While abroad, washing your clothes and leaving them to dry in the open air can lead to significant problems for the international traveller. In many of the hotter regions of the world a fly can actually lay her eggs on damp clothing which has been laid out to dry.
This usually happens when the clothes are drying in shaded areas and not so often if they are left in the direct sunlight. The unsuspecting traveller may then put on the clothes when they dry (without ironing them first) and this leads to irritating skin infection known as Tissue Myiasis.
Where Myiasis is found
The regions where this infection is most commonly found includes sub-Saharan Africa, southern Spain, Central and South America and Asia. We have seen many patients from areas like Barbados and the Inca Trail as well as others who have trekked across Africa how have come for post travel health screening.
During the period of time when the larva is developing under the infected individuals skin (remember there may be many lesions) they are not as painful as might be expected from a traditional boil. The diagnosis may be confirmed by carefully looking (this may require a magnifying glass) for the characteristic air spiracles, which are small black splinter like tubes. They come from the larva to the skin surface and allow it to breathe.
Treatment for myiasis consists of covering the lesions with any occlusive ointment such as Vaseline or an antibiotic/steroid cream for 24 hours. This blocks the air spicule and encourages the larva to move towards the surface. At this stage it is easier to very gently exert pressure around the lesion to encourage the larva out. If care is not taken at this point the larva will be ruptured and this may easily lead to severe inflammation.
Prevention of Myiasis relies on trying to dry clothes in areas where the adult flies cannot lay their eggs. If clothing has been hung out-of-doors it should always be ironed on both sides before it is worn. This is especially true of underclothing, babies nappies and socks. Any clothing may become infected. The elasticated waists on clothing will also need special attention. Rewashing of the clothing may not be sufficient to clear the larva.
Thank you for reading How to prevent Myiasis – Travel Health Advice. For more information please see Avoiding Tissue Myiasis – Travel Health PDF.