Background/Objectives: Chronic wounds represent a growing challenge for the aging population, significantly impairing their quality of life, increasing the frequency of medical consultations, and imposing substantial healthcare costs. Chronic wounds are prone to complications, including local and systemic infections, and in severe cases, amputations. The therapeutic use of live larvae from the blowfly Lucilia sericata (biological debridement) has regained attention for its ability to debride necrotic tissue and stimulate granulation. Despite its benefits, this therapy is constrained by the logistical challenges of producing and delivering live larvae and by patient adherence issues. Objectives: This study aimed to develop a lyophilized extract of Lucilia sericata larvae and evaluate its efficacy in treating chronic wounds. Methods: A lyophilized maggot extract (Larveel®, Alpha-Biocare GmbH, Neuss, Germany) of the larvae of Lucilia sericata was produced under GMP conditions. In a total of ten patients with chronic refractory wounds, the extract was used in individual therapeutic trials and its effect on bacterial colonization and wound healing was investigated. Wound healing was documented photographically and measured visually in terms of a reduction in the wound slough, an increase in the granulation tissue, and a reduction in the wound area. Results: Of the ten patients, three discontinued their treatment due to P. aeruginosa colonization. In seven patients, significant fibrin reduction, granulation, and wound healing occurred, with two achieving complete closure and four showing advanced epithelialization. Conclusions: In 7 of the 10 patients, the application of the extract led to a marked reduction in wound slough, and improved granulation and the progression of wound healing. These effects are likely attributable to the extract’s ability to disrupt bacterial biofilm formation. The findings suggest that this novel therapeutic approach may provide a practical and effective alternative to live larval therapy for managing chronic wounds.

The so-called Silk Road connected during the Middle Ages regions of China of our days to Southern regions in Europe, passing countries like Iran, Iraq, Kazakhstan, etc., of our days, since European people wanted materials and products based on silk. These East-Western connections led to cultural connections as well as to the exchange and transfer of severe bacterial diseases like plague and cholera as well as viral diseases like Spring-summer-meningo-encephalitis/tick-borne encephalitis (Fig. 6.1).

The term Silk Road was created in the Middle Ages for a rather low spectrum of streets (roads) being used to transport goods from China to Europe and back, passing different cultures. However, not only goods had been and are still today (intensively) spread along this pathway, but also agents of (often) severe diseases. Thus, constant control systems have to be established and permanently controlled with respect to their efficacy. Today, it takes only a few days (if not hours) until persons, goods, and agents of diseases are transported from one continent to the other. The old and the present pathways are enlarged daily, thus increasing the worldwide network.

This paper considers the recent status of the spreading of malaria, the symptoms of disease and the chances and needs of control. Worldwide many countries have started projects, which target the elimination of malaria in order to protect their inhabitants and tourists. However, final elimination of malaria is far from being totally successful. This is due to the fact that infected persons may travel without symptoms in many countries and spread their infectious load. Furthermore poor countries cannot induce and steer elimination programs. Thus tourists and foreign workers are highly advised to protect themselves by use of repellents when entering endemic countries.

Humans and their animals are worldwide attacked by different groups of flies. The adults which may transfer various types of agents of diseases and their larvae even may enter the body of humans thus inducing eventually severe or even lethal diseases called myiasis. These parasites occur worldwide and thus also can be found often in large numbers in warm regions of the South American continent. Some common and important species are the targets of the present chapter.

Biofilms are aggregates of bacteria encased in an extracellular polymer matrix that acts as a diffusion barrier protecting the microbial community. Bacterial communication occurs by small signaling molecules called quorum sensing (QS) factors, which are involved in the activation of virulence genes and formation of biofilms. Larvae of the green bottle blowfly Lucilia sericata remove necrotic tissue by mechanical action (debridement) and proteolytic digestion. We produced a freeze-dried storable powder from larval extract and investigated its therapeutic effect on biofilms. Larval extract in concentrations of 6 and 12 mg/mL in combination with 0.5% antibiotics (≙50 U/mL penicillin and 50 μg/mL streptomycin) diminished free-floating (planktonic) Pseudomonas aeruginosa maintenance, while it showed no effect on Staphylococcus aureus and was not toxic to dermal cells. We established an ex vivo human dermal wound model. Larval extract in concentrations of 24 and 75 mg/mL in the presence of antibiotics (0.5%) significantly destroyed the biofilm stability of both P. aeruginosa and S. aureus biofilms. Furthermore, SEM analyses revealed crack and gap formations on P. aeruginosa. biofilm surface and decreased expression of P. aeruginosa biofilm maturation and virulence genes (lasR, rhlR and rhlA) was observed after treatment by larval extract in combination with antibiotics.

The risk of malaria recurrence increases due to the main vector, Anopheles pharoensis. The physiological age of the mosquito population is needed to expect malaria vector dynamics. The number of completed gonotrophic cycles is of great importance in determining the physiological age of females. A technique has been described that focuses on the number of dilatations remaining in the ovarioles after each oviposition to determine how many blood meals have been taken. At each gonotrophic cycle, the chances of infection of the vectors are repeated. The histological changes that occur immediately in the ovarioles and ovulation itself were studied. Under the influence of the contractions of the ovarian muscles, the eggs begin to move over the distal end of the ovariole into the inner oviduct. The terminal pedicle is markedly dilated near the diameter of the eggs. After the expulsion of the mature eggs, ovariole dilations were found at the point of their development in the terminal pedicle due to the accumulation of nurse cell remnants and follicular epithelium. The results were used to develop epidemiological localization and to evaluate the effectiveness of antimalaria interventions. The ovarian inspection often provides a technique to distinguish nulliparous from parous female anophelines. In addition, this study can provide basic entomological knowledge on the physiological age of mosquitoes by considering the histological changes in the ovaries, which allow the evaluation of vector management strategies in the field.

The skin of humans and animals is attacked by a broad spectrum of mites belonging to the genera Sarcoptes and Demodex, which may induce severe skin diseases. This article presents an overview on their morphology, their infection pathways, their reproduction, diagnostic and control measurements.

Hookworms (= bloodsucking nematodes) belong to the group of the most common and extremely dangerous worms worldwide. They attack humans as well as animals, especially in so-called developing countries in warm climates as in South America. Especially people living in regions with a low-graded health system are still today highly endangered and suffer from large numbers of death cases ranging from young kids to old persons. The present chapter gives insights into the life cycle of these worms, their morphology, their life cycle, prevention methods, and treatment changes in times of progressing drug resistances. Thus it is time to ameliorate the hygienic systems in these countries by the help of the One Health program and by information targeted to a broad spectrum of endangered people how to avoid infections.