Many dipteran flies produce larvae that must lead a parasitic existence and result in obligatory myiasis. Only one fly in North America, Cochliomyia hominivorax (see ), is a primary invader of fresh, uncontaminated skin wounds of domestic animals. Another species of screwworm, Chrysomya bezziana, is found in Africa and southern Asia, including Papua New Guinea.
Chrysomya bezziana
(Old World Screwworm, Oriental Fly, Bezzi’s Blow Fly)
Chrysomya bezziana is found in Africa, the Indian subcontinent, and southeast Asia from Taiwan in the north to Papua New Guinea in the south. This fly is not indigenous to Australia. Owing to its geography, the most likely potential port of entry for C bezziana to the US is Hawaii.
Adult screwworms are usually not seen in the field. The adult fly has a dark metallic green body with abdominal segments with narrow bands along the caudal margins. The legs are black or partially brown. The face is orange/yellow. The first larval stage probably goes unnoticed because of its small size, up to 3 mm at the time of its molt to the second stage. The second stage is quite similar to the third but is 4–9 mm long. The third-stage larvae are large, up to 18 mm. The body is composed of 12 segments that have broad encircling bands of spinules. All three stages are maggot-like in their appearance and have caudal spiracles that are unique to the species. The caudal end of the larva has its spiracular plate located in a deep cleft at the end of the eighth abdominal segment. The spiracular plates are large and well separated. The peritreme and the three breathing slits are wide.
The Old World screwworm fly, C bezziana, produce a particularly vile myiasis. Female flies are attracted to open wounds of humans and domestic and wild animals, laying their eggs in masses of 150–500 at the edge of wounds or near body orifices. Larvae develop to the third stage ~2 days after hatching. They burrow deep into the wound such that only their caudal ends are visible. The entire larval stage lasts 5–6 days. The pupal stage lasts 7–9 days in tropical conditions and longer in cooler environments. The adult flies emerge later to breed, locate a new host, and continue the cycle. Female flies breed only once during their lifetime—a fact paramount in prevention and control. Under favorable conditions, there may be ≥8 generations per year.
Pathology of C bezziana in Animals
The larvae of C bezziana are obligatory wound parasites, never developing in carcasses or decomposing organic material.
Although female flies are attracted to open wounds, occasionally eggs are deposited on the unbroken, soft skin of various parts of the body, especially if contaminated by blood or mucous discharge. When the larvae hatch, they burrow into the flesh of the host, using their hooked mouthparts to scrape away at the tissues and lacerate the fine blood vessels. Larvae are voracious blood feeders. During the bloodsucking phase, only the caudal ends of the maggots with their blackish peritremes remain visible at the surface of the lesion, enabling the larvae to breathe. As many as 300 maggots have been seen in some wounds. In untreated wounds, the destructive activity of the larvae may lead to the death of the animal within a very short time. Secondary infestation with the facultative myiasis-producing flies may complicate treatment and control.
Diagnosis of C bezziana of Animals
Diagnosis is based on identification of the rarely observed adult flies. In suspect cases, the extracted larva should be submitted to an entomologist for definitive diagnosis.
Diagnosis may often be made by residence in or history of travel to an area endemic for C bezziana. If a wound is thought to be infested with larvae of C bezziana, samples should be collected and sent to appropriate eradication officials.
Treatment and Control of C bezziana of Animals
Screwworm treatment involves removing and killing of the larvae in the lesion
Suspected cases where C bezziana is exotic must be reported to veterinary authorities
Treatment of screwworm infestation involves killing the larvae in the lesions, promoting healing, and preventing secondary reinfestation with larvae of the facultative myiasis-producing flies. The extent of the lesions is determined by clipping the hair coat and removing as many larvae as possible. The larvae that are removed should be killed to prevent them from pupating and developing into adults. Larvae located deep within tissues must be extracted.
Ivermectin arrests C bezziana infestation in cattle at dosages of 50, 100, 200 and 300 mcg/kg. After treatment with 200 mcg/kg, residual protection lasted 16–20 days, 2–3 times that of most insecticide smears. Oral spinosad plus milbemycin registered for flea treatment is used for fast and spontaneous expulsion of screwworm maggots in dogs.
All wounds on domestic animals should be properly dressed, and all elective surgical procedures avoided during the fly season.
Female flies breed only once during their lifetime, which is an important consideration in the control of C bezziana. Pupal flies exposed to irradiation lead to sterile adults that can be released to breed with wild male and female flies. As a result, no viable offspring are produced in the wild.
Wolves (Warbles) of Small Animals
Larvae of the genus Cuterebra are often referred to as wolves, warbles, rabbit bots, or rodent bots. These fly larvae infest the skin of rabbits, squirrels, mice, rats, chipmunks, and occasionally dogs and cats. (For clinical findings, diagnosis, and treatment, see Cuterebra Infestation in Small Animals.)
Gray Flesh Flies
The gray flesh fly, Wohlfahrtia vigil, is responsible for cutaneous myiasis in North America, particularly in southern Canada and the northern part of the US. The adult flies have been recorded from the New England states to Alaska; however, most reports are from eastern sections of Canada and the neighboring northeastern parts of the US. All reports of infestation are in the skin of healthy animals, particularly the unbroken skin of the young.
All three larval stages are maggot-like in their appearance and have caudal spiracles unique to the species. The first larval stage is 1.5 mm at hatching and grows to 3.5 mm at the time of its molt to the second stage. The third stage is 7–18.5 mm long. Its caudal end is narrow, and it is covered with many irregular rows of small spines that have dark points and are directed caudally. This larva is better adapted to maintain an attachment to living tissues. The oral hooks are strongly developed. The caudal end of the larva has its spiracular plate located in a deep pit formed by the margins of the segment. The caudal spiracles have wide slits and a strong peritreme.
The gray flesh fly is larviparous—it deposits larvae instead of eggs on healthy, uninjured skin of suitable hosts, particularly young animals. Larvae penetrate the unbroken skin and form a boil-like (furuncular) swelling. Development to the infective third-larval stage is usually completed in 9–14 days. The parasites then drop to the ground and pupate for ~11–18 days, varying with the season of the year and the temperature. When cold weather approaches, the pupation period is greatly prolonged. Under laboratory conditions, it has been observed to last 7 months. Parasites survive the winter in pupal form. Adults emerge and breed after ~3–4 days. Female flies begin larviposition ~1 week later, depositing 6–16 larvae at a time. Female flies live for 35–40 days; males seldom survive >3 weeks.
Pathology of Gray Flesh Flies of Animals
Female W vigil deposit active larvae near or directly on the host. Although larvae usually penetrate unbroken skin, in small animals, penetration may go deeper than the dermal tissue, even into the coