Bulletin of the World Health Organization

Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues

Hermann Feldmeier & Jorg Heukelbach

Volume 87, Number 2, February 2009, 152-159

Table 1. Biological and epidemiological characteristics of the six major EPSD

Characteristics Scabies Pediculosis capitis Pediculosis corporis Pediculosis pubis Tungiasis HrCLM
Infective agent Sarcoptes scabiei Pediculus humanus var. capitis Pediculus humanus var. corporis Phthirus pubis Tunga penetrans Animal hookworm species such as A. caninum, A. braziliense, Uncinaria stenocephala
Taxonomical classification Acaridae (mite) Phtiraptera (louse) Phtiraptera (louse) Phtiraptera (louse) Siphonaptera (flea) Helminths (nematode)
Life-cycle Completely on-host Completely on-host Completely on-host Completely on-host Partially on-hosta Partially on-host (biological impasse)
Person-to-personb +++ +++ +++ (+)
Sexual + +++
Fomite + + +++ + (+) (+)
Soil-to-skin +++ +++
Capacity to transfer pathogenic microorganisms
Actively Not known (+) +++ + Not known
Passively + ++ ++ ++ +++ ++
Occurrence Worldwide Worldwide Restricted mainly to cold-climate regions Worldwide Caribbean, sub-Saharan Africa, South America Predominantly in hot-climate countries
Seasonal variation Peak during cold seasonc Peak during cold seasonc Inconsistent data Peak during cold season Peak in hot and dry season Peak in rainy season
Animal reservoir nod no no no Dogs, cats, pigs, ratse Dogs, catse

EPSD, epidermal parasitic skin diseases; HrCLM, hookworm-related cutaneous larva migrans.+, rare; ++, frequent; +++, very frequent.
a Female fleas penetrate into the epidermis, develop and produce eggs; Eggs develop into larvae, pupae, adults off-host in soil.
b Other than sexual.
c Only in cold-climate countries.
d Sarcoptic mange may be transmitted to humans from pet dogs but causes self-limiting manifestations.
e Other animals may serve as a reservoir.

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