An emerging reindeer menace
Via Heather Griffiths (5 PM Micro) a timely alert: physicians in Sweden have published in the New England Journal of Medicine a case report detailing human infestation with Hypoderma tarandi larvae, most likely acquired from a reindeer reservoir. H. tarandi is a sub-Arctic insect that lays its eggs on the hair of reindeers. When the larvae hatch, they burrow into the skin and mature in a condition termed myiasis, and then leave the mammalian host via holes in the skin in the spring. Myiasis is a significant problem in many animals, and insects such as screwflies and botflies are frequently responsible. There are very few cases of human myiasis in the United States, and generally these occur with people who have traveled to tropical or sub-tropical locations and returned.
The current case report is a bit atypical, due to its geographic location. Among the 12 cases of human myiasis reported since 1980 in Norway and Sweden, patients typically presented with ophthalmomyiasis. For 5 patients between 2008 and 2010, all reported traveling to reindeer herding areas during the summer, when the insect agent was likely the most active. None of the patients recalled being attacked by a fly. Initial presentation of disease was via swollen facial lymph nodes and migrating swellings, and subsequently surgical removal of larvae from the eye was performed. Patients were treated with the anti-parasitic drug Ivermectin to kill residual larvae.
The recommendation of the doctors is that myiasis should be considered in people visiting reindeer herding areas, and that Ivermectin may have significant prophylactic potential in preventing surgery in advanced cases. I would further recommend spraying down all wrapped presents with insecticide as well, to further ensure your safety. On a final note, here is a repeat video of Hypnotoad, who we can all now diagnose with myiasis: