Human myiasis caused by the reindeer warble fly, Hypoderma tarandi, case series from Norway, 2011 to 2016

Abstract

Hypoderma tarandi causes myiasis in reindeer and caribou (Rangifer tarandus spp.) in most northern hemisphere regions where these animals live. We report a series of 39 human myiasis cases caused by H. tarandi in Norway from 2011 to 2016. Thirty-two were residents of Finnmark, the northernmost county of Norway, one a visitor to Finnmark, and six lived in other counties of Norway where reindeer live. Clinical manifestations involved migratory dermal swellings of the face and head, enlargement of regional lymph nodes, and periorbital oedema, with or without eosinophilia. Most cases of human myiasis are seen in tropical and subtropical countries, and in tourists returning from such areas. Our findings demonstrate that myiasis caused by H. tarandi is more common than previously thought. Healthcare professionals in regions where there is a likelihood of human infestation with H. tarandi (regions populated by reindeer), or treating returning travellers, should be aware of the condition. All clinicians are advised to obtain a detailed travel history when assessing patients with migratory dermal swellings. On clinical suspicion, ivermectin should be given to prevent larval invasion of the eye (ophthalmomyiasis). Since H. tarandi oviposits on hair, we suggest wearing a hat as a prevention measure.

A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?

“…The administration of oral ivermectin for myiasis has proven to be effective as it prevents complications in surgery and reduces the difficulty of mechanical removal of the larvae [ 56 ]. Children are vulnerable to nasal [ 57 ], oral [ 57 , 58 ], ocular [ 59 – 61 ], and auricular myiasis [ 57 , 62 ]. Treatment of children with oral ivermectin (200–350 μg/kg) for myiasis is effective [ 30 , 59 – 61 , 63 ] but use in children weighing less than 15 kg has been extremely limited due to the current contraindication [ 38 , 39 ].…”

“…Children are vulnerable to nasal [ 57 ], oral [ 57 , 58 ], ocular [ 59 – 61 ], and auricular myiasis [ 57 , 62 ]. Treatment of children with oral ivermectin (200–350 μg/kg) for myiasis is effective [ 30 , 59 – 61 , 63 ] but use in children weighing less than 15 kg has been extremely limited due to the current contraindication [ 38 , 39 ].…”

Children hospitalized for myiasis in a reference center in Uruguay

“…A significant number of cases requiring exploration and surgical cleaning were recorded in this study. The possible causes were late consultation, the consequent migration of the larvae to deeper planes, and the pathogenic mechanism of C. hominivorax itself [1][2][3][4][5][6][7][8][17][18][19] . The manual removal of larvae is a minimally painful procedure but generates much anxiety in the child and family, especially in cases of cephalic involvement.…”

“…Ivermectin selectively binds to glutamate-regulated chloride channels of parasites' nerve and muscle cells, increasing their permeability and causing paralysis and death. In this series, ivermectin was prescribed in 14 cases: to treat associated parasitosis (scabies or pediculosis) in five cases and due to deep or cavitated myiasis in nine cases [1][2][3][4][5]8,[17][18][19][20][21][22][23] .…”

Report of a rare case of severe allergic reaction due to nasal myiasis and a brief review of the literature in Turkey

“…Myiasis is a term defining condition characterized by infestation of a mammal by fly larvae in order to feed on its tissues. 1 While, in primary, myiasis larvae feed on living tissues, in secondary, myiasis larvae feed on dead tissues. 2 Human myiasis is often classified according to the area infested such as cutaneous, oral, ocular, nasal, urogenital and gastrointestinal myiasis.…”