Images of mite bites on human skin: Pictures of Bug Bites, Stings, Allergies, and Infections
Mites That “Bug” People | NC State Extension Publications
On a world-wide basis, mites are important nuisance pests and some are capable of transmitting disease agents. Fortunately, the mites that we commonly encounter in North Carolina do not transmit disease agents that affect people. The majority of mites are free-living. Some are beneficial feeding on decaying organic matter while others are predators of insects and other mites. There are also thousands of species that are parasites of animals or plants. Most of these are external parasites (i..e., they feed on the exterior of their hosts), but some species inhabit the ear canals, lungs, intestine and bladder of vertebrates, particularly domestic animals. Their biting and bloodsucking behavior can cause considerable discomfort to their hosts and a few species also cause serious allergic reactions, such as asthmatic attacks, in people. Because of their relatively small size, mites are often the “suspects” of a whole range of biting/itching symptoms. Understanding mite biology and the symptoms associated with mite infestations can help determine if they are the actual cause of a particular problem.
Mites are not insects; they are more closely related to ticks and spiders. Most mites are visible to the unaided eye and usually measure 1⁄8 inch or less in length. Their life cycle has four basic stages: egg, larva, nymph and adult (Figure 1). The egg hatches into a larval stage, which molts to the nymphal stage. After 1-2 more times, the nymph matures into an adult. Mites, like ticks, have three pairs of legs as larvae and four pairs of legs as nymphs and adults. The life histories of some common mites associated with people are described below.
Figure 1. Example of a mite life cycle.
Mike Merchant, Texas A&M
Sarcoptes scabiei, commonly known as the scabies, mange or itch mite, is a parasite of humans and other animals. Scabies mites are host-specific. The varieties of scabies that infest domestic animals can penetrate the skin of humans and cause the typical itching and rash, but they cannot complete their life cycles there. The adult female burrows into the outer layer of the skin (epidermis) where she feeds on tissue fluids and lays eggs that she cements to the floor of the burrow. Females lay eggs at a rate of up to 3 per day for a period of 8 weeks, producing about 200 eggs over her lifetime. These eggs hatch in 3-4 days and the newly-hatched larvae emerge from the burrows onto the surface of the skin and molt to form the first nymphal stage.
The rash and intense itching associated with scabies occurs when the nymphs burrow into the skin and begin feeding. These symptoms usually appear several weeks to a month after the initial infestation. The majority of mites are found in lesions in folds of skin between the fingers, on the sides of the feet, on the wrists and genitals, and in the bends of the knees and elbows. After feeding on tissue fluids, the nymphs molt to become adults. The life cycle, from egg to adult, can be completed in about two weeks. Scabies mites are readily transmitted within families and within institutions such as nursing homes. Personal contact, particularly holding or shaking the hands of an infested person, is a principal method by which the mites are spread. Intimate contact and sleeping with an infected person can also spread the mites.
Proper treatment and control of a scabies problem requires:
- Positive diagnosis of the problem by a physician. Scabies mites are extremely small; females measure about 1⁄60 inch. In the case of both scabies and straw itch mites, the rash or bites associated with these mites is the primary diagnostic characteristic.
- Application of an insecticide-containing prescription lotion to the body. Because there is time lag between the initial mite infestation and the appearance of symptoms, family members or people coming in close contact with infested persons may require treatment as well. Follow the directions for using these products carefully. Overuse of these lotions can cause skin reactions or sensitivity.
- Sanitation is extremely critical to successful control. An infested person’s clothing and bed linen should be washed regularly in hot, soapy water. NOTE: Human scabies mites cannot survive off a host for more than about 24 hours. Therefore, insecticide foggers (“bug bombs”) and sprays to furniture, carpeting or other areas do not help eliminate the problem and are unnecessary.
Eutombicula alfreddugesi are very small, reddish mites that feed only in the larval stage on humans and other animals, particularly rodents. The red color of the larvae is not blood but a natural red pigment. On animals, chigger larvae remain attached to the skin for several days but on humans, they are usually dislodged within several hours of attachment. Unlike scabies mites, chiggers do not burrow into the skin. They feed at the base of a hair follicle or in a pore (Figure 2). Chiggers generally attach to those areas of the body where clothing fits tightly, such as at the sock line and waistline. Larvae ingest lymph and partially digested cells after the chigger attaches. The bites commonly cause itching in about 3 to 6 hours and dermatitis develops in about 10 to 16 hours. Some people experience allergic reactions to the bites and develop blister-like lesions. Chiggers do not transmit any diseases to people. The adults and nymphs are free-living predators of insects. In the South, chiggers can be active virtually year round. They are commonly encountered at the woodland borders, along the periphery of swamps, and in shrub thickets and unmowed areas of lawn. Areas that contain thick layers of pine straw, leaf litter or thatch are suitable habitats for chiggers and their prey. Treating chigger-infested areas with a pesticide spray will provide some control. Ground cover in these areas should be wetted down to the soil surface. Avoid excess treatments that can lead to pesticide runoff into creeks, streams and storm sewers. For personal protection, use insect repellents. DEET or Permanone (permethrin) can be applied to clothing. DEET is appropriate to use on exposed skin. Repellents should be used in moderation by children and pregnant women. For more information about repellents, see Insect Repellent Products.
Note: Another red-colored mite often seen in the springtime and mistaken for a chigger is the clover mite which is a plant and nuisance pest (see below).
Figure 2. Chigger bites on person’s leg.
M.A. Parsons, CDC
Pyemotes tritici commonly breed in stored grain, dried beans and peas, wheat straw, hay and other dried grasses. They are frequently a problem for people doing landscaping or feeding horses and other livestock. The mites are actually beneficial because they attack insects that feed on stored grain and similar materials. People who handle mite-infested materials will be attacked. The bites of straw itch mites are characteristically found on the trunk of the body and on the arms.
The best control strategy is to eliminate the mite’s host insects. If possible, clean storage areas thoroughly and then treat the areas with a pesticide, such as cyfluthrin. Treating the straw is difficult because the mites are inside the bales as well as on the surface and there is no way to treat the entire bale. Additionally, there are no insecticidal sprays labeled in North Carolina for application to hay that is use used as feed for animals. If necessary, stored commodities can be fumigated with Phostoxin® to disinfest them. Fumigation should be performed by persons holding the appropriate private applicator license or North Carolina F-phase structural pest control license or certification. More importantly, the individual must have the technical training to handle these products safely. Fumigated hay must be handled properly to make certain it is fumigant free before using it.
The northern fowl mite (NFM), Ornithonyssus sylviarum, is the most common species of bird mite in North Carolina and can be a pest of domestic fowl, pigeons, starlings, house sparrows and other wild birds commonly associated with people. Mite populations build up rapidly and a generation can be completed in 5 to 12 days. Several generations occur each year. Northern fowl mites spend virtually their entire life on the host bird. They can survive off a host for about a week or so. Mites that fall off host birds may be found wandering indoors. In poultry houses, they are sometimes found in the litter or on eggs, crates and cages.
Dermanyssus gallinae, the chicken mite (or red mite of poultry), is similar to the fowl mite in its host preferences. Unlike NFM, the chicken mite spends much of its time off the host bird, hiding in cracks and crevices during the day and feeding at night. Depending on environmental conditions, they can survive for several months off of a host. It can be a serious problem to workers who handle birds. Around residences and other structures, mite problems tend to be more sporadic. Bird nests are often located in chimneys and tucked under eaves or window-mounted air conditioners. In the spring, nestling birds may be parasitized by thousands of mites. When the nestlings mature and leave their nest, mites may invade buildings in search of alternate hosts.
In some areas of the state, bird mite problems may continue year round because hosts such as pigeons are constantly present. Mites that find their way indoors are easily removed by vacuuming or can be killed with an aerosol insecticide. The key to reducing bird mite problems is to prevent the birds from nesting on/in structures and to remove abandoned nests quickly. Although pigeons, starlings and sparrows can be removed readily, birds such as chimney swifts are protected under the 1918 Federal Migratory Bird Treaty Act and cannot be disturbed. The best approach is to install a screened chimney cap in early spring or fall when the birds are not present.
Dermatophagoides pteronyssinus and D. farinae are the most common species of house dust mites in North Carolina. These tiny mites are most abundant in warm, humid areas. House dust mites do not bite or sting, but they may cause a skin reaction. They feed on “dander,” shed human skin scales that collect in the dust on furniture, particularly mattresses and on carpeting below beds, couches, and chairs where people spend significant time. House dust mites are important medically because they produce allergens in their secretions and excrement. Inhaling airborne house dust containing mite feces and cast skins is a common cause of asthma in young children.
Products containing benzoyl benzoate and other ingredients are often used for severe infestations of house dust mites. Since dust mites can cause respiratory problems, avoid using insecticides that may further aggravate such conditions. The long-term solution to reducing a house dust mite problem is sanitation and environmental modifications:
- Vacuum (possibly with a HEPA-filtered vacuum cleaner) frequently and thoroughly to remove mites and the organic debris on which they feed. Target critical areas, such as:
- mattresses and bed frames
- rugs and carpets
- overstuffed furniture (and the area underneath)
- Replace or clean air conditioner filters frequently and maintain low (less than 50%) indoor humidity to reduce conditions favorable to dust mites.
- Encase mattresses and pillows in plastic covers and change bed linen frequently to help prevent mite populations from building up.
Bryobia praetiosa is a small (1/32 inch) mite easily recognized because of its reddish-brown color and long pair of front legs that are often mistaken for antennae. Clover mites do not bite. They are a nuisance because hot dry weather in the spring and early summer nay cause clover mites to migrate indoors. In the fall, the mites may also migrate indoors seeking shelter from low winter temperatures. In attempting to remove the mites, homeowners often crush them, leaving red stains on furniture and drapes. Mite invasions are most common from vigorously-growing lawns and other vegetation surrounding homes, especially if shrubs are close to or touching the walls.
There is some anecdotal evidence that suggests that applying too much nitrogen fertilizer may worsen clover mite problems. A simple, non-chemical control method involves leaving a strip (12-18 inches) of bare soil or gravel mulch around foundation walls (Figure 3). This plant-free zone discourages mites from migrating onto the walls and provides an area that is easily treated if needed. If mites become a problem, application of a miticide to nearby foliage and lawns may help. Insecticides applied to foundation walls, door thresholds and window ledges make an excellent barrier. Indoors, the mites are easily killed with aerosol insecticide sprays, but vacuuming is a preferable alternative. Sevin®, cyfluthrin, bifenthrin, and permethrin sold under a variety of brand names are examples of pesticides that are currently labeled for such use. Read the pesticide label carefully and select products appropriate for use indoors or outdoors as needed. For additional information about clover mites as a pest in turf, refer to Clover Mites in Home Lawns.
Figure 3. Gravel mulch can help slow pests such as clover mites.
M. Waldvogel, NC State
Sensations of bites and rashes for which a specific cause cannot be identified are often attributed to so-called “paper mites” (because they are associated with paper stored in cabinets or boxes) or to “pepper mites” (because of black pepper-like specks found on window sills and other surfaces). These are not actual mites and In these situations, the objects seen are typically nothing more than debris or possibly “booklice” which are non-biting insects that are sometimes found in old boxes of stored books and papers stored in attics, closets, or garages. Other actual biting/stinging pests, such as fleas and bedbugs, are easily seen and produce very noticeable and characteristic bites and other evidence of their feeding. Although mites are extremely small, they are usually detectable with the unaided eye (as in the case of bird mites) or by skin scrapings or biopsy or other samples collected and examined by a physician. In the case of scabies and straw itch mites, the rash or bites caused by these mites help in identifying them as the cause of the problem. However, bit marks (or presumed bite marks) are not entirely reliable on their own to confirm the cause of the problem.. Very often we unconsciously and repeatedly scratch irritated areas of the skin (particularly at night while sleeping) and this will only worsen the condition. Bird mites, “black pepper mites” and “paper mites” are often used as reasons to justify pesticide treatments in homes and offices. Pesticide applications made without first identifying a specific pest problem (and target application site) are usually ineffective and should not be used. More importantly, repeated and widespread pesticide applications are potentially hazardous to you and others around you. This includes constant (and multiple) applications of insect repellents and other insecticides to your skin (which can cause rashes and irritation) and to your clothing and / or bedding. You need to identify the cause of a problem before you resort to spraying any pesticides in your home.
