Aradhana Sood1, D K Raman2, R K Joshi3, Darpan Gupta4. 1. Associate Professor, Department of Dermatology & Venereology, Armed Forces Medical College, Pune 411040, India. 2. Associate Professor, Department of Pathology, Armed Forces Medical College, Pune 411040, India. 3. Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India. 4. Classified Specialist (Surgery), Command Hospital (Western Command), Chandimandir, India.
Abstract
BACKGROUND: Tungiasis is an ectoparasitosis caused by the sand flea Tunga penetrans. It is endemic in the under privileged communities of Latin America, the Caribbean and Sub Saharan Africa with geographic and seasonal variations even within endemic areas. We describe investigation of an outbreak of Tungiasis in troops deployed as part of UN peacekeeping force in Central Africa. METHODS: Tungiasis was diagnosed in an unusually large number of cases of severely pruritic boils over feet in soldiers of a UN peacekeeping battalion. An outbreak investigation was carried out and the outbreak was described in time, place and person distribution. A retrospective cohort study was done to ascertain the associated risk factors. RESULTS: A total of 36 cases were identified of which 33 had laboratory confirmation. Of the 36 cases, 10(27.77%) had only Fortaleza Stage II lesions, 22 (61.11%) a combination of Fortaleza Stage II and III lesions and four (11.11%) cases had a combination of Stage, II, III and IV lesions. Secondary bacterial infection was seen in 25 (69.44%) cases. Epidemiological analysis revealed that it was a common source single exposure outbreak traced to a temporary campsite along one of the patrolling routes. CONCLUSION: In a Military setting an integrated approach combining health education and environmental control is required to prevent such outbreaks.
BACKGROUND: Tungiasis is an ectoparasitosis caused by the sand flea Tunga penetrans. It is endemic in the under privileged communities of Latin America, the Caribbean and Sub Saharan Africa with geographic and seasonal variations even within endemic areas. We describe investigation of an outbreak of Tungiasis in troops deployed as part of UN peacekeeping force in Central Africa. METHODS: Tungiasis was diagnosed in an unusually large number of cases of severely pruritic boils over feet in soldiers of a UN peacekeeping battalion. An outbreak investigation was carried out and the outbreak was described in time, place and person distribution. A retrospective cohort study was done to ascertain the associated risk factors. RESULTS: A total of 36 cases were identified of which 33 had laboratory confirmation. Of the 36 cases, 10(27.77%) had only Fortaleza Stage II lesions, 22 (61.11%) a combination of Fortaleza Stage II and III lesions and four (11.11%) cases had a combination of Stage, II, III and IV lesions. Secondary bacterial infection was seen in 25 (69.44%) cases. Epidemiological analysis revealed that it was a common source single exposure outbreak traced to a temporary campsite along one of the patrolling routes. CONCLUSION: In a Military setting an integrated approach combining health education and environmental control is required to prevent such outbreaks.
Authors: H Feldmeier; J Heukelbach; M Eisele; A Queiroz Sousa; L Marilac Meireles Barbosa; C B M Carvalho Journal: Trop Med Int Health Date: 2002-07 Impact factor: 2.622
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