Veterinary Epidemiology and Zoonosis

CUTANEOUS LARVAL MIGRANS

Synonym

• Creeping eruption

Type of zoonosis

• Saprozoonosis, Anthropozoonosis

Etiology

• Cutaneous larval migrans (CLM) is caused by the larvae of the dog and cat hookworms, Ancylostoma braziliense and Ancylostoma caninum. A number of other animal hookworms, gnathostomiosis and strongyloidosis are rarely also causative agents.

Reservoir and incidence

• Cutaneous larval migrans is prevalent throughout the tropic and subtropics.
• Human infection is common in contact with moist sandy soil (e.g., beaches, children's sand piles) contaminated by dog or cat faeces.

Transmission

• Direct skin contact with larvae (soil to skin contact, contamination with animal faeces).

Figure: Direct contact of children with dog

Disease in animals

• Loss of blood together with malnutrition produce anaemia.
• Severe enteritis causes haemorrhagic diarrhoea and weight loss from intestinal malabsorption.
• Prenatal infection of the dog causes death of the foetal pups.
• Mild infections generally cause no clinical signs.

Disease in man

• Intensely pruritic erythematous papules appear at the site of larval entry, particularly on the hands or feet.
• Two to 3 days later, serpiginous eruptions appear as the larvae migrate at a rate of several millimeters a day. The process continues for weeks or up to a year, and the lesions may remain severely pruritic, vesiculate and become encrusted and secondarily infected.
• Without treatment, the larvae eventually die and are absorbed.

Diagnosis

• Based on history and characteristic clinical signs.

Treatment

• Treatment is not needed, but, antihistamines and antibiotic ointments can be applied
• Albendazole or thiabendazole can be taken.

Prevention and control

• Decontaminate environment with sodium borate or sodium hypochlorite solution.
• Prevent environmental contamination.
• Minimize contact.
• Public health education.