Here are some tips for collecting specimens for identification.
- Repeated scraping or gouging into your skin with razors, knives or other items in order to collect samples or “relieve” the symptoms may actually worsen the problem and even result in a secondary infection. Specimens containing bodily fluids, skin tissue, etc. should be collected and examined by a medical professional.
- Never use adhesive (“Scotch”) tape to “trap” specimens on your skin. Key features that are important for pest identification can easily be damaged or obscured.
- Use mouse glueboards, or cockroach sticky traps (available at most hardware stores) as monitors. Keep track of where and when you place each one. Such information may be critical if mites or insects are found. If sending glueboards through the mail, first cover the glue surface with clear plastic wrap.
- Brush/knock suspected specimens from your clothing or skin onto a light-colored piece of paper or cardboard.
- Use a fine artist paint brush to pick up the specimens. Place them carefully into a small prescription vial or bottle filled with alcohol (rubbing alcohol should work). Label the vial as to where you collected the specimen.
- Make sure that the vial/bottle is sealed tightly so that the contents do not leak.
- Take the specimen to your county Cooperative Extension center.
- Please note: Samples of bodily fluids, excise (removed/scraped) skin, etc. will not be accepted by Cooperative Extension staff. These are considered medical samples. Contact your primary care physician for advice. Similarly, do not send vacuum cleaner bags filled with debris and possibly pesticide-laden dust. These items pose a potential hazard to the people handling them and will simply be discarded.
If no insects or mites can be found, then you need to keep a broad perspective and consider other possible non-arthropod (insects, mites, spiders, etc.) causes for your symptoms. A previously unidentified (or recently developed) allergy or sensitivity may a mimic biting sensation and bite-like marks or rashes. These allergies can include: certain foods, chemicals (including laundry detergents), dust, pollen, as well as interactions among medications (and even medications with various health supplements). Even changes in your indoor environment (e.g., changes in humidity) and stressful situations can trigger skin reactions and sensitivities. Medications and other products intended for use on pets and/or livestock should never be used on a person. Repeated use of “natural” treatments or frequent (several times daily) bathing or showering can dry your skin too much and cause itching or sensitivity. For that reason, you should consult your family physician or preferably a medical specialist such as a dermatologist, allergist, neurologist, etc.
When mites attach to skin, the saliva they secrete causes the intense itch that may be felt for several days after the mite is no longer attached. As soon as possible after walking through chigger-infested areas or being exposed to other mites, you should bathe in hot, soapy water and scrub down with a wash cloth. Oral antihistamines and/or application of a hydrocortisone cream to bites may help to relieve itching. If you develop a severe reaction, then consult your physician.
Axtell, R. C., and J. J. Arends. 1990. Ecology and management of arthropod pests of poultry. Annual Review of Entomology. 35: 101-126.
Fine, Robert M., and Harold G. Scott. 1965. Straw itch mite dermatitis caused by Pyemotes ventricosus: comparative aspects. Journal of the Southern Medical Association. Vol. 58, No. 4., pages 416-420.
Goddard, Jerome. 1993. Physician’s Guide to Arthropods of Medical Importance. CRC Press.
- Michael Waldvogel
Extension Specialist (Household & Structural Entomology)
Entomology and Plant Pathology
- Matt Bertone
Director, Plant Disease and Insect Clinic
Entomology & Plant Pathology
- Charles Apperson
Entomology and Plant Pathology
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Publication date: June 1, 2015
Revised: March 18, 2020
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Mite Bites – Injuries; Poisoning
Dermatitis is caused by mites that occasionally bite humans but are ordinarily ectoparasites of birds, rodents, or pets and by mites associated with plant materials or stored food or feed.
Bird mites may bite people who handle live poultry or pet birds or who have birds’ nests on their homes.
Rodent mites from cats, dogs (especially puppies), and rabbits may bite people.
Swine mange mites (S. scabiei var suis) from pig farms or pet pigs may also bite humans.
The straw itch mite (Pyemotes tritici) is often associated with seeds, straw, hay, and other plant material; it is a parasite of soft-bodied insects that are or have been present in such materials. These mites often bite people who handle the infested items. Granary workers, people who handle grass seeds or grass hay, and people who make dried plant arrangements are most at risk.
House dust mites do not bite but feed on sloughed skin cells in pillows and mattresses and on floors (especially on carpets). They are significant because many people develop pulmonary hypersensitivity to allergens in the exoskeletons and feces of house dust mites.
Symptoms and Signs of Mite Bites
Most bites cause some version of pruritic dermatitis; pruritus due to chigger bites is especially intense.
Diagnosis of Mite Bites
Diagnosis of burrowing mites can often be made presumptively based on history and a scabies-like pattern of skin lesions. If the diagnosis is unclear or if treatment is ineffective, the diagnosis can be confirmed by skin biopsy.
Treatment of Mite Bites
Treatment of nonburrowing mite bites is symptomatic. Topical corticosteroids or oral antihistamines are used as needed to control pruritus until the hypersensitivity reaction resolves. Through discussion of possible sources, the physician can help patients avoid repeated exposure to mites. For Demodex bites, veterinary consultation is needed.
Mites that bite include chiggers (too small to see) and occasionally mites that are ectoparasites of birds, rodents, or pets and mites associated with plant materials or stored food or feed.
Mites that bite and burrow include Sarcoptes scabiei, which causes scabies, and Demodex mites, which cause a scabies-like dermatitis.
Mites that bite usually cause pruritic dermatitis.
Diagnose patients by history and, for burrowing mites, scabies-like pattern of skin lesions.
Treat symptoms (eg, topical corticosteroids or oral antihistamines for itching) and treat burrowing mite bites with antimicrobial therapy.
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Problems in Diagnosing Scabies, a Global Disease in Human and Animal Populations
Clin Microbiol Rev. 2007 Apr; 20(2): 268–279.
Shelley F. Walton
Menzies School of Health Research,1 Institute of Advanced Studies, Charles Darwin University,2 Northern Territory Clinical School, Flinders University and Department of Medicine, Royal Darwin Hospital, Darwin, Australia3
Bart J. Currie
Menzies School of Health Research,1 Institute of Advanced Studies, Charles Darwin University,2 Northern Territory Clinical School, Flinders University and Department of Medicine, Royal Darwin Hospital, Darwin, Australia3
Menzies School of Health Research,1 Institute of Advanced Studies, Charles Darwin University,2 Northern Territory Clinical School, Flinders University and Department of Medicine, Royal Darwin Hospital, Darwin, Australia3
*Corresponding author. Mailing address: Menzies School of Health Research, P.O. Box 41096, Casuarina NT 0811, Australia. Phone: 61 8 89228928. Fax: 61 8 89275187. E-mail: [email protected] © 2007, American Society for MicrobiologyThis article has been cited by other articles in PMC.
Scabies is a worldwide disease and a major public health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia, prevalences of up to 50% among children have been described, despite the availability of effective chemotherapy. Sarcoptic mange is also an important veterinary disease engendering significant morbidity and mortality in wild, domestic, and farmed animals. Scabies is caused by the ectoparasitic mite Sarcoptes scabiei burrowing into the host epidermis. Clinical symptoms include intensely itchy lesions that often are a precursor to secondary bacterial pyoderma, septicemia, and, in humans, poststreptococcal glomerulonephritis. Although diagnosed scabies cases can be successfully treated, the rash of the primary infestation takes 4 to 6 weeks to develop, and thus, transmission to others often occurs prior to therapy. In humans, the symptoms of scabies infestations can mimic other dermatological skin diseases, and traditional tests to diagnose scabies are less than 50% accurate. To aid early identification of disease and thus treatment, a simple, cheap, sensitive, and specific test for routine diagnosis of active scabies is essential. Recent developments leading to the expression and purification of S. scabiei recombinant antigens have identified a number of molecules with diagnostic potential, and current studies include the investigation and assessment of the accuracy of these recombinant proteins in identifying antibodies in individuals with active scabies and in differentiating those with past exposure. Early identification of disease will enable selective treatment of those affected, reduce transmission and the requirement for mass treatment, limit the potential for escalating mite resistance, and provide another means of controlling scabies in populations in areas of endemicity.
Scabies is a common parasitic infection caused by the mite Sarcoptes scabiei. Infestations occur when the “itch” mite, S. scabiei, burrows into the skin and consumes host epidermis and sera. The predominant disease manifestations are mediated through inflammatory and allergy-like reactions to mite products, leading to intensely pruritic lesions. Scabies is a major global health problem in many indigenous and Third World communities. It causes outbreaks in nursing homes (99) and is recognized in those with human immunodeficiency virus and human T-cell leukemia virus type 1 infections (47, 48, 73, 97). Scabies is transmitted by skin-to-skin contact, as demonstrated in classical studies by Mellanby (79), who showed that direct person-to-person body contact was generally necessary for transmission of scabies. Thus, it is a disease of overcrowding and poverty rather than a reflection of poor hygiene (57). It has been estimated that 300 million people suffer from scabies infestation at any one time (102), although this number has been disputed (25). Scabies is an important disease of children, but it occurs in both sexes, at all ages, in all ethnic groups, and at all socioeconomic levels. Importantly, the associated morbidity is frequently underestimated. In addition to the discomfort caused by the intensely pruritic lesions, infestations often become secondarily infected, especially with group A streptococci and Staphylococcus aureus. Epidemic acute poststreptococcal glomerulonephritis (APSGN) is often associated with endemic scabies in the affected community (29, 96). Despite the availability of chemotherapy, repeated scabies infestations and the resultant recurrent pyoderma have now been identified as important cofactors in the extreme levels of renal and rheumatic heart disease observed in Aboriginal communities (30, 63, 112). Scabies is also a major problem among important livestock and companion animals, with, for example, approximately 25% of pigs in some areas of the United States experiencing scabietic mange, leading to major economic losses (22, 89). Moreover, many millions of wild animals worldwide suffer from sarcoptic mange. Even though this worldwide disease has been recognized throughout history, in the modern era there have been long interruptions and significant gaps in the research about scabies. Molecular studies of the parasite have been very limited, due to the generally low parasite burden and lack of an in vitro culture system. The first molecular studies of Sarcoptes scabiei var. hominis were enabled via the collection of large numbers of mites from the shed skin of crusted scabies patients in 1997 (107).
Scabies has been known to humankind since ancient times, with Aristotle (384 to 322 BC), the first person believed to have identified scabies mites, describing them as “lice in the flesh” and utilizing the term “akari.” Subsequently, scabies has been mentioned by many different writers, including Arabic physician Abu el Hasan Ahmed el Tabari, around 970, Saint Hildegard (1098 to 1179), and the Moorish physician Avenzoar (1091 to 1162) (93). In 1687, Bonomo and Cestoni accurately described the cause of scabies in a letter (81). Their description recounting the parasitic nature, transmission, possible cures, and microscopic drawings of the mite and eggs of S. scabiei is believed to be the first mention of the parasitic theory of infectious diseases. Nevertheless, it was not until 1868, 2 centuries later, that the cause of scabies was established with the publication of a treatise by Hebra (19a, 52).
S. scabiei is an obligate ectoparasitic arthropod taxonomically grouped in the class Arachnida, subclass Acari, order Astigmata, and family Sarcoptidae (39). The members of the Astigmata are relatively slow-moving mites with thinly sclerotized integuments and no detectable spiracles or tracheal systems. Over 15 different varieties or strains have been described from various hosts, although morphologically they appear to be similar (38). However, cross-infestation experiments (10) and molecular epidemiology studies (106, 108) indicate clear physiological and genetic differences between host strains.
