalence rebounded within 1 mo of dusting. We used a bioassay that exposed fleas to deltamethrin to directly evaluate resistance. Fleas from colonies with >8 yr of exposure to deltamethrin exhibited survival rates that were 15% to 83% higher than fleas from sites that had never been dusted. All fleas were paralyzed or dead after 55 min. After removal from deltamethrin, 30% of fleas from the dusted colonies recovered, compared with 1% of fleas from the not-dusted sites. Thus, deltamethrin paralyzed fleas from colonies with long-term exposure to deltamethrin, but a substantial number of those fleas was resistant and recovered. Flea collections from live-trapped prairie dogs in Thunder Basin National Grassland, Wyoming, US, suggest that, in some cases, fleas might begin to develop a moderate level of resistance to deltamethrin after 5-6 yr of annual treatments. Restoration of black-footed ferrets and prairie dogs will rely on an adaptive, integrative approach to plague management, for instance involving the use of vaccines and rotating applications of insecticidal products with different active ingredients.

Seasonal Effects and the Impact of In-Hive Pesticide Treatments on Parasite, Pathogens, and Health of Honey Bees.

Honey bee, Apis mellifera (L.; Hymenoptera: Apidae), populations are in decline and their losses pose a serious threat for crop pollination and food production. The specific causes of these losses are believed to be multifactorial. Pesticides, parasites and pathogens, and nutritional deficiencies have been implicated in the losses due to their ability to exert energetic stress on bees. While our understanding of the role of these factors in honey bee colony losses has improved, there is still a lack of knowledge of how they impact the immune system of the honey bee. In this study, honey bee colonies were exposed to Fumagilin-B, Apistan (tau-fluvalinate), and chlorothalonil at field realistic levels. No significant effects of the antibiotic and two pesticides were observed on the levels of varroa mite, Nosema ceranae (Fries; Microsporidia: Nosematidae), black queen cell virus, deformed wing virus, or immunity as measured by phenoloxidase and glucose oxidase activity. Any effects on the parasites, pathogens, and immunity we observed appear to be due mainly to seasonal changes within the honey bee colonies. The results suggest that Fumagilin-B, Apistan, and chlorothalonil do not significantly impact the health of honey bee colonies, based on the factors analyzed and the concentration of chemicals tested.