Threat of skin disease for football fans and travellers to South America


Dr John McGarry is lecturer in parasitology at the University of Liverpool’s School of Veterinary Science and Institute of Infection and Global Health

“As we near the final of the World Cup 2014 and reflect on the excitements and disappointments of the tournament, we also ask what this great event has meant for the fans travelling to new climates.

As a scientist focused on infectious disease, I published a comment in the Lancet describing the behaviour of some of the insects that travellers to Brazil might encounter.

Fly larvae can cause particular problems in this area of the world, such as human myiasis, which is the invasion of tissue that manifests as boils, abscesses or life threatening wounds filled with maggots.

The type and severity of the lesion depends on the type of fly involved but this is always a distressing disorder, endemic in many tropical and subtropical countries of the world.

The risk of myiasis for visiting football fans from non endemic zones is likely to be very low – especially if the tournament experience is unfortunately brief – but nonetheless a real threat exists and many myiasis cases are seen by UK clinicians each year in travel clinics.

In the case of lumps and boils, signs of infection appear slowly as the maggot feeds and grows in the skin, becoming evident weeks or months following return.

On the other hand the notorious burrowing screwworms of the Amazonian rainforest cause acute wounds in a matter of days, even in the most hygienic individual and must be removed as soon as practically possible before they can cause deep tissue damage.

By highlighting the potential threat to visiting fans, we can highlight the plight of rural, poor indigenous peoples in endemic regions of the world, who are subject to continuous risk of infestation.

Although myiasis is recognised as a neglected tropical disease, it remains misunderstood and therefore marginal, and is, in my opinion, inappropriately grouped with the much less serious, but no less repulsive, ectoparasitic skin disorders known as scabies (skin mites) and tungiasis( fleas under the skin).   It is important to explain the main forms of human myiasis in South America and Africa, and the case for basic research and country-specific assessments of risk.2

The Lancet for Infectious Disease article can be found here.


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