The female mite burrows just under the surface of the skin and lays two to three eggs per day in the stratum corneum for up to 6 weeks at a time, resulting in raised papules on the skin’s surface. However, it appears that fewer than 1% of the laid eggs develop into adult mites (78). Developmental instars include egg, larva, protonymph, and tritonymph (12). Adult mites emerge on the surface of the skin after approximately 2 weeks, and after mating, they reinfect the skin of the host or of another human. The male mite is reported to die after mating, although this has been disputed (1, 54).
S. scabiei is creamy white with brown sclerotized legs and mouthparts (Fig. ). The adult female is approximately 0.3 to 0.5 mm long by 0.3 mm wide, and the male is slightly smaller, around 0.25 mm long by 0.2 mm wide. Larvae have six legs, and nymphs and adults have eight legs, with stalked pulvilli (suckers) present on legs 1 and 2 of both the male and female adult mites, enabling them to grip the substrate. Additionally, mites bear spur-like claws, and they have six or seven pairs of spine-like projections on their dorsal surfaces. The adult male is distinguishable from the female by its smaller size, darker color, and the presence of stalked pulvilli on leg 4; leg 4 in the adult female ends in long setae.
Female scabies mite with egg, taken from skin scraping.
Infectivity, Survival, and Transmission
Scabies transmission is mediated primarily by close, prolonged personal contact with an infected person and therefore is common among family members and often seen in institutional settings. Among adults, sexual contact is perhaps the most important means of transmission. The probability of being infected is related to the number of mites on the infected person and the length of contact. Scabies is not readily transmitted by clothing, bed sheets, or other fomites (78), but this mode of transmission should be considered with cases of crusted (severe) scabies, due to the extreme mite burden. When the mite is dislodged from its host, it can survive for 24 to 36 h at room temperature with normal humidity (21°C and 40 to 80% relative humidity) and even longer at lower temperatures with high humidity (9). However, the mites’ ability to infest the host decreases with increased time off the host. The sightless mite uses odor and thermal stimuli for active host taxis (3, 11).
In many tropical and subtropical areas, such as Africa (85, 100), Egypt (53), Central and South America (56, 104), northern and central Australia (109), the Caribbean Islands (96), India (72, 84), and Southeast Asia (92), scabies is endemic. In industrialized countries, scabies is observed primarily in sporadic individual cases and institutional outbreaks (32, 36). Epidemiological studies indicate that the prevalence of scabies is not affected by sex, race, age, or socioeconomic status. The primary contributing factors in contracting scabies seem to be poverty and overcrowded living conditions (45, 109). Notwithstanding this, certain groups are more affected by the disease than others. Scabies is most commonly observed in the very young, followed by older children and young adults (1). In situations where scabies is endemic, this most likely reflects reduced immunity as well as increased exposure (27). Other age groups more commonly affected by scabies infestations include mothers of young children and the elderly in nursing homes. The latter cases are often related to index cases of crusted scabies in combination with compromised immune systems and possibly a decreased ability to kill the mites by scratching due to dementia and/or strokes. Lack of sensitization and/or reduced scratching is also believed to be the reason patients with paralysis or sensory neuropathy can develop localized crusting in affected areas (B. J. Currie and S. F. Walton, personal observation). It has yet to be established whether asymptomatic cases of scabies can occur and whether a history of infection with S. scabiei will cause long-term immunity.
Cyclical Pattern of Infection
Early accounts of the epidemiology of human scabies described large epidemics or pandemics of scabies. The principal peaks appear to coincide with major wars and occurred between 1919 and 1925, 1936 and 1949, and 1964 and 1979 (46). Because scabies is not a reportable disease, this may not be truly representative of its prevalence, as data are often based on variable recording methods and come from countries with widely varied social and physical environments. Furthermore, peak incidences of disease did not occur simultaneously in all countries (87). Herd immunity has been suggested as a reason for the possible cyclical nature of the disease, as it has been demonstrated that both people and animals with reinfestations have reduced parasitic burdens and some previously infected individuals can eliminate a second infestation (8, 78). However, this theory does not account for the endemicity of scabies in many tropical and subtropical communities (e.g., northern Australia, India, and South Africa) without any apparent fluctuations in overall incidence (84, 87, 109). Overcrowding and the continuous availability of new cohorts of susceptible young children may maintain the infection cycle in communities where scabies is endemic, whereas during war, the most likely reason for outbreaks is the crowding together of scabies-naïve adult populations (27). Of note, increases in scabies often run parallel to increases in the prevalence of other external arthropod parasites, e.g., head or body lice. Again, this is indicative of the role of the social environment in transmission (34).
Poverty, Overcrowding, and Poor Hygiene
The relationship between the prevalence of scabies and the relative levels of poverty, crowding, and hygiene within a community is complex. Evidence indicates that scabies is not influenced by hygiene practices or the availability of water. This can be observed in institutional outbreaks, where high standards of hygiene are observed (60, 88), and in coastal tropical communities with plentiful access to water and meticulous hygiene (69, 101). Furthermore, scabies is known to affect people from all socioeconomic levels, including affluent populations, if exposure occurs. Poverty and overcrowding, however, are often concomitant, and overcrowding is believed to have a significant effect on the spread of scabies, reflecting the fundamental role of physical contact in person-to-person transmission. Poverty also leads to other associated problems, such as poor nutritional status, which may in turn contribute to the immune status of the individual and the levels of disease within the community. Nutritional status has been reported as a significant risk factor in a scabies outbreak in an Indian village (84), and malnutrition may predispose individuals to crusted scabies (97).
Significance in Australian Indigenous Communities
Despite the availability of effective chemotherapy, scabies is still a major problem in many remote Aboriginal communities in Australia, relating primarily to levels of poverty and overcrowding (30). Carapetis et al. published prevalences for scabies of 25% in adults from these communities (21). Higher rates in schoolchildren were recorded, with prevalence rates of 30 to 65% (26). Nair et al. related a similar level of endemic scabies in an Indian village (84). Scabies is increasingly recognized as a major driving force of streptococcal pyoderma in children in these communities, underlying 50 to 70% of all skin infections. Group A streptococcus is responsible for the continuing outbreaks of APSGN and acute rheumatic fever reported in these communities, with rates of acute rheumatic fever and rheumatic heart disease among the highest in the world (29). Furthermore, scabies and skin infections in childhood have been linked with the extreme rates of end-stage renal failure in indigenous adults. Children with skin sores are five times more likely to develop APSGN during an epidemic, while the risk is doubled for those with scabies (65). Having had APSGN in childhood increases the risk of adult renal disease sixfold (112).
Clinical presentation with a primary infestation of scabies is reported to take place 4 to 6 weeks after infection. Presentation is with generalized itching, which is frequently reported to be more intense at night. Localization of the pruritic papules in human patients with scabies is classically in the webs of the fingers, the flexor aspects of the wrists, the extensor aspects of the elbows, the periumbilical skin, the buttocks, the ankles, the penis in males, and the periareolar region in females. The number of mites per patient is reported to be approximately 10 to 12, and with repeated infestations, this number reduces substantially (78). Although scabies infestation and total mite numbers in humans are usually self-limiting, spontaneous recovery from scabies in humans has been described to occur only with subsequent reinfestations (78). Depending on the extent and severity of the inflammatory response, the clinical appearance of scabies can be wide-ranging, but the classical clinical sign for the diagnosis of scabies is the burrow. The adult female, approximately 0.3 mm in length, makes the burrow as it digests and consumes the horny layer of the epidermis and the sera that seeps into the burrow from the dermis. Burrows present as serpiginous, grayish lines approximately 5 mm long, but often these are not detectable, especially in tropical locations (S. F. Walton and B. J. Currie, unpublished observations; D. Taplin, personal communication). An atypical appearance is frequently found in patients with long-standing infestations who may develop chronic excoriation and eczematization of the skin. Patients taking topical or oral steroids or who are immunosuppressed due to other diseases may also present uncharacteristically. In some situations, the rash and itch of scabies can persist for up to several weeks after curative treatment, possibly due to dead mites or mite products remaining within the skin layers. In a few cases, nodules can develop (nodular scabies), which can persist for several months after successful treatment. These firm, red-brown nodules are often extremely itchy and are commonly found in the groin, buttocks, and periumbilical area.
With reinfestation, sensitization develops rapidly, and the associated lesions and pruritus are evident within 24 to 48 h.
The clinical signs and symptoms of scabies infestations can mimic many other skin conditions. These include bites from insects such as midges, fleas, and bedbugs; infections such as folliculitis, impetigo, tinea, and viral exanthema; eczema, contact dermatitis, and allergic reactions such as papular urticaria; and immunologically mediated diseases such as bullous pemphigoid and pityriasis rosea. Diagnosis can therefore be problematic.
Untreated scabies is often associated with pyoderma from secondary infection with group A streptococcus and S. aureus (19) (Fig. ). Sequelae include cellulitis, invasive bacterial infections, and APSGN. Scabies and skin infections in childhood have been linked with the extremely high rates of end-stage renal failure in indigenous adults.
Scabies of the hand with secondary infection.
Crusted scabies was first described among leprosy patients in Norway in 1848 and thus is historically known as Norwegian scabies. It is a severe, debilitating disease characterized by large numbers of mites, high immunoglobulin E (IgE) levels, peripheral eosinophilia, and the development of hyperkeratotic skin crusts that may be either loose, scaly, and flaky or thick and adherent (Fig. ). The distribution over the body can be localized or extensive and can include the neck, scalp, face, eyelids, and the area under the nails (Fig. ). Crusts reveal large numbers of mites and eggs, totaling over a million in the most severe cases. Consequently, crusted scabies is considerably more infectious than ordinary scabies. People with crusted scabies have been recognized as “core-transmitters” (23, 29, 36) and as sources of reinfection following intervention programs (28). Patients with crusted scabies may also remain infectious for long periods of time because of the difficulty in eradicating mites from heavily crusted areas of the skin. Crusted scabies is caused by the same variety of mite that causes ordinary scabies. Progression from ordinary scabies to crusted scabies is uncommon, and susceptibility to the more severe form of the disease has been associated with a number of predisposing conditions. These include leprosy (Fig. ), infection with human T-cell leukemia virus type 1 and human immunodeficiency virus, and immunosuppression by medication. However, crusted scabies can occur in overtly immunocompetent individuals, and some familial clustering suggests the possibility of a specific immune defect in these individuals (97). Furthermore, the crusted scabies seen in former leprosy patients can occur long after infection has been treated and in the absence of sensory neuropathy. This has resulted in our hypothesis that the immune defect predisposing to clinical disease in leprosy may also predispose to hyperinfestation following S. scabiei infestation (66). Nevertheless, crusted scabies can also occasionally occur locally in a paralyzed limb or a limb with sensory neuropathy, presumably reflecting the absence of itch or the inability to scratch (23). Crusted scabies has also been observed in patients with cognitive deficiency and in institutionalized patients, seemingly because they are unable to properly interpret the associated pruritus or are unable to physically respond to the itching (67). Fissure development and secondary bacterial infections are common and are associated with the high mortality rates for this form of the disease (28) (Fig. ).
Crusted scabies of the feet.
Crusted scabies of the eyelid.
Crusted scabies in a patient with leprosy.
Crusted scabies with chronic secondary ulcers and depigmentation.
Worldwide, S. scabiei causes mange in many companion and livestock animals and is responsible for epizootic disease in wild populations of a number of animal species (89). Sarcoptic mange is considered a major cause of mortality among red foxes (Vulpes vulpes) (14), coyotes (90), and common wombats (Vombatus ursinus) (74). Veterinary concerns include difficulties in diagnosis and control and the economic effect of mange on feed conversion efficiency. In production herds, the intense pruritus associated with the disease interferes with milk production, weight gain, and leather quality and can inflict serious economic losses on primary industries (35, 95).
