Abstract
Tungiasis is a major health issue in economically marginalized populations in the neotropics. An efficient spreading capacity and flexible lifestyle drive this zoonotic ectoparasite from the endemic South American countries to entire sub-Saharan Africa and other countries. Tunga penetrans and Tunga trimamillata are the two culprit sand fleas that penetrate the human skin around the toes and stay over a month to balloon up impressively producing hundreds of eggs that develop into adults with the minimal requirement. Silently, ecotourism is bringing the parasite from the jigger-infested rotten sufferers to the high-tech environments. Unsuspected clinical presentation in returned travellers can escape proper diagnosis to land upon mistherapeutic thrusts. While an itchy papule may progress to gangrene and sepsis, an additional danger of deadly tetanus also looms. The infrastructural paucity and lack of hygiene are possibly transmitting human immunodeficiency virus and hepatitis viruses through reused needles and instruments from the bloody flea extraction in the resource-poor settings. While the undisturbed surgical extraction of the flea is preferred, any tearing would call upon severe inflammation. Microscopy remains the only way to prudent diagnosis. A heavy toll on animal sufferers multiplies the dispersal and loss of productivity. Neither a vaccine nor medicine has shown the ray of hope. Tungiasis remains a possible yardstick to monitor economic progression.
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Further Reading
Feldmeier H, Eisele M, Sabóia-Moura RC, Heukelbach J. Severe tungiasis in underprivileged communities: case series from Brazil. Emerg Infect Dis. 2003;9(8):949–55. https://doi.org/10.3201/eid0908.030041.
Feldmeier H, Heukelbach J, Ugbomoiko U, Sentongo E, Mbabazi P, von Samson-Himmelstjerna G, et al. Tungiasis—a neglected disease with many challenges for global public health. PLoS Negl Trop Dis. 2014;8(10):e3133.
Heukelbach J. Tungiasis. Rev Inst Med Trop Sao Paulo. 2005;47(6):307–13.
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Linardi P, de Avelar D. Neosomes of tungid fleas on wild and domestic animals. Parasitol Res. 2014;113(10):3517–33.
Luchetti A, Mantovani B, Pampiglione S, Trentini M. Molecular characterization of Tunga trimamillata and T. penetrans (Insecta, Siphonaptera, Tungidae): taxonomy and genetic variability. Parasite. 2005;12(2):123–9.
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Nagy N, Abari E, D’Haese J, Calheiros C, Heukelbach J, Mencke N, et al. Investigations on the life cycle and morphology of Tunga penetrans in Brazil. Parasitol Res. 2007;101(S2):233–42.
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Case Study
Case Study
A 34-year-old man comes to you with few warty lesions adjacent to the right toenail. He noticed those lesions due to intense itching. You observed the lesions with a magnifying lens to discover papular lesions with a central black spot. The patient had a leisure trip to beaches in Brazil last month.
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What are the suggestive points in support of tungiasis?
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How would you confirm?
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What microscopic findings would aid in differentiation from myiasis?
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What will be your advice for the next trip to the same location?
Research Questions
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What is the mechanism of hyperkeratosis and nail deformity in the chronic stages of tungiasis?
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What low-cost effective preventive measures may be suggested for tungiasis?
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What is the extent of tungiasis problem among animals?
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Maiti, S. (2022). Tungiasis. In: Parija, S.C., Chaudhury, A. (eds) Textbook of Parasitic Zoonoses. Microbial Zoonoses. Springer, Singapore. https://doi.org/10.1007/978-981-16-7204-0_61
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DOI: https://doi.org/10.1007/978-981-16-7204-0_61
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