but there are no reliable statistics on worldwide cases. Dengue viruses are a significant health risk globally. Severe cases of dengue often require hospitalization and can be life-threatening shortly after infection. Symptoms include a high fever, aches and pains, vomiting, and rashes. Warning signs of severe dengue infection include vomiting blood, bleeding from the gums or nose, and stomach tenderness/pain. Equine encephalitis viruses, such as Eastern equine encephalitis virus, Western equine encephalitis virus, and Venezuelan equine encephalitis virus, can be spread by mosquito vectors such as Aedes taeniorhynchus. Tularemia, a bacterial disease caused by Francisella tularensis, is variously transmitted, including by biting flies. Culex and Culiseta are vectors of tularemia, as well as arbovirus infections such as West Nile virus. Zika, recently notorious, though rarely deadly, causes fever, joint pain, rashes and conjunctivitis. The most serious consequence appears when the infected person is a pregnant woman, since during pregnancy this virus can originate a birth defect called microcephaly. St. Louis Encephalitis, a mosquito-borne disease that is characterized by fever and headaches upon initial onset of infection, arises from mosquitoes who feed on birds who are infected with the illness, and can result in death. The most common vector of this disease is Culex pipiens, also known as the common house mosquito. Heartworm disease, a parasitic roundworm infection that affects dogs and other canids. Mosquitoes transmit larvae to the definitive host through bites. Adult heart worms infest the right heart and pulmonary artery, where they can cause serious complications including congestive heart failure. Potential transmission of HIV was originally a public health concern, but practical considerations and detailed studies of epidemiological patterns suggest that any transmission of the HIV virus by mosquitoes is at worst extremely unlikely. Various species of mosquitoes are estimated to transmit various types of disease to more than 700 million people annually in Africa, South America, Central America, Mexico, Russia, and much of Asia, with millions of resultant deaths. At least two million people annually die of these diseases, and the morbidity rates are many times higher still. Methods used to prevent the spread of disease, or to protect individuals in areas where disease is endemic, include: Vector control aimed at mosquito control or eradication Disease prevention, using prophylactic drugs and developing vaccines Prevention of mosquito bites, with insecticides, nets, and repellents Since most such diseases are carried by "elderly" female mosquitoes, some scientists have suggested focusing