Clinical Features of Mange
The clinical signs of mange in animals are slightly raised red papules seen on the sparsely haired regions of the body. Intense pruritus is evident, with consequent scratching, excoriation, and skin inflammation. If mange is left untreated, loss of hair, scaling, and crusting of the skin with dried exudate of serum are observed (Fig. ). Secondary pyoderma may occur. Transmission of mites among a group of animals is most likely through direct contact or via contaminated bedding.
Crusts and alopecia in a dog with severe scabies.
Mite populations are primarily host specific, with little evidence of interbreeding between strains. Cross-infection studies describe unsuccessful experimental attempts to transfer scabies mites from dogs to mice, pigs, cattle, goats, and sheep (10). This is supported by molecular genotyping studies that reveal genetically distinct dog and human host-associated mite populations in Australian indigenous communities where scabies is endemic (106, 108). Occasional cases of human scabies have been reported following exposure to animal scabies, but these infestations are generally self-limiting, with no evidence of long-term reproduction occurring on the nonnormal host (15).
HOST IMMUNE RESPONSE
Studies of the symptoms and signs of scabies pointed to the development of host immunity, but until the recent Scabies Gene Discovery Project (43), only a small number of the antigens responsible for the immune reactions to scabies had been sequenced and characterized (51, 75). Consequently, there is a dearth of literature reporting scabies-specific humoral or cellular immunity. Limited past investigations of humoral immunity in scabietic patients show contradictory results and have used whole-mite scabietic extracts from other hosts, such as dogs (82). Immunoblotting studies demonstrate that sera from crusted scabies patients showed strong IgE binding to up to 21 S. scabiei var. canis proteins (4). However, the identity of these allergens was unknown. Patients with crusted scabies are noted to have extremely high serum levels of total IgE and IgG (97). Cell-mediated host immune responses have been identified primarily by histopathological examination of skin biopsy specimens from scabietic lesions. Mite burrows are surrounded by inflammatory cell infiltrates comprising eosinophils, lymphocytes, and histiocytes (Fig. ). Furthermore, biopsy specimens containing both mites and inflammatory papules have been observed to contain IgE deposits in vessel walls in the upper dermis (20). Unknown components in an extract of S. scabiei var. canis have been shown to influence cytokine expression in cultured human keratinocytes, fibroblasts, human peripheral blood mononuclear cells, and dendritic cells (5-7). Current studies are investigating scabietic patients’ antibody and cellular responses to specific recombinant S. scabiei var. hominis antigens. Results have identified patients with both crusted and ordinary scabies to have strong peripheral blood mononuclear cell proliferative responses and IgE antibody responses to multiple S. scabiei homologues to house dust mite allergens (Walton and Currie, unpublished). Scabies mite-inactivated serine protease paralogues have been identified both internally in the mite gut and externally in feces (114). Furthermore, human IgG has been identified in the guts of mites, which must presumably also contain the serine protease cascades of both the blood clotting and complement fixation pathways. Complement has been shown to be an important component in a host’s defense against ticks (113). Both of these pathways must be inhibited while simultaneous digestion of epidermal protein as food takes place.
Skin biopsy of crusted scabies showing mites in the epidermis with hyperkeratosis and inflammatory response.
Immediate versus Delayed-Type Hypersensitivity Reactions to Scabies Mites
The severe itching and papular rash of the primary infestation are accompanied by skin lesions characterized by inflammatory cell infiltrates typical of a delayed sensitivity cell-mediated immune reaction. However, immediate wheal reactions have been elicited by intradermal injection of scabies mite extracts in both ordinary and crusted-scabies patients but not healthy volunteers (42, 105). This response was observed to wane with time, and patients injected 15 to 24 months after infestation did not react.
Cross-Reactivity between Scabies Mite Infections and House Dust Mite Allergy
Investigations have demonstrated that patients sensitive to house dust mites but with no history of scabies have circulating IgE antibodies that recognize antigens in S. scabiei var. canis extract (13). Furthermore, Western blot and radioallergosorbent assays demonstrated that individuals with scabies showed strong IgE binding to house dust mite extract (40). The specific cross-reactive molecules remain unidentified but may represent some polysaccharide-related IgE cross-reactivity (71). Scabies mites and house dust mites are phylogenetically related arthropods, and it is not surprising that they or their excretions or secretions have homologous allergens. However, it is unknown how many of these will be cross-reactive or what the clinical significance of any such cross-reactivity is. For example, studies on cross-reactivity between the group 5 allergens of house dust mites Dermatophagoides pteronyssinus and Blomia tropicalis (Der p 5 and Blo t 5) have been undertaken, and although they have 43% amino acid identity, they have been found not to be cross-reactive (68).
There are a number of agents available on the market to treat scabies, and choice is largely based on the age of the patient, state of their health, degree of excoriation or eczema, potential toxicity, cost, and availability. For instance, previously, lindane (gammabenzene hexachloride) was the topical agent most commonly recommended for treatment of scabies in Western countries. However, because of potential neurotoxicity, it has now been removed from the market in Australia and much of Europe. Five percent permethrin is now the most frequently prescribed topical treatment in affluent countries, but its cost precludes its use in many regions where scabies is endemic. Topical application of active substances is the primary means of effective treatment, although oral ivermectin is increasingly used and is now registered for scabies treatment in France (25, 98). In situations where scabies is endemic, empirical treatment is often more cost-effective than attempting laboratory-based diagnoses. Intervention programs in Panama, Brazil, the Solomon Islands, and remote northern Australian Aboriginal communities have resulted in dramatic reductions in the prevalence of scabies and skin sores (58, 103, 116). These programs involve either mass topical treatment of community members with 5% permethrin or administration of oral ivermectin, with different models adapted to local conditions. Success at the individual community level has varied and has not always been sustainable. Often low levels of scabies persist within communities after the implementation of these community-based programs (115). Furthermore, mass community treatment in communities of endemicity creates an environment for emerging drug tolerance or resistance, and new approaches to control are needed. Published in vitro acaricide efficacy studies indicate that S. scabiei mites in northern Australia are becoming increasingly tolerant to 5% permethrin (111), and clinical and in vitro ivermectin resistance in cases of scabies has recently been documented (31). Resistance should also be considered in regions of nonendemicity when patients experience persistent symptoms for up to several weeks after curative treatment. Promising new acaricides include a number of essential oils in which terpenoids are most likely the primary active components (110). Encouraging in vitro and field results have been obtained for 5% tea tree oil extracted from the tree Melaleuca alternifolia (110, 111), 20% lippia oil extracted from Lippia multiflora Moldenke (86), a paste made from neem (Azadirachta indica ADR) and turmeric (Curcuma longa) (24), camphor oil (Eucalyptus globulus) (83), and a commercially available repellent containing coconut and jojoba oil (55). In regions in which the prevalence of scabies among children is between 5 and 10%, it is important to be able to counteract epidemics of scabies with effective treatments and a sensitive and specific tool able to determine both clinical and subclinical infestations. In the treatment of crusted scabies, the importance of combining topical therapy with oral ivermectin has been noted (77). Severe crusted-scabies cases may require up to seven doses of ivermectin to ensure the cure and eradication of mites (64, 97).
Currently there is no efficient means of diagnosing human or animal scabies. To date, diagnosis is via clinical signs and microscopic examination of skin scrapings, but experience has shown that the sensitivity of these traditional tests is less than 50%. Detecting visible lesions can be difficult, as they are often obscured by eczema or impetigo or are atypical. Detection of burrows with India ink was advocated more than 20 years ago (117), but the test is often impractical and is not routinely used. Presumptive diagnosis can be made on the basis of a typical history of pruritus, pruritus that is worse at night, the distribution of the inflammatory papules, and a history of contact with other scabies cases (76).
Definitive diagnosis is based on the identification of mites, eggs, eggshell fragments, or mite fecal pellets from skin scrapings (e.g., from scabietic papules or from under the fingernails) or by the detection of the mite at the end of its burrow. One or two drops of mineral oil are applied to the lesion, which is then scraped or shaved, and the specimens are examined after clearing in 10% KOH with a light microscope under low power. This method provides excellent specificity but has low sensitivity for ordinary scabies, due to the low numbers of parasites. Furthermore, several factors may influence the level of sensitivity, e.g., the clinical presentation (unscratched lesions are more valuable), the number of sites sampled and/or repeated scrapings, and the sampler’s experience. A skin biopsy may confirm the diagnosis of scabies if a mite or parts of it can be identified. However, in most cases, the histological appearance is that of nonspecific, delayed hypersensitivity with superficial and deep perivascular inflammatory mononuclear cell infiltrates with numerous eosinophils, papillary edema, and epidermal spongiosis (41). In practice, identifying a mite is challenging, and a negative result, even from an expert, does not rule out scabies. Presumptive therapy can be used as a diagnosis, but its value is questionable and confounded by the variable delay until resolution of symptoms following therapy. A positive response to treatment cannot exclude the spontaneous disappearance of a dermatological disease other than scabies, and a negative response does not exclude scabies, especially with resistant mites (25). In the absence of confirmed mites, diagnosis is currently based entirely on clinical and epidemiological findings. Given the extensive differential diagnoses, the specificity of clinical diagnosis is poor, especially for those inexperienced regarding scabies. Furthermore, there are the difficulties in distinguishing among active infestation, residual skin reaction, and reinfestation.
Epiluminescence microscopy and high-resolution videodermatoscopy are noninvasive techniques that allow detailed inspection of the patient’s skin, from the surface to the superficial papillary dermis (2, 49, 80). Diagnosis is by observations of the “jet-with-contrail” pattern in the skin representing a mite and its burrow. Due to difficulties obtaining skin scrapings from some patients, e.g., infants, and the lack of sensitivity of classical methods, dermatoscopy might be informative (49), but studies performed on large cohorts are lacking (25) and limited by the high cost of the equipment.
Antigen Detection and PCR Diagnostic
The key weakness of a scabies PCR diagnostic is that, as with microscopy diagnosis, it relies on the physical presence of a mite or mite part in the sample. Therefore, it is unlikely to become a viable test for widespread use, due to the generally low mite burden and, thus, low sensitivity. PCR followed by enzyme-linked immunosorbent assay detection of the PCR product was suggested to be a sensitive technique for diagnosing patients with atypical scabies (16). However, the method described was labor-intensive and time-consuming.
Intradermal Skin Test for Scabies
The intradermal skin test method is currently not feasible to use with whole-mite extract due to the inability to culture sufficient quantities of S. scabiei. Furthermore, whole-mite extracts obtained from animal models contain a heterogenous mixture of host and parasite antigens, including house dust mite cross-reactive epitopes, and vary in composition, potency, and purity. Patients with scabies often present to clinicians with a generalized pruritus of unknown cause. Purified, well-characterized recombinant scabies mite allergens with standardized protein contents could potentially be utilized in the future for scabies skin test assays for clinically difficult-to-diagnose cases and for immunotherapy.
Studies document that scabies mite infestation causes the production of measurable antibodies in infested host species (4, 40). Furthermore, host IgG has been demonstrated in the anterior midgut and esophagus of fresh mites (94, 114). Enzyme-linked immunosorbent assays have now been developed for the detection of antibodies to S. scabiei in pigs and dogs and are commercially available in Europe (17, 18, 59). These assays rely on whole-mite antigen preparations derived from S. scabiei var. suis and the itch-mite of the red fox, S. scabiei var. vulpes, and therefore have limitations in availability and specificity. Importantly, a recent study looking at cross-reacting IgG antibodies to the fox mite antigen in human scabies reported a sensitivity of only 48%, in comparison with 80% in pig scabies and 84% in dog scabies (50). This is not surprising, as studies using molecular markers suggest that S. scabiei organisms from humans and animals are genetically distinct and that interbreeding or cross-infection appears to be extremely rare (106, 108).
