Summary about Disease
Jigger infestation, also known as tungiasis, is a parasitic skin disease caused by the female sand flea Tunga penetrans. These fleas burrow into the skin, typically on the feet, causing inflammation, pain, and itching. Left untreated, tungiasis can lead to secondary infections and other complications. It's prevalent in impoverished communities in tropical and subtropical regions, particularly in sub-Saharan Africa, South America, and the Caribbean.
Symptoms
Small, black dot on the skin (usually on the feet, between toes, or under toenails)
White halo around the black dot
Pain
Itching
Inflammation
Difficulty walking (if infestation is severe)
Secondary bacterial infections (e.g., cellulitis, abscesses)
Ulceration
Causes
Tungiasis is caused by the female sand flea, Tunga penetrans, burrowing into the skin. This typically occurs when people walk barefoot or wear open shoes in infested soil or sand. Areas with poor sanitation, lack of proper footwear, and close contact with domestic animals are breeding grounds for the fleas.
Medicine Used
Physical removal: The primary treatment involves carefully extracting the embedded jigger using a sterile needle or scalpel. It is crucial to avoid crushing the flea to prevent releasing eggs and causing further inflammation.
Topical treatments:
Ivermectin: Topical ivermectin can be used to kill the fleas.
Metrifonate: Topical metrifonate has also been used.
Antibiotics: Topical or oral antibiotics are prescribed if secondary bacterial infections occur.
Tetanus vaccination: Recommended, especially if the person's vaccination status is uncertain.
Is Communicable
Tungiasis is not directly communicable from person to person. It is acquired through contact with infested environments (soil, sand) where the sand fleas reside. However, multiple people living in the same infested environment can be affected simultaneously.
Precautions
Wear closed-toe shoes and socks, especially when walking in sandy or soil-rich areas.
Avoid walking barefoot in known infested areas.
Improve sanitation and hygiene practices, including regular cleaning of living areas.
Control sand flea populations in domestic animal habitats.
Apply insect repellent to feet and ankles.
Wash and inspect feet regularly, especially after exposure to potentially infested environments.
How long does an outbreak last?
Individual jigger infestations last for several weeks. Once the female flea burrows into the skin, it matures, lays eggs (which are expelled), and eventually dies, usually within 4-6 weeks. However, if untreated or if reinfection occurs, the problem can persist for much longer, leading to a chronic condition.
How is it diagnosed?
Tungiasis is usually diagnosed clinically by visual examination of the skin. The characteristic appearance of the lesion (small black dot with a surrounding white halo) is often sufficient for diagnosis. Dermoscopy can aid in visualization and confirm the presence of the flea within the skin. Lab tests are generally not required.
Timeline of Symptoms
Day 1-3: Flea burrows into the skin; slight itching or irritation may be present.
Day 4-7: Black dot becomes more prominent; white halo appears; pain and itching intensify.
Day 8-21: Swelling and inflammation increase; egg laying occurs; secondary infections may develop.
Day 22-42: Flea dies; lesion may ulcerate; if untreated, symptoms can persist and worsen due to secondary infections. Note: This timeline can vary depending on individual immune responses, hygiene, and the presence of secondary infections.
Important Considerations
Prompt treatment is crucial to prevent complications.
Proper technique for jigger removal is essential to avoid secondary infections.
Community-based interventions, including health education and environmental sanitation, are vital for controlling tungiasis in endemic areas.
Pain management may be necessary, especially in severe cases.
Address underlying factors such as poverty, poor sanitation, and lack of access to healthcare to prevent recurrence.