Klebsiella pneumoniae Credit: Uploaded by Muriel Gottrop
http://en.wikipedia.org/wiki/Klebsiella_pneumoniae#/media/File:Klebsiella_pneumoniae_01.png
E. coli
Credit: Rocky Mountain Laboratories, NIAID, NIH
"Disease-producing organisms such as bacteria, protozoa, and viruses have been found in cockroach bodies. Different forms of gastroenteritis (food poisoning, dysentery, diarrhea, etc.) appear to be the principal diseases transmitted by these cockroaches. These disease-causing organisms are carried on the legs and bodies of cockroaches, and are deposited on food and utensils as cockroaches forage. Cockroach excrement and cast skins also contain a number of allergens, to which many people exhibit allergic responses such as skin rashes, watery eyes, congestion of nasal passages, asthma, and sneezing." http://ento.psu.edu/extension/factsheets/american-cockroaches
Pseudomonas aeruginosa CC BY-SA 3.0 File:Pseudomonas aeruginosa and Staphylococcus aureus colonies.jpg Uploaded by New HanseN.
http://en.wikipedia.org/wiki/Pseudomonas_aeruginosa#/media/File:Pseudomonas_aeruginosa_and_Staphylococcus_aureus_colonies.jpg
"They are proven or suspected carriers of the organisms causing:
— diarrhoea
— dysentery
— cholera
— leprosy
— plague
— typhoid fever
— viral diseases such as poliomyelitis. In addition they carry the eggs of parasitic worms and may cause allergic reactions, including dermatitis, itching, swelling of the eyelids and more serious respiratory conditions (4)."
4. Stankus RP, Horner E, Lehrer SB. Identification and characterization of important cockroach allergens. Journal of allergy and clinical immunology, 1990, 86: 781–787. http://www.who.int/water_sanitation_health/resources/vector288to301.pdf

— dysentery
— cholera
— leprosy
— plague
— typhoid fever
— viral diseases such as poliomyelitis. In addition they carry the eggs of parasitic worms and may cause allergic reactions, including dermatitis, itching, swelling of the eyelids and more serious respiratory conditions (4)."
4. Stankus RP, Horner E, Lehrer SB. Identification and characterization of important cockroach allergens. Journal of allergy and clinical immunology, 1990, 86: 781–787. http://www.who.int/water_sanitation_health/resources/vector288to301.pdf
Salmonella
Credit: Rocky Mountain Laboratories, NIAID, NIH
Excerpted from Everything You Didn’t Want to Know About Cockroaches By Rebecca Kreston:
Excerpted from Everything You Didn’t Want to Know About Cockroaches By Rebecca Kreston:
"All types of passengers are welcome on this cockroach bus. Over 30 species of bacteria have been found on the cuticle and gut of roaches, including those of serious medical import such as E. coli, various species of Salmonella and Staphylcoccous, Pseudomonas aeruginosa and Klebsiella pneumoniae (4). These bacteria cause diseases such as urinary tract infections, dysentery, diarrhea, pneumonia, cholera, polio, septicemia and wound infections (5). One study that trapped cockroaches in order to measure their bacterial load found that number was as high as 14 million microbes found on the exterior of the bodies, and 7 million in their fecal droppings (5).
Credit: CDC Division of Parasitic Diseases http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Ascariasis_il.htmhttp://www.dpd.cdc.gov/dpdx/images/ParasiteImages/A-F/Ascariasis/Ascaris_female.jpg

Trichuris trichiura Credit: Delorieux for Johann Gottfried Bremser, uploaded by Citron
"Viable eggs and dormant cysts of parasites also hitch a ride; the culprits include the ova of Ascaris lumbricoides (giant roundworm), Anchylostoma deodunale (hookworm), Trichuris trichura (whipworm), Enterobius vermicularis (pinworm) and Strongyloides stercoralis (threadworm), and the cysts of Entomoeba hystolitica, Balantidium coli, C. parvum, C. cayetenensis and Isospora belli (4). Even the virus that causes polio, poliomyelitis, has been found within the guts of cockroaches (6).