S. SCABIEI GENE DISCOVERY
A major limitation in biomedical research on scabies has been the difficulty of obtaining mites in sufficient numbers, due to the generally low parasite burden and the lack of an in vitro culture system. To overcome this, cDNA libraries have now been constructed from S. scabiei var. hominis and S. scabiei var. vulpes (43, 44, 70), and large expressed sequence tag databases containing both partial and complete DNA sequences of S. scabiei genes have been established. From these databases, scabies mite homologues to most of the known house dust mite allergens have now been identified, as well as many other relevant molecules (33, 43, 61, 62, 75, 91). Recombinant antigens promise a continuous, reproducible quantity of allergenic proteins in a purified form suitable for use in in vitro assays.
Immunodiagnostic Assay Using Recombinant
S. scabiei Allergens
Recently, a number of scabies mite homologues to house dust mite allergens have been cloned, expressed, and affinity purified. These include mature forms of both active and inactive homologues of the cysteine protease group 1 allergens (62), mature forms of active and inactive homologues of the serine protease group 3 allergens (61), a mu class and a delta class glutathione S-transferase group 8 allergen (33, 91), and a homologue to the C terminus of an apolipoprotein group 14 allergen (51). Immunohistochemical staining of sections of human skin which was highly infested with S. scabiei mites showed that anti-group 8 and anti-group 14 antibodies (generated in mice and rabbits, respectively) localized to the internal organs of the scabies mites and the cuticle, with minor staining in the digestive system (51) (Fig. ). Moreover, the group 1 and group 3 scabies mite allergens have now been expressed in Pichia pastoris, with considerable evidence that they are in native conformation and that they are localized to the digestive system of the mite (114; D. Kemp and K. Fischer, personal communication). Studies are now under way to evaluate the diagnostic potential of the identified proteins by characterizing specific human and animal humoral and cellular immune responses. Serological features that are diagnostically important are the interval between exposure to infection and antibody response and the nature of the antibodies that make up the response.
Serial section of human scabies mite. Red shows binding of polyclonal S. scabiei anti-group 8 antibodies raised in rabbits to protein in vivo. (Courtesy of C. Willis, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.)
Using an appropriate recombinant antigen, the development of an S. scabiei immunodiagnostic assay is now a real possibility. Its development will enable the selective treatment of affected individuals and animals, reducing the requirement for mass treatment and the associated costs. This should decrease the potential for escalating mite resistance and provide another means of controlling scabies in highly affected areas. There is little evidence that simple mass treatment is effective in the long term. Molecular studies aimed at improved diagnosis and better therapeutic options will significantly contribute to reductions in the high prevalence of scabies observed currently in resource-poor communities.
This work was supported by Australian National Health and Medical Research Council grants 283300 and 320867 and the Channel 7 Children’s Research Foundation of South Australia.
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Straw itch mites | Agriculture and Food
Straw itch mites can be a problem when dried foodstuffs (fruits, seeds, cereal products and pet food) and especially baled hay, are infested with the larvae of storage insects and placed in warm, humid environments. Under these conditions large numbers develop. The mites are predators of insect larvae and also attack man and any domestic animal that comes into contact with infested material.
Biology of itch mites
Itch mites develop from an egg to a larva, nymph and adult. The life cycle usually takes two to four weeks but this depends on the mite species and the weather. Female mites can lay up to 200 to 300 eggs.
Itch mites are extremely small, normally only 0.2mm long, but a female engorged with eggs can reach 2mm.
Straw itch mites live on the larvae of several stored product pests such as the Angoumois grain moth, the saw-toothed grain beetle, the pea weevil and the cowpea weevil.
Symptoms of itch mite bites
After contact with infested produce, skin irritations may develop. These may be caused by an allergic response to the produce, but in many cases the small itchy welts or sores are a symptom of a condition commonly known as hay or chaff itch.
Mites bite the covered areas of the human body, especially the waist, under-arms and the inside leg, but do not bore into the skin like the scabies mite.
The bites cause an allergic reaction on the skin in most people, characterised by a red weal with a central blister. This is accompanied by a severe itching sensation. Rubbing or scratching of the affected area will burst the blister and promote secondary infections and other problems including dermatitis.
Straw itch mites do not breed on mammals, and if infested produce is avoided for several days, the condition will subside.
Treatment of itch mite bites
If you think you have been attacked by itch mites, remove the infested clothing and shower before putting on clean clothing.
When the welts appear, try not to scratch them. Seek medical advice, because the symptoms can be reduced, and prompt action will decrease the likelihood of skin infections or dermatitis.
In severe cases of mite attack, victims have reported headache, fever, nausea, vomiting, mild diarrhoea and joint pains. Do not feel embarrassed about seeking medical advice to cure the problem – itch mites have been biting humans long before we stopped using straw as a mattress filler.
Prevention and control of itch mites
The best way to avoid attack from itch mites is to prevent the mite population from developing in the first place. Keep stored food free of insects by either oven-drying, or by storing it at temperatures below 15°C to minimise the development of host larvae.
Small amounts of infested produce can be heated to 60°C in a oven and held at this temperature for one hour, or microwaved on a low setting for 5 minutes to kill the mites and their hosts. Larger quantities of infested produce will need to be fumigated in a chamber with methyl bromide or aluminium phosphide by a licensed operator. If the produce is heavily infested with stored product pests and itch mites, it may simpler to burn or dump the offending material.
When handling infested produce, apply a personal insect repellent to wrists, ankles, neck and waist before entering the infested area. The repellent should contain at least 50% of the active constituents as diethyltoluamide (DEET). This will greatly reduce the likelihood of receiving bites.
Oak Mite Bites – Forefront Dermatology
Just when we thought the 2020s decade couldn’t possibly throw anything else new at us, well—you might want to take a seat. We would like to introduce you to the wonderful world of oak mites, and the unpleasant side effect they are leaving behind on our skin.
What are oak mites?
Oak mites are small, microscopic parasites, oftentimes unable to be seen by the naked eye. They also go by the names itch mites, oak leaf gall mites, or oak tree mites. While they are new to many individuals this year, the first reported case in the United States was in 2004 when a breakout of these biting mites was discovered in Kansas, Missouri, Texas, and Nebraska. Since 2004, oak mites have spread and are commonly noticed in the summer and late fall. Experts on oak mites have stated they can go from minimal counts to infestation levels within a very short window of time. Multiple generations can be born in a single week and can fall from oak trees in numbers of more than 300,000 at a time. Their small size allows them to travel in the wind, and they often get into homes through open windows or land on people sitting or walking beneath the trees.
Insect experts have found that oak mites don’t tend to be an issue every year, but instead develop in cycles. Oak mites are hitting the east coast–particularly the Washington D.C. and Arlington region–hard this summer. Dr. Rhett Kent, board-certified dermatologist with Forefront Dermatology in Arlington shared, “In August alone, 60% to 90% of my patients have experienced oak mite bites. I’ve never seen anything before where I could say that over 50% of the patient population is having any one such problem. It’s quite dramatic. The oak mites are definitely getting around right now.”
What does an oak mite bite look like?
Because oak mites can fall from trees in large quantities and go vastly undetected, they can easily surprise an individual with bites. Oak mite bites are most commonly seen on the arms, neck and face, but can occur on any area of your body that is exposed. When an oak mite bites a human it releases a small amount of venom, similar in nature to a mosquito. This venom of an oak mite can cause redness, swelling, welts, bumps and itchiness. It is common for an oak mite bite to initially develop as a small bump and transform into an itchy blister or painful rash. “There is a spectrum of bite reaction severity that we see year-to-year. Most patients will have a mild reaction to other common season arthropods, such as the mosquito,” stated Dr. Kent. “In the case of the oak mites, almost everyone is having an exuberant redness with some blistering in the center. It is definitely a more severe end of the spectrum that we’re dealing with right now.” Although uncomfortable, an oak mite bite is typically not dangerous but can leave you uncomfortable for 2 weeks.
What is the best way to avoid an oak mite bite?
While you can’t avoid oak mites that get taken away by the wind, it is best to avoid sitting beneath or being in close proximity to oak trees. If you need to be outdoors and in a wooded area, it is best to cover as much skin as possible. Oak mites can stay on your body or clothing until you wash them off. It is best after coming indoors for the day to immediately wash your clothing and take a shower.
What treatment is available for an oak mite bite?
“Over-the-counter hydrocortisone creams can be used for most mild bites, but they do very little for more robust oak mite bites. For more severe bite reactions, like the ones being seen recently with oak mites, Dr. Kent recommends a prescription-grade topical steroid in combination with an oral non-sedating antihistamine such as Allegra or Zyrtec.
If you are experiencing any of the symptoms of an oak mite rash, you can request an appointment with a Forefront Dermatology skin specialist by finding your nearest location here. If you are in the Arlington, VA area and wish to meet with Dr. Kent, you can schedule an appointment online here.
Microscopic oak mites give monstrously itchy bites
Oak mites are making more people than usual miserable with itchy, welts and bumps on their skin. A northern Virginia allergist has good news and bad news and advice for what to do.
Oak mites are making more people than usual miserable with itchy, welts and bumps on their skin. A Northern Virginia allergist has good news and bad news and advice for what to do.
Oak mites are microscopic; they can’t be seen with the naked eye. They create welts and bumps with a centralized blister that begin to develop 8 to 12 hours after they bite you.
The good news? They won’t be around long. They’re especially abundant this year because they’ve been feeding on the larvae of Brood X cicadas, but that’s about to change.
“This has been a particularly troublesome year, just with the cicada season,” said Dr. Troy Baker, an allergist with Kaiser Permanente in Springfield. “So, it’s generally not this miserable.”
“Once the oak mites’ food source dies off, [when] those cicada larvae burrow underground, then this problem is going to go away for us,” he said.
The bad news? Victims can expect to be itchy for about two weeks.
“They usually will stay on your skin till they die. And by the time you notice it, it’s kind of too late. And so then, you’re kind of doing damage control if you haven’t done the prevention part,” Baker said.
Anyone spending time outdoors anywhere near oak trees or dry grasses might be at risk of oak mite bites. They get blown around easily. Baker’s prevention tips include wearing long sleeves when outdoors and using a bug repellent containing DEET.
What remedies work? Try something with hydrocortisone.
“Nonprescription creams or ointments generally will work fine,” he said. “If it’s not cutting it after two days, then I would ask your physician for a stronger topical steroid cream to help you be a little bit more comfortable.”
Baker said long-lasting antihistamines in the morning, in addition to Benadryl at bedtime, will help.
Other tips include using cold cloths or ice to help soothe the area. Also, use a soap for sensitive skin while bathing. Once out of the shower, don’t rub the towel over your skin; pat yourself dry. Cut fingernails short and filed smooth, and resist the urge to scratch.
Scratching an itch only makes you feel itchier, Baker said, and it can allow germs to create a skin infection.
“It also damages the skin, so you’re more likely to get bruising or some hyperpigmentation, some darkening of the skin, that will last several weeks once the bite resolves,” Baker said.
You can find additional information about oak mite bite prevention and treatment on the Kaiser Permanente blog.
Baker also had a word of warning: “If you’re feeling anything like fevers or you’re having joint aches, or you feel unwell, that’s probably not an oak mite, and that’d be something you’d want to go see your physician to get looked at,” he said.
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Bites and Stings: Insects | Johns Hopkins Medicine
Fleas, mites, and chiggers
Fleas, mites, and chiggers often bite humans, but are not poisonous. It is sometimes difficult to assess which type of insect caused the bite, or if the rash is caused by poison ivy or other skin conditions.
What are the symptoms of a flea, mite, or chigger bite?
The following are the most common symptoms of a flea, mite, or chigger bite. However, each individual may experience symptoms differently. Symptoms may include:
Small, raised skin lesions
Pain or itching
Dermatitis (inflammation of the skin)
Allergic-type reactions in hypersensitive people with swelling or blistering
The symptoms of a flea, mite, or chigger bite may resemble other conditions or medical problems. Always talk with your healthcare provider for a diagnosis.
Treatment for bites caused by fleas, mites and chiggers
Specific treatment for these insect bites will be discussed with you by your healthcare provider. Some general guidelines for treatment may include the following:
Clean the area well with soap and water.
