Because vector control programs vary in coverage and effectiveness, travel health practitioners should advise travelers to use repellents and other general protective measures against biting arthropods. Although prophylactic drugs are available to protect against malaria, the effectiveness is variable depending on patterns of drug resistance, bioavailability, and compliance with medication.
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And while vaccines are available for diseases such as yellow fever and Japanese encephalitis, there are no available vaccines or chemoprophylaxis for other mosquitoborne diseases such as dengue, chikungunya, Zika, filariasis, and West Nile encephalitis; for tickborne diseases such as Lyme borreliosis, tickborne encephalitis, and relapsing fever; for sand fly—borne diseases such as visceral and cutaneous leishmaniasis; and for black fly—borne diseases such as onchocerciasis river blindness. Avoid outbreaks. As much as possible, travelers should avoid known foci of epidemic arthropodborne disease transmission.
Wear appropriate clothing. Travelers can minimize areas of exposed skin by wearing long-sleeved shirts, long pants, boots, and hats.
Tucking in shirts, tucking pants into socks, and wearing closed shoes instead of sandals may help reduce risk. Application of repellents or insecticides, such as permethrin, to clothing and gear can provide an added layer of protection. Remind travelers to always follow instructions on the label when applying repellents to clothing.
Additional information on clothing repellents and their proper use is included below. Check for ticks. Travelers should inspect themselves and their clothing for ticks during outdoor activity and at the end of the day. Prompt removal of attached ticks can prevent some infections. Bed nets provide essential protection to travelers staying in accommodations lacking adequate window screens and air conditioning.
Bed nets that do not reach the floor should be tucked under mattresses. Treating bed nets with a pyrethroid insecticide helps maximize their efficacy. Travelers may opt to buy a pretreated net or, as an alternative, apply the insecticide after purchase. Nets treated with a pyrethroid insecticide will be effective for several months if not washed. Long-lasting pretreated nets may be effective for much longer. Insecticides and spatial repellents. Active ingredients in these products, metofluthrin and allethrin, provide protection from mosquito bites over a wide area.
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Spray aerosols can clear rooms or areas of mosquitoes; coils, vaporizing mats, and spatial repellents repel mosquitoes from a circumscribed area. Although many of these products demonstrate insecticidal or repellent activity under particular conditions, their efficacy in preventing vectorborne disease has not been evaluated adequately in peer-reviewed studies. For this reason, reliance on these products alone may afford insufficient protection from bites. CDC has evaluated information published in peer-reviewed scientific literature and data available from EPA to identify several types of EPA-registered products that provide repellent activity sufficient to help people reduce the bites of disease-carrying insects.
Products containing the following active ingredients typically provide reasonably long-lasting protection:. Published data indicate that repellent efficacy and duration of protection vary considerably among products and among mosquito and tick species. Ambient temperature, level of activity, perspiration, water exposure, abrasive removal, and other factors affect efficacy and duration of protection.
In general, higher concentrations of active ingredients provide longer duration of protection, regardless of the active ingredient. Products that offer sustained-release or controlled-release microencapsulated formulations, even with lower active ingredient concentrations, may provide longer protection times.
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Recommendations regarding use of repellents are based on peer-reviewed scientific studies and data submitted to regulatory agencies. People may experience some variation in protection from different products. Ideally, travelers should purchase repellents before traveling. They are sold online as well as in hardware stores, drug stores, supermarkets, camping, sporting goods, and military surplus stores.
When purchasing repellents overseas, look for the active ingredients specified above on the product labels. Repellency Awareness Graphic A new graphic appearing on the label of insect repellents applied to the skin helps consumers more easily identify for how long the repellent is effective against mosquitoes and ticks Figure Use of this graphic by manufacturers is voluntary. From onwards Merian, her daughters and her mother lived with the Labadist community, who had settled on the grounds of a stately home — Walt h a Castle — at Wieuwerd in Friesland.
They stayed there for three years and Merian found the time to study natural history and Latin, the language in which scientific books were written. In Wieuwerd the Labadists engaged in printing and many other occupations, including farming and milling. Visitors came from England, Italy, Poland and elsewhere, but not all approved of the strict discipline , separatism and community property. In , Merian's mother had died. A year later, she moved with her daughters to Amsterdam. In , her husband divorced her.
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In Amsterdam the same year, her daughter Johanna married Jakob Hendrik Herolt, a successful merchant on Surinam, originally from Bacharach. The flower painter Rachel Ruysch became Merian's pupil. By Merian lived in a well-furnished house on Kerkstraat. In , the city of Amsterdam granted Merian permission to travel to Suriname in South America, along with her younger daughter Dorothea Maria.
On 10 July, the fifty-two year old Merian and her daughter set sail. The goal of the mission was to spend five years illustrating new species of insects. In Holland , with much astonishment what beautiful animals came from the East and West Indies. I was blessed with having been able to look at both the expensive collection of Doctor Nicolaas Witsen , mayor of Amsterdam and director of the East Indies society, and that of Mr. Jonas Witsen , secretary of Amsterdam.
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Moreover, I also saw the collections of Mr. Fredericus Ruysch , doctor of medicine and professor of anatomy and botany, Mr. Livinus Vincent , and many other people. In these collections I had found innumerable other insects, but found that their origin and their reproduction is unknown, it begs the question as to how they transform, starting from caterpillars and chrysalises and so on. All this has, at the same time, led me to undertake a long dreamed of journey to Suriname. She worked for two years,  traveling around the colony and sketching local animals and plants.
She recorded local native names for the plants and described local uses. Unlike other Dutch naturalists, Merian was not employed by a commercial enterprise or corporation. But her journey was partly financed by the directors of the Dutch West India Company. She was given a slave helper for her research and the interaction she could thus have with the Amerindian and African slaves in the colony assisted her in researching the plants and animals of Surinam. Merian also took an interest in agriculture and lamented the colonial merchants' resistance to plant or export anything other than sugar.
She later showcased the vegetables and fruits that could be found in Surinam, including the pineapple. In June malaria forced her to return to the Dutch Republic. She sold specimens she had collected and engravings of plant and animal life in Suriname. In , she published a book Metamorphosis Insectorum Surinamensium about the insects of Suriname.
In , Merian suffered a stroke. Despite being partially paralysed she continued her work. Merian first made a name for herself as a botanical artist.
In she started to publish a three volume series, each with 12 plates depicting flowers. The drawings were decorative and not all were drawn based on observation. Some of the flowers in the three-volume series appear to be based on drawings by Nicolas Robert and her step-father Jacob Marrel. Merian included insects among the flowers, again she may not have observed them all herself and some may be copies of drawings by Jacob Hoefnagel. Copying from other artists was an essential part of an artists training at the time.
Butterflies and damselflies interplayed with plants, reflecting the decorative compositions of Hoefnagel.
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