Enterobius vermicularis. Posterior end of the worm in File:Evermicularis SC anterior.jpg. Note the long, slender pointed tail. Credit:
-http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/A-F/Enterobiasis/body_Enterobiasis_il2.htm

-http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/A-F/Enterobiasis/body_Enterobiasis_il2.htm
Strongyloides stercoralis larva.jpg Uploaded by Salvadorjo
This micrograph stained with chlorazol black, revealed an Entamoeba histolytica cyst. Several protozoan species in the genus Entamoeba infect humans, but not all of them are associated with disease. Entamoeba histolytica is well recognized as a pathogenic ameba, associated with intestinal and extraintestinal infections. This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #1474. -
Balantidium coli
Cryptosporidium parvum
Credit: United States Environmental Protection Agency/H.D.A. Lindquist
Illustration of Isospora belli life cycle
Credit: CDC/Alexander J. da Silva, PhD/Melanie Moser
Credit: CDC/Alexander J. da Silva, PhD/Melanie Moser
ID#:3398 This is an illustration of the life cycle of Isospora belli, the causal agent of Isosporiasis. At time of excretion, the immature oocyst contains usually one sporoblast (more rarely two) (1). In further maturation after excretion, the sporoblast divides in two (the oocyst now contains two sporoblasts); the sporoblasts secrete a cyst wall, thus becoming sporocysts; and the sporocysts divide twice to produce four sporozoites each (2). Infection occurs by ingestion of sporocysts-containing oocysts: the sporocysts excyst in the small intestine and release their sporozoites, which invade the epithelial cells and initiate schizogony (3). Upon rupture of the schizonts, the merozoites are released, invade new epithelial cells, and continue the cycle of asexual multiplication (4). Trophozoites develop into schizonts which contain multiple merozoites. After a minimum of one week, the sexual stage begins with the development of male and female gametocytes (5). Fertilization results in the development of oocysts that are excreted in the stool (1). Isospora belli infects both humans and animals.

This photomicrograph revealed stool exudates in a patient with shigellosis, which is also known as “Shigella dysentery”, or “Bacterial dysentery”. Usually, those who are infected with Shigella develop diarrhea, which is often bloody, fever, and stomach cramps starting a day or two after they are exposed to the bacterium.
Credit: Centers for Disease Control and Prevention Public Health Image Library
Excerpted from Everything You Didn’t Want to Know About Cockroaches By Rebecca Kreston: "There are several documented cases of small outbreaks that pinpoint to cockroaches playing an indirect but prominent role in disease transmission. In one county in Northern Ireland in the late 1970s, fifteen food-handlers in various establishments fell ill to dysentery caused by the Shigella bacterium over the course of eight weeks (2). These restaurants had serious infestations, particularly in the kitchen and dining areas, and the stomach contents of trapped roaches showed viable Shigella dysenteriae serotype 7 bacteria, incriminating the arthropods in the spread of the disease.
Hepatitis A virus
Credit: CDC/Betty Parvin
"Cockroaches were also suspected to be the cause of a hepatitis A outbreak in a Los Angeles housing project in the late 1950s. From 1956 to 1959, the Carmelitos Housing Project represented 39% of all cases of hepatitis A in Los Angeles County with numbers of the infected steadily increasing through the years (7). It was only until a full-scale cockroach control program employing a newly developed insecticide, the industrial silica aerogel Dri-Die 67, was the outbreak halted. Two years following the program, incidences of hepatitis A from the Housing Project dropped to 0.0% and cockroaches traversing between the sewage system and the Project were pinpointed as the source of the epidemic.
Rose spots on the chest of a patient with typhoid fever due to the bacterium Salmonella typhi. Symptoms of typhoid fever may include a sustained fever as high as 103° to 104° F (39° to 40° C), weakness, stomach pains, headache, loss of appetite. In some cases, patients have a rash of flat, rose-colored spots.
Credit: Centers for Disease Control and Prevention Public Health Image Library
Excerpted from Everything You Didn’t Want to Know About Cockroaches By Rebecca Kreston:
"Typhoid patients in Italy were found to have cockroaches harboring S. typhi in their homes in a study conducted in 1943 (2). Similarly, the same organism was found in cockroaches infesting a Belgian hospital’s children’s ward undergoing an epidemic of gastroenteritis in 1950 (2). Most recently, outbreaks of Klebsiella pneumoniae in neonatal units have been tied to cockroach infestations in hospitals in Ethiopia and South Africa (8)(9). These studies indicate that cockroaches may play an unappreciated role in the epidemiology of infections in both the home and hospital.
"Typhoid patients in Italy were found to have cockroaches harboring S. typhi in their homes in a study conducted in 1943 (2). Similarly, the same organism was found in cockroaches infesting a Belgian hospital’s children’s ward undergoing an epidemic of gastroenteritis in 1950 (2). Most recently, outbreaks of Klebsiella pneumoniae in neonatal units have been tied to cockroach infestations in hospitals in Ethiopia and South Africa (8)(9). These studies indicate that cockroaches may play an unappreciated role in the epidemiology of infections in both the home and hospital.