Use an antihistamine, if needed, for itching.
Take acetaminophen, if needed, for discomfort.
When should I call my healthcare provider?
Call your healthcare provider if any, or all, of the following symptoms are present:
Persistent pain or itching
Signs of infection at the site, such as increased redness, warmth, swelling, or drainage
Call 911 or your local emergency medical service (EMS) if the individual has signs of a severe allergic reaction such as trouble breathing, tightness in the throat or chest, feeling faint, dizziness, hives, and/or nausea and vomiting.
Ticks are small insects that live in grass, bushes, wooded areas, and along seashores. They attach their bodies onto a human or animal host and prefer hairy areas such as the scalp, behind the ear, in the armpit and groin, and also between fingers and toes. Tick bites often happen at night and happen more in the spring and summer months.
What to do if you find a tick on your child
Recommendations for removing a tick include the following:
Do not touch the tick with your bare hand. If you do not have a pair of tweezers, take your child to your nearest healthcare facility where the tick can be removed safely.
Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head as close to your child’s skin as possible.
Pull up slowly and steadily without twisting until it lets go. Do not squeeze the tick, and do not use petroleum jelly, solvents, knives, or a lit match to kill the tick.
Save the tick and place it in a plastic container or bag so it can be tested for disease, if necessary.
Wash the area of the bite well with soap and water and apply an antiseptic lotion or cream.
Call your child’s healthcare provider to find out about follow-up care.
Regardless of how careful you are about animals in your home, or how many precautions you take when your child is outdoors playing, animal and insect bites and stings are sometimes unavoidable.
By remaining calm and knowing some basic first aid techniques, you can help your child overcome both the fear and the trauma of bites and stings.
Facts about insect stings
Bees, wasps, yellow jackets, and hornets belong to a class of insects called Hymenoptera. Most insect stings cause only minor discomfort. Stings can happen anywhere on the body and can be painful and frightening for a child. Yellow jackets cause the most allergic reactions in the U.S. Stings from these insects cause 3 to 4 times more deaths than poisonous snake bites, due to severe allergic reaction. Fire ants, usually found in southern states, can sting multiple times, and the sites are more likely to become infected.
The 2 greatest risks from most insect stings are allergic reaction (which can sometimes be fatal if the allergic reaction is severe enough) and infection (more common and less serious).
What are the symptoms of an insect sting?
The following are the most common symptoms of insect stings. However, each child may experience symptoms differently. Symptoms may include:
Local skin reactions at the site or surrounding the sting, including the following:
Generalized symptoms that indicate a more serious and possibly life-threatening allergic reaction, including the following:
Tickling in the throat
Tightness in the throat or chest
Breathing problems or wheezing
Nausea or vomiting
Dizziness or fainting
Itching and rash elsewhere on the body, remote from the site of the sting
Treatment for stings
Specific treatment for stings will be discussed with you by your child’s healthcare provider. Large local reactions usually do not lead to generalized reactions. However, they can be life-threatening if the sting happens in the mouth, nose, or throat area. This is due to swelling that can close off the airway.
Treatment for local skin reactions only may include:
Calm your child and let him or her know that you can help.
Remove the stinger, if present, by gently scraping across the site with a blunt-edged object, such as a credit card or dull knife. Do not try to pull it out, as this may release more venom.
Wash the area well with soap and water.
Apply a cold or ice pack wrapped in a cloth to help reduce swelling and pain (10 minutes on and 10 minutes off for 30 to 60 minutes).
If the sting happens on an arm or leg, elevate the limb to help reduce swelling.
To help reduce the itching, consider the following:
Apply a paste of baking soda and water and leave it on for 15 to 20 minutes.
Apply a paste of nonseasoned meat tenderizer and water and leave it on for 15 to 20 minutes.
Apply a wet tea bag and leave it on for 15 to 20 minutes.
Use an over-the-counter product made to use on insect stings.
Apply an antihistamine or corticosteroid cream or calamine lotion.
Give acetaminophen for pain.
Give an over-the-counter antihistamine, if approved by your child’s healthcare provider. Be sure to follow dosage instructions carefully for your child.
Observe your child closely for the next hour for any signs of allergic reaction that would warrant emergency medical treatment.
Call 911 or your local emergency medical service (EMS) and seek emergency care immediately if your child is stung in the mouth, nose, or throat area, or for any signs of a systemic or generalized reaction.
Emergency medical treatment may include the following:
Prevention of insect stings
Some general guidelines to help reduce the possibility of insect stings while outdoors include:
Avoid perfumes, hairsprays, and other scented products.
Avoid brightly colored clothing.
Do not let your child walk or play outside barefoot.
Spray your child’s clothing with insect repellent made for children.
Make sure your child avoids locations of hives and nests. Have the nests removed by professionals.
Teach your child that if an insect comes near to stay calm and walk away slowly.
Some additional preventive measures for children who have a known or suspected allergy to stings include the following:
Carry a bee sting kit (such as EpiPen) at all times and make sure your child knows how to use it. These products are available by prescription.
Make sure your child wears long-sleeve shirts and long pants when playing outdoors.
See an allergist for allergy testing and treatment.
90,000 Myasnikov and Agapkin – on how to protect themselves
Alexander Myasnikov and Sergey Agapkin urge to take seriously the danger that every year becomes more terrible and more real – encephalitis ticks. The experts of the program “On the Most Important” discussed this problem more than once on the air of the TV channel “Russia 1”. Year after year, the media describe the dire consequences that Russians face when bitten by these arachnid arthropods, but the number of victims is growing, and residents of all Russian regions, without exception, continue to complain about the infestation of ticks.How to protect yourself and your loved ones? What rules should everyone know when visiting the forest? What to do first when a tick bites? How to properly remove a tick from the bite site? And why are autumn ticks no less dangerous than their spring counterparts? You will find out about this in our article. Alexander Myasnikov and Sergey Agapkin answer the most popular questions.
What to look for first?
Over the past year, over 500 thousand tick bites were registered in Russia.According to Sergei Agapkin, these numbers will only grow. He answered the question whether a tick bite is dangerous for a person if it has not yet had time to suck. According to him, if the insect simply crawls on the skin, then it has not yet had time to bite. Unlike mosquitoes, the tick bites through the skin and becomes attached to it. And when it is saturated, it does not creep anywhere and simply disappears.
If the tick did bite, then it is necessary to remove it, place it in a test tube and hand it over to the laboratory, where it is examined for borreliosis and tick-borne encephalitis.And if it is found that the tick was infected, then the person will be prescribed a special treatment.
Agapkin noted that in the Moscow region, cases of bites by infected ticks, mainly borreliosis, are common. Lyme disease (tick-borne borreliosis) is a dangerous infectious disease with very serious consequences. The skin, brain, heart, and joints are affected.
What diseases do ticks carry. Disease symptoms
One insect can carry three most dangerous infections at once: borreliosis, or Lyme disease, ehrlichiosis and encephalitis.The first two are as dangerous as encephalitis. They can be paralyzing and there is no vaccine for them. The main insidiousness of tick-borne infections is that the first signs of the disease do not appear immediately and not in everyone. The incubation period can last up to 30 days. In addition, it can be difficult to understand that the cause of the ailment is precisely the tick bite, and not ARVI or COVID-19. Among the symptoms, the experts of the program “On the most important” identified headache, body aches, convulsions, fever. They are typical for other infections as well.It is possible to understand that we are talking about borreliosis only thanks to analyzes.
According to Dr. Alexander Myasnikov, the effects of a tick bite can appear even in winter. According to statistics, every fifth patient may have the consequences of a bite. “Patients often come with complaints of joint pain and arrhythmia. You start digging and it turns out that there was a tick bite in the summer,” the specialist noted.
How to get the tick yourself
How to properly remove a tick from the bite site? Dr. Myasnikov explained the sequence of actions when faced with a dangerous arthropod.According to many viewers, the tick must be lubricated with oil so that it suffocates and crawls out on its own. However, the physician objects to such actions: the tick cannot suffocate, because it breathes on the surface of the skin. According to him, it is desirable that the insect be removed by a specialist, but still it is worth trying to do it yourself. To do this, you must correctly grab the tick and turn it out. If the head and legs remain under the skin, the epidermis can push them out by itself over time, but in this case there is a danger of suppuration.
What to do next?
After removing the tick, experts advise to wrap it in a handkerchief or put it in a jar, box and take it for examination to a center where research is carried out for the presence of pathogens. Because only experts can tell whether he is infected with any virus or not. If a virus is found, it is imperative to contact infectious disease specialists for treatment. If there are no laboratories nearby, then it is worth observing the bite site for 2-3 weeks. If you develop any of the above symptoms, see your doctor immediately.As you know, the consequences of infection with viruses from a tick can be very serious, both for women and men.
Required rules when visiting the forest that everyone should know
Alexander Myasnikov outlined simple but important rules that must be followed to avoid tick attacks. The doctor is urged not to forget about the precautions and protection against ticks. The main thing is to dress correctly.
- When going to the forest, you need to put on a hat, wrap your wrists tightly with cuffs, tuck your shirt into trousers, tuck your trousers into socks or boots, be sure to close your neck.
- Treat clothes and exposed areas of the body with anti-mite preparations in accordance with the instructions.
- During a walk, do not forget to examine yourself and your companions, after returning home, carefully check your clothes and the whole body (especially the neck area, behind the ears and groin).
- It is not recommended to sit down and lie down on the grass once again.
- After walking pets, examine them for ticks.
Myasnikov spoke about amnesia after a tick bite
“Don’t be frivolous,” Alexander Myasnikov calls on.As part of his author’s program “Doctor Myasnikov”, he recalled the sad consequences of an encephalitis tick bite.
“One tick bite can deprive a person of his memory, deprive him of the opportunity to eat normally, lead to paralysis,” the expert recalled. “I will never forget the consultation to which a young patient from Siberia was brought. bitten by a tick, encephalitis developed, which led to memory loss.A young, healthy man, he forgot everything that happened.He remembers himself as having just come from the army, does not recognize his wife. After what I have seen, I will be vaccinated. “
No cure exists – only vaccination
The first thing to remember is that there is no cure for encephalitis, only vaccination. By the way, Myasnikov himself is vaccinated every year. To confirm the significance of his words, Myasnikov got himself vaccinated against tick-borne encephalitis right in the studio of the “On the Most Important One” program. “I am vaccinated against coronavirus, I am vaccinated against tetanus, I am also vaccinated against pneumococcus.And every year I am vaccinated against tick-borne encephalitis. I will go to Siberia soon. And there is nowhere without this vaccination. And I recommend it to you, “Myasnikov specified.
Protection against encephalitis – three vaccinations given within one month. Immunity lasts from three to five years, depending on the characteristics of the organism. It is now in mid-June, the time to start the vaccination cycle. The peak of tick activity is expected in September, and vaccination protects in 95% of cases.
Autumn – the second wave of ticks
In the fall, Russians run the risk of facing a second wave of tick activation.Doctors warn that at this time of the year they will be no less dangerous than in the spring – after all, they suffer the same diseases. The tick activity season lasts, as a rule, until October. Finally, the activity of ticks stops with the onset of frost. “Be carefull!” – call the experts of the program “On the most important”. And the ways to protect yourself from harmful insects in any season are vaccinations and the right clothes for walking.
Even more interesting news – in our Instagram and Telegram channel @smotrim_ru.
90,000 6 main rules – Rossiyskaya Gazeta
About 11 thousand Muscovites have already been vaccinated against tick-borne encephalitis this season, reported recently in Rospotrebnadzor in Moscow.
Fortunately, no cases of viral tick-borne encephalitis, as well as cases of tick-borne borreliosis among the residents of the capital, have been registered in the current season.
Nevertheless, you should not relax. In the second week of May alone, more than 1.4 thousand people turned to clinics in the capital.people after tick bites, said in Rospotrebnadzor.
