Iron your clothes and prevent diseases


Cordylobia
anthropophaga, the mango fly, tumbu fly, tumba
fly, putzi fly or skin maggot fly is a species of blow-fly
common in East and Central Africa. It is a parasite
of large
mammals (including humans) during its
larval stage.
Anthropophaga
has been endemic in the subtropics of Africa
for more than 135 years and is a common cause of myiasis
in humans in the region.

Its
specific epithet anthropophaga derives from the Greek
word anthropophagos, “human eater”.


The
mode of infection by the Cayor Worm
Doctors Rodhain and Bequaert conclude, from their observations in
the Congo Free State, that Cordylobia anthropophaga
lays its eggs on the ground. The larvae, known
generally as Cayor Worms, crawl over the soil until
they
come in contact with man or a mammal,
penetrate the skin
and lie in the subcutaneous
tissue, causing the formation of
tumors. On
reaching full growth, the larvae leave the host,
fall to the ground, bury themselves and there – pupate.
This fly is said to be the most common cause of human or animal myiasis in tropical Africa, from Senegal to Natal.
In
the region of Lower Katanga where these
investigations
were made, dogs appeared to be
the principal hosts,
although Cordylobia
larvae were found also in guinea-pigs,
a
monkey and two white men.
The
larvae are always
localized on those parts of the hosts
which come in
immediate contact with the
soil.” (Ann. Soc. Entom. De
Belgique, Iv,
pp. 192–197, 1911) summary translation in
Entomological
News. 1911 Vol. xxii: 467.
History
of Discovery
The
larvae of the tumbu fly, Cordylobia anthropophaga,
were first described in Senegal in 1862, and Blanchard
first
described the adult and gave it its name
in 1893. In 1903,
Grunbert placed the tumbu
fly in a new genus, Cordylobia.
Life
cycle
Female
tumbu flies deposit 100-300 eggs in sandy soil
often contaminated with animal feces. The hatched larvae
can remain viable in the soil for 9–15 days until
they need
to find a host for development.
If
a larva finds a host, it
will penetrate the
skin and take 8–12 days developing
through
three larval stages before it reaches the pre-pupal
stage. It will then leave the host, drop to the ground,
bury
itself, and pupate. It then becomes an
adult fly able to
reproduce and begin the cycle
all over again.
Clinical
Presentation in Humans
Successful
penetrations in humans will result in furuncular
(boil-like) myiasis, typically on the backs of arms or
about
the waist, lower back, or buttocks.
Anthropophaga
rarely causes severe problems, and mainly causes cutaneous myiasis. Geary et
al. describe the presentation of cutaneous myiasis caused by the tumbu fly
thus, “At the site of penetration, a red papule forms and gradually
enlarges. At first the host may experience only intermittent, slight itching,
but pain develops and increases in frequency and intensity as the lesions
develop into a furuncle. The furuncle’s aperture opens, permitting fluids
containing blood and waste products of the maggot to drain.”
Transmission
Female
tumbu flies lay their eggs in soil contaminated with
feces or urine or on damp clothing or bed linens. Damp
clothing hanging to dry makes for a perfect spot. The
larvae
hatch in 2–3 days and attach to
unbroken skin and
penetrate the skin,
producing swelling.[7] If the larvae hatch
in
soil, any disturbance of the soil causes them to wriggle to
the surface to penetrate the skin of the host.
Reservoir
and Vector
A
natural reservoir is defined as an organism that can
harbor a pathogen indefinitely with no ill effects.
Although
C. anthropophaga larvae can cause ill
effects for animal
hosts, because we are
talking about myiasis in humans, we
will
consider any animal hosts as reservoirs.
Many
animals are hosts of C. anthropophaga. The dog is
the most common domestic host and several species of
wild rats are the preferred field hosts. Domestic
fowl are
dead-end hosts, meaning that the
larvae cannot develop
when they enter the
tissue of a fowl.
Humans
are in fact accidental hosts, which mean that
tumbu fly larvae do not usually infect humans. We as a
species are not necessary for the transmission cycle
of the
Fly.
A
vector is an organism that carries the parasites (the
larvae) from one host to another. The tumbu fly itself is
the
vector in a loose sense, because the
female deposits the
eggs in soil or on damp
cloth, where the larvae can hatch
and attach
to human or animal skin.
Diagnostics
Cutaneous
myiasis caused by the tumbu fly should be
suspected when a patient who has just spent time in Africa
presents with ulcers or boil-like sores. Definitive
diagnosis
is only possible when the larvae are
found. They should be
removed and allowed to
develop into adult flies for
identification
purposes.
Treatment
In
cases of cutaneous myiasis, the larvae are most often
removed without an incision. Applying petroleum jelly to
the
skin blocks the breathing hole and cuts
off the larva’s air
supply. This pushes the
maggot to the surface of the skin as
it
searches for air. The larva can then easily be extracted
from the skin. If this does not work, local anesthetic can
be
administered and an incision made to
extract the maggot.
Another
treatment discussed in the March 2014 Journal
of the American Medical Association is to inject a combination of anesthetic and epinephrine into the insect’s
chamber, thus expelling it hydraulically.
Patients
should be monitored for additional and subsequent
lesions, as development does not occur in unison and some
larvae may take longer to reach the pre-pupal stage.
To
prevent bacterial infection after removal
of the larvae,
antibiotics can be
administered.
Epidemiology
C.
anthropophaga is the most common cause of myiasis in
Africa (WHO).
The
tumbu fly is endemic to the tropical regions of Africa,
south of the Sahara desert. Myiasis caused by C. anthropophaga is the most common cause of myiasis in
Africa but can be seen worldwide because of air
travel, as
human movements carry infestation
outside endemic areas.
Public
Health and Prevention Strategies
The
fly commonly infects humans by laying its eggs on wet
clothes, left out to dry. The eggs hatch in one to three
days and the larvae (who can survive without a host
for up
to 15 days) then burrow into the skin
when the clothes are
worn. A prevention method
is to iron all clothes, including
underwear,
which will kill the eggs/larvae.
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