"Though it’s difficult to say what part roaches play in small disease outbreaks, they are capable of harboring antibiotic-resistant bacteria. A 2012 study in Ethiopia looked at cockroaches trapped in a neonatal intensive care unit and found widespread multi-drug resistance among individual species of bacteria residing in the roaches. Reading the lists of antibiotics these bacteria were found to be resistant to is like a “who’s who” of the antibiotic world – ampicillin, augmentin, tetracycline, chloramphenicol, amoxicillin, doxycycline, and ciprofloxacin (8). An earlier study in South Korea found that cockroaches trapped in homes located 3 miles from a hospital harbored bacteria that were resistant to anywhere from 6 to 12 commonly used antibiotics (3). These medications are the mainstay for treating bacterial infections and the discovery that cockroaches in hospitals harbor bacteria no longer susceptible to them is discomfiting to say the least."
References
(2) Burgess NR & Chetwyn KN. (1981) Association of cockroaches with an outbreak of dysentery. Trans R Soc Trop Med Hyg. 75(2): 332-3
(3) Hsiu-Hua P et al. (2005) Isolation of bacteria with antibiotic resistance from household cockroaches (Periplaneta americana and Blattella germanica) Acta Tropica 93: 259–265 T
(4) Tatfeng YM et al. (2005) Mechanical transmission of pathogenic organisms: the role of cockroaches. J Vect Borne Dis. 42: 129–134
(5) Chaichanawongsaroj et al. (2004) Isolation of gram-negative bacteria from cockroaches trapped from urban environment. Southeast Asian J Trop Med Public Health. 35(3): 681-4(6) Healing TD. (1993) Arthropod Pests as Disease Vectors. Proceedings of the First International Conference on Urban Pests. Accessible here.
(7) Tarshis IB. (1962) The cockroach–a new suspect in the spread of infectious hepatitis. Am J Trop Med Hyg 11: 705-11
(8) Tilahun et al. (2012) High load of multi-drug resistant nosocomial neonatal pathogens carried by cockroaches in a neonatal intensive care unit at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. Antimicrobial Resistance and Infection Control. 1: 12
(9) Cotton MF et al. (2000) Invasive disease due to extended spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal unit: the possible role of cockroaches. J Hosp Infect. 44(1): 13-7
http://blogs.discovermagazine.com/bodyhorrors/2012/05/09/cockroaches/#.VRgiDijfbII
References
(2) Burgess NR & Chetwyn KN. (1981) Association of cockroaches with an outbreak of dysentery. Trans R Soc Trop Med Hyg. 75(2): 332-3
(3) Hsiu-Hua P et al. (2005) Isolation of bacteria with antibiotic resistance from household cockroaches (Periplaneta americana and Blattella germanica) Acta Tropica 93: 259–265 T
(4) Tatfeng YM et al. (2005) Mechanical transmission of pathogenic organisms: the role of cockroaches. J Vect Borne Dis. 42: 129–134
(5) Chaichanawongsaroj et al. (2004) Isolation of gram-negative bacteria from cockroaches trapped from urban environment. Southeast Asian J Trop Med Public Health. 35(3): 681-4(6) Healing TD. (1993) Arthropod Pests as Disease Vectors. Proceedings of the First International Conference on Urban Pests. Accessible here.
(7) Tarshis IB. (1962) The cockroach–a new suspect in the spread of infectious hepatitis. Am J Trop Med Hyg 11: 705-11
(8) Tilahun et al. (2012) High load of multi-drug resistant nosocomial neonatal pathogens carried by cockroaches in a neonatal intensive care unit at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. Antimicrobial Resistance and Infection Control. 1: 12
(9) Cotton MF et al. (2000) Invasive disease due to extended spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal unit: the possible role of cockroaches. J Hosp Infect. 44(1): 13-7
http://blogs.discovermagazine.com/bodyhorrors/2012/05/09/cockroaches/#.VRgiDijfbII
"Kamble and Keith [6] note that most cockroaches produce a repulsive odor that can be detected in infested areas. The sight of cockroaches can cause considerable psychologic or emotional distress in some individuals. They do not bite, but they do have heavy leg spines that may scratch."
6. Kamble ST, Keith DL. Cockroaches and their control. Lincoln, NE: University of Nebraska Cooperative Extension; 1995.
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