It’s no secret that parasites are activated with the onset of heat. The period of their activity is from the end of March to October. A tick can be “picked up” not only outside the city, but also while walking in a city park. Favorite places of “hunting” for arthropods are the sides of paths with low grass and thickets of bushes. Ticks are most active in the morning and evening hours, but they really do not like the sun’s rays. They are either sucked in immediately, or they are looking for open areas with thin skin on the body.
Basic rules of protection against ticks
When going to the forest or park for a walk, dress in light-colored clothes – this way the stuck tick will be more visible than on the dark one.
You can pre-treat clothes with special agents against ixodid ticks. There are also protective sprays and creams that are applied to the skin.
It is better to tuck trousers into boots or socks with a thick elastic band, and a shirt (or sweater) into trousers.
Sleeves should fit snugly against the skin of the hands.It is better to put a hood on your head, tightly sewn to a jacket, a cap or a scarf.
When in the forest, try to check your clothes more often. After returning home, take off your clothes and inspect them and yourself thoroughly.
If you are parking in the forest, it is better to choose pine for this purpose. In such, there is usually no grass with which the tick can cling to a person.
If the bite of the parasite did occur, in no case pull it off. First, treat the bite with alcohol.
Having made a loop of thread, place it between the “head” and the body of the tick and tighten. While pulling and twisting the thread, without making any sudden movements, remove the bloodsucker.
But if possible, it is best to do it in an emergency room, since there is a risk that the tick particles remaining under the skin can cause inflammation.
Do not be lazy, take the tick to the laboratory for microscopic diagnostics for encephalitis and borreliosis.
In the FBUZ “Center for Hygiene and Epidemiology in the City of Moscow” a point has been opened for the reception and examination of ticks for infection with pathogens of tick-borne infections.
Tick bite. What to do? What to look for? – Network of MC “Doctor Bogolyubov”
So, if you see that a tick has sucked on your child’s skin, you must act calmly, clearly and confidently.
1) ideally, the tick is removed by a surgeon or traumatologist (regardless of the child’s age), if you are away from qualified help, the tick must be removed yourself. It can be removed with tweezers, a clip, and there are also special devices for removing ticks on the free market, for example: Uniclean Tick Twister
(has an advantage over tweezers and a clamp, since this device does not squeeze the body of the tick, and it is easier to get it completely (important for further diagnostics))
If none of the above is listed, then you can use an ordinary strong thread – twisting the thread as close to the proboscis as possible, it is tied into a knot and smoothly! pull the tick up.
If you are removing a tick with tweezers, grab the tick as close to the proboscis as possible and tighten it while rotating it around its axis. There should not be any sudden movements at this moment, otherwise you will simply tear off the little body from the proboscis. If you nevertheless damaged the integrity of the tick, then it is better to contact a surgeon or traumatologist who will remove the head of the tick for you or your child. If this is not possible, then treat the area with the tick’s head with alcohol and remove the head yourself with a calcined (sterile) needle.
After removing the tick, treat the bite site with tincture of iodine or alcohol (so that the site does not become infected and does not fester). It is also advisable to mark the date of the bite on the calendar so as not to get confused during the consultation with the doctor.
2. if you did it successfully and took out the whole tick, then you need to place it in a jar with wet gauze and close the lid tightly, then give it to the laboratory within 2 days (in Moscow it is: Laboratory of Rospotrebnadzor, Moscow, Grafsky lane., 4, building 9 (entrance from the courtyard, door opposite the entrance to the vivarium), tel. 8 (495) 687-40-47. Federal Center for Hygiene and Epidemiology (FGUZ FTS GiE Rospotrebnadzor), Moscow, Varshavskoe shosse, 19 A, tel. +74985404098; Institute of Poliomyelitis and Viral Encephalitis, Moscow Region, Vnukovo, pos. Moscow, tel. 439-90-96. Baklaboratory in the Moscow region, Mytishchi, Semashko st., 2. tel 8 (498) 684-48-17 Invitro in Moscow (495) 363-0-363, 8 (800) 200-363-0
for another method of examination (PCR), parts of a non-living tick are also suitable, and at the same time the delivery time of the fragments can be lengthened.
All this diagnostics is carried out so that you can 1 – track the Sanepid situation in the regions, and 2 – be on the alert for parents if the examination of a tick for dangerous infections (tick-borne encephalitis and borreliosis) gave a “positive” result, that is, the tick could infect a child. Why exactly “be on the alert”? After all, the fact that a source of infections was found in a given tick does not mean that the transmission of infection has occurred.
How long does it take for a child to be tested to exclude / confirm infections in a child? (tick-borne encephalitis, borreliosis)
After 10 days from the moment of the bite, you can donate blood for PCR (borreliosis and tick-borne encephalitis).
After 14 days from the moment of a bite on Ig M to tick-borne encephalitis virus.
After 21 days from the moment of a bite on IgM to Borrelia. If the results are positive, then you need to contact an infectious disease specialist.
If you take these important tests before the specified time, they simply will not be informative.
What to look for after a tick bite?
The first and main symptoms that you need to pay attention to in a child if a tick bite has occurred: temperature – in the first hours + redness at the site of the bite – rather, an allergic reaction manifests itself.If the temperature appears on days 2-10, and has a wave-like course (the rise for 2-4 days lasts for 2 days, then it normalizes, and by the 8-10th day there is also a rise in body temperature), it may indicate the onset of an infectious process (tick-borne encephalitis ) – in the presence of this symptom, immediately contact an infectious disease specialist!
It is also necessary to monitor the bite site – the appearance of red rings around the bite site in the period from 3 to 30 days after the bite indicates the onset of borreliosis – with this symptom, you should also contact an infectious disease specialist!
And also carefully monitor the general condition of the child, if there is weakness, sweating, the child is capricious, the appetite is reduced, pains in the muscles and joints appear, the state of health is poor and you directly associate this with the tick bite that happened, then observation by an infectious disease specialist is highly desirable.
To prevent the bite and the consequences of a tick bite, you need to when visiting a forest and forest park area:
1) choose clothes that cover the whole body (sweater shirts – with long sleeves, tight cuffs and a high collar that fits tightly to the body, long trousers – so that you can tuck into socks, be sure to go with a hat or in a hood that will protect not only the head but and neck)
2) clothes should be light (it is easier to detect a tick when it gets on clothes)
3) as a rule, ticks live more in tall grass, bushes and bushes – therefore, be careful so that children do not run around and between this type of plants
4) use deterrent drugs (repellents) – DETA-prof – aerosol, DEFI-Taiga – solution, pencil, lotion, emulsion, aerosol, balm, cream, gel; Ultraton USA – lotion, aerosol (but use with caution in children early age (only according to the instructions))
5) carefully examine yourself, children, animals and everything that you took to the forest or from the forest before you go home
6) to prevent the consequences of a tick bite, namely tick-borne encephalitis, children are vaccinated.At the moment, in the territory of the Russian Federation, the most popular vaccine “Tick-borne encephalitis vaccine cultural purified concentrated inactivated dry” …
There is currently no vaccination against borreliosis.
Be attentive to your health and the health of your loved ones.
The ticks are awake! The whole truth about parasites
The best way to protect yourself from tick-borne encephalitis (for which there is still no effective treatment) is to get vaccinated on time.However, there are no vaccinations against another formidable disease that ticks also carry – borrelliosis. Therefore, vigilance is our everything!
Our expert is Director of the Institute of Medical Parasitology, Tropical and Vector-borne Diseases. E. I. Martsinovsky Sechenov University Alexander Lukashev .
Myth. Ticks are only dangerous in May.
Actually . Ticks can appear as early as April, although their peak activity is May-June.However, in some regions (in particular, in Moscow) there is also a second season – the end of August – September. Compared to the first, it is less pronounced, but nevertheless, the risk of being bitten by a tick can persist until autumn.
Myth. Only residents of Siberia, the Urals and the Far East should be afraid of ticks.
Actually . There are much more areas endemic for tick-borne encephalitis. The dangerous territory stretches from the Baltic Sea to the Pacific Ocean.But you can get infected in the Central Federal District (in almost half of the territories of Tver, Yaroslavl regions, etc.). A complete list of endemic areas is available on the Rospotrebnadzor website. Moscow and Moscow region (with the exception of Dmitrovsky and Taldomsky districts) are free from this disease. However, a tick bite is dangerous not only with tick-borne encephalitis, but also with borreliosis (Lyme disease) – a no less dangerous, but more common disease that affects every third tick in the Moscow region.
Myth.Ticks jump from trees. You can get infected even while walking along the alleys of the park.
Actually . Ticks live near the ground, and attack only from grass and small bushes. Therefore, if a person walks along the path without turning into the grass, the tick is not afraid of him. But sometimes the owners can get a tick from their pets, from whose fur the ticks briskly run over to them. Climbing up the human body, ticks seek out places convenient for sucking. Often they sit in the groin, under the armpits, on the neck.Therefore, upon returning from “risky” walks, it is important to completely undress and carefully examine yourself and children, pets and removed clothes too.
Myth. The tick bite is painful and easy to spot.
Actually . When sucking, the tick makes “anesthesia” by injecting an anesthetic substance under the skin, so the victim does not feel the bite itself. And the mite can remain on the skin for 1-3 days. And all this time, viruses or bacteria from the saliva of a bloodsucker will enter the human blood.Unfortunately, you can get infected with tick-borne encephalitis quickly enough. The virus is contained in the salivary glands of the tick, and the suction time does not play a big role. But the risk of contracting borreliosis very much depends on the duration of contact. The fact is that Borrelia are located in the intestines of an arthropod, and the longer it drinks blood, the higher the likelihood of infection. Therefore, it is very important to remove the tick as soon as possible.
Myth. The mite can be easily removed by sprinkling it with oil or gasoline.
Actually . It is better to remove the tick in the emergency room. But you can do it yourself. You should act with tweezers or a thread (but you don’t need to use your bare hands, there is a risk of damaging the tick, and it will partially remain in the skin, causing suppuration). It is categorically impossible to pour oil, cologne or something else on the tick – otherwise it will die and remain in the wound. The tick should be grasped as close to the head (that is, to the skin) as possible and carefully, slowly twist or pull it out of the wound. After removing the bloodsucker, you must put it in a matchbox and take it for research.And the wound should be treated with an antiseptic (and do this for several days until it heals).
Myth. A tick removed from the wound needs to be burned.
Actually . It is better to take it to the laboratory for analysis, where it is examined for 4 common infections. With tick-borne encephalitis, an anti-tick immunoglobulin is administered for 96 hours (the effectiveness of which has recently been questioned), and with borreliosis, a course of antibiotics is required.
Myth.If everything is in order within 2 weeks after the tick bite, then it has passed.
Actually . Unfortunately no. And if tick-borne encephalitis most often proceeds with obvious symptoms, then borreliosis in about 20% of cases passes in a latent form. In addition, it is of three types: cutaneous, articular and neuroborreliosis (the latter is the rarest and most dangerous). Nevertheless, after removing the tick, it is extremely important to monitor your condition and wound for several days. If a crimson spot or circular erythema (scarlet or purple circle around the wound) appears at the site of the bite – signs of the acute phase of borreliosis, it is important to immediately contact an infectious disease specialist.At an early stage, you can be cured in a week. But articular and neuroborreliosis, which manifests itself only a few months after infection, are difficult to treat and take a long time.
How to protect yourself from ticks
- Dress appropriately before going into the forest, when gardening or in contact with tall grass . Better in light – so it is easier to notice the tick. Tuck trousers into boots, long-sleeved shirt into trousers. Fasten the collar and cuffs tightly (it is better to have them with an elastic band).A headdress is required.
- The territory of the dacha, if it is in an endemic area, must be treated with special means . And be sure to regularly mow the grass and fight rodents. It has been proven: if there is no tall grass and mice on the site and around, there will be no tick-borne encephalitis.
- Treat clothing (especially cuffs and collars) with mite repellent . Always read the instructions before using these products. But in any case, do not spray on the skin – after all, this agent does not scare away (like a mosquito repellent), but kills ticks, since it contains poison.Therefore, it is impossible to spray pets, it is better to buy them special tick collars.
- Do not camp in the grass . Sunbathe and rest only on “bare” areas. Do not bring bouquets from the forest, do not put wreaths woven from forest or wild flowers on your head – a tick may lurk there.
- Upon returning from a forest walk, each time undress and examine yourself, children and animals, as well as inspect removed clothes .
- Get vaccinated against tick-borne encephalitis .There are also forms of vaccines for children. Do not have time to pass the standard vaccination – go through it according to the express scheme. Its effectiveness is lower, but it is better than nothing.
90,000 Balashikha residents were told about the prevention of tick bites
With the establishment of warm weather, we all actively strive to get out into the suburban forest zone for recreation, forgetting about precautions, about protection from ixodid tick sucking. Territories of risk are also a summer cottage, recreation centers, summer health camps for children, city parks and alleys.The tick can be brought into the house with freshly picked flowers and on clothes. Dogs on their fur and skin can also bring the parasite into a city apartment after a walk.
Ixodid ticks are carriers of many microorganisms – causative agents of diseases such as ixodic tick-borne borreliosis, tick-borne encephalitis, human monocytic ehrlichiosis, anaplasmosis and Crimean hemorrhagic fever.
Each of these pathogens after penetration into the human body occupies its own “ecological niche”: the tick-borne encephalitis virus, which enters the bloodstream with the liquid saliva of a tick, affects the nervous system, the initial reproduction period of borrelia occurs in the skin, ehrlichia and anaplasma are parasites of blood cells – leukocytes.In addition, complex pathological processes can develop due to the simultaneous ingress of various microbes into the body.
Tick-borne infections have quite a few similar clinical features, especially at the onset of the disease. From April to October, persons affected by a tick bite are subject to examination for the entire range of diseases, pathogens of which are transmitted by ticks. The tick itself is also subject to research; for its removal and for specialized medical care, it is necessary to contact the trauma centers of the city:
– m.Balashikha, Lenin Avenue, 63 – tel. 8 (495) 5296397
-y. Balashikha, md. Railway, st. Proletarskaya, 3 – tel. 8 (495) 5220553
Balashikha is not included in the number of territories endemic for tick-borne encephalitis, but persons traveling to endemic areas in order to carry out agricultural, irrigation, construction, logging, fishing, geological, exploration, expeditionary, deratization, disinsection works, as well as cleaning and landscaping forests and parks, dredging, should be vaccinated against this infection.Persons traveling to endemic regions for the purpose of tourism, including children, are also subject to vaccination. Vaccinations against tick-borne encephalitis are carried out in clinics and private vaccination rooms.
What will help reduce the risk of being bitten by these parasites?
– Dress properly before going into the forest. Wear long sleeves that fit snugly around your wrist – cuffs, elastic bands, hooded jacket preferred. A headdress is required. Ideally, if it is a kerchief.Clothes should be light-colored so that the tick can be spotted in time. Be sure to tuck your trousers into socks or knee-highs, it is better if you choose high boots from shoes. It is good if the sweatpants are made of fabrics with a smooth surface;
– Use tick repellants to treat clothing;
– When moving through the forest, try to stay in the middle of the paths, avoiding tall grass and low bushes. If possible, avoid sitting or lying on the grass.Campings, halts and overnight stays in the forest should be chosen in areas devoid of vegetation, in dry pine forests and on sandy soils;
– Try not to pluck branches;
– After returning from the forest or from a walk, you must shake off your outerwear, undress, inspect both outerwear and underwear.
Whole body skin is subject to inspection. Be sure to comb your hair with a fine comb. Don’t forget about mutual reviews. First of all, it is necessary to examine the children.Do not forget about the inspection of pets.
With their children who go on vacation to health camps, you should talk about ways to protect yourself from tick bites, children should know that they should seek medical help if a tick is found on the skin.
What to do if you find a sucked parasite?
– A sucked tick should not be pressed or pulled out sharply. This can only increase the likelihood of infection through microcracks;
– if you cannot seek specialized medical care at the emergency room at your place of residence, you need to fill the tick and the skin around it with fat, oil, kerosene, baby cream and wait a little.Without air supply, the mite will not be able to stay in the wound for a long time if it is not damaged. Often, after such processing, it disappears by itself;
– You can carefully remove the tick with tweezers, grabbing it closer to the head, as if twisting it along the axis in any direction. You can grab it with a loop of thread. There is also a way to pull it out with a syringe, from the cylinder of which the top is cut off;
– Do not discard the tick if you can deliver it for research. Otherwise, it must be burned or poured with boiling water.All ticks removed from the skin of patients in the trauma centers of the Balashikha Regional Hospital are sent for research in order to determine the likelihood of infection with pathogens. When self-extracting the parasite, it should be placed in a sealed bottle with a damp cloth for delivery to any laboratory accepting this biomaterial.
– It is possible to remove the tick on your own only with gloves. After removing it, treat your hands with soap, disinfect the bite site with alcohol, antiseptic, iodine or brilliant green.
– If part of the tick has remained in the wound, if the tick has been sucked for a long time and a roller of inflamed skin has formed around it, then all the more, you should immediately seek medical help, the doctor will prescribe preventive treatment at the emergency room. It is necessary to contact the emergency room no later than 96 hours after the bite.
– After removing the tick, the victim is sent to the clinic at the place of residence for medical observation for 21 days with daily thermometry;
– In the case when, according to the results of a tick study, it is necessary to administer an anti-tick immunoglobulin to the patient and according to clinical indications in the presence of neurological symptoms, the patient is sent for inpatient treatment to branch number 1 of the Balashikha Regional Hospital.
90,000 The number of complaints about tick bites has increased in Russia – RBK
Photo: Sergey Vedyashkin / AGN “Moscow”
From late April to early May, Russia recorded 18% more tick bites in humans than in the same period last year.This is stated in the study of the online medical service “SberZdorovye” (available at the disposal of RBC).
Russians’ visits to doctors increased by 18% for suspected human bites and 20% for a pet.
According to the data of the service, most often with suspicion of a tick bite in humans, they turned to the therapists on duty, as well as pediatricians, allergists and dermatologists. The most common complaints were itching and redness of the skin, weakness and fever. The owners of pets who have contacted the service’s veterinarians also report a loss of appetite and a decrease in activity in their pets.
In Ulan-Ude, the police detained protesters who interfered with disinfection from ticks
The largest number of applications came from residents of the Sverdlovsk Region, Moscow, Moscow Region, St. Petersburg, Krasnodar Region, Krasnoyarsk Region, Samara Region, the Republic of Tatarstan, Chelyabinsk Region, Novosibirsk Region, Perm Region, Voronezh Region, Irkutsk Region and Nizhny Novgorod Region.Pet bites were reported in St. Petersburg, Sakhalin Oblast, Volgograd Oblast and Tatarstan.
Caution: pliers! – News – Official portal of Kazan
Photo: Denis Gordiyko
(Kazan KZN.RU, May 25). With the onset of warm May days, nature comes to life, and with it the ticks, whose activity season is already in full swing. According to the sanitary doctors, since the beginning of 2021, 475 people have applied for medical help in Tatarstan for tick bites – this does not exceed the average long-term indicators.No cases of infection with tick-borne viral encephalitis and other tick-borne infections have yet been recorded. However, you should not forget about precautions. The Rospotrebnadzor Administration for the Republic of Tatarstan talks about basic safety rules.
Where do ticks live?
On branches and grass. When an animal or person approaches, they can cling to wool or clothing, and then make their way to open areas of the skin, most often, to the neck, scalp, back, axillary and groin areas.Tick saliva contains an anesthetic substance, so the bite may not be felt, and the tick itself may not be noticed.
Who is most prone to tick bites?
All people are susceptible to infection, regardless of age and gender. For infections transmitted by ticks, seasonality is more characteristic – from spring to autumn.
Nevertheless, people whose activities are associated with being in the forest are at greatest risk: employees of timber industry enterprises, geological exploration parties, builders of roads and railways, oil and gas pipelines, power lines, topographers, hunters, and tourists.Citizens become infected in suburban forests, forest parks, and garden plots.
Why is a tick bite dangerous?
The consequences of a bite can be tick-borne borreliosis or viral encephalitis.
The incubation period borreliosis lasts from 2 to 30 days, on average two weeks. A characteristic sign of the onset of the disease in 70% of cases is reddening of the skin at the site of the bite. The red spot is round or oval, less often of irregular shape, gradually increases along the periphery, reaching 1-10 cm in diameter.Without treatment, it persists for two to three weeks, then disappears. Intoxication syndrome is noted: headache, chills, nausea, fever from subfebrile to 40 degrees, myalgia and arthralgia, severe weakness, fatigue, drowsiness.
Without treatment, the disease progresses, becomes chronic, and in some cases leads to disability. If erythema or symptoms of intoxication appear, you should contact the infectious disease doctor of the territorial polyclinic at your place of residence.
Tick-borne viral encephalitis is an acute infectious viral disease, with a primary lesion of the central nervous system. The consequences of the disease range from complete recovery to health problems leading to disability and death.
The incubation period usually lasts 10-14 days, with fluctuations from 1 to 60 days. The disease begins acutely, accompanied by chills, severe headache, a sharp rise in temperature to 38-39 degrees, nausea, vomiting.After a bite, the patient is worried about muscle pain, which is most often localized in the neck and shoulders, thoracic and lumbar regions of the back, and extremities. The patient’s face is hyperemic (filled with blood), often spreading to the trunk.
How to protect yourself from the effects of a bite?
Those who visit endemic areas and travel to nature should be vaccinated against tick-borne encephalitis. Vaccination is the most effective measure of protection against this disease.
Several vaccines against tick-borne viral encephalitis have been registered in Russia. The vaccination can be done in medical organizations that provide this service, however, prior consultation with a general practitioner is required. The vaccination course should be carried out in advance, it consists of two vaccinations with an interval of 5-7 months, at least 1-2 months. Vaccination should be completed two weeks before departure to the natural focus of infection, revaccination is carried out in a year.
Prevention of tick-borne borreliosis is antibiotic therapy.
How to protect yourself from tick bites in nature?
You should choose such clothes that would prevent ticks from crawling through the collar, sleeves, under trousers. The shirt should have long sleeves with elastic at the wrists and tucked into the trousers, and the ends of the trousers should be tucked into socks and boots. Cover your head and neck with a scarf.
To protect against ticks, you can use repelling and destroying them means – acaricidal-repellent and acaricidal, with which clothes are treated.Before using drugs, you should read the instructions.
Each person, being in a natural focus of tick-borne encephalitis during the season of their activity, should inspect their clothes and body every 15 minutes on their own or with the help of other people. It is also worth checking the coat of pets.
Is it possible to independently extract a tick from the skin?
The sucked tick should be removed at the trauma center or clinic at the place of residence.If this is not possible, you can do it yourself. In this case, you need to remove the tick very carefully so as not to cut off the proboscis, which is attached strongly and deeply.
When removing a tick, it is necessary to grab it with tweezers or fingers wrapped in clean gauze; keep it strictly perpendicular to the surface of the skin. When removing the tick from the skin, it is necessary to turn it around its axis.
The bite site should be disinfected with any means suitable for these purposes (70% alcohol, 5% iodine, cologne).After removing the tick, wash your hands thoroughly with soap and water. If a black dot remains at the site of the bite, this means that the oral apparatus was not removed – it must be treated with 5% iodine and left until it falls off.
What preventive measures against ticks are carried out in the republic?
Anti-mite treatments are carried out in areas where people are often, and the effectiveness of the treatments is monitored. Since the beginning of the year, anti-mite treatments have been carried out in Tatarstan on an area of 423 hectares.
Control over vaccination and seroprophylaxis of tick-borne viral encephalitis continues. In 2021, 2,286 people were vaccinated, of which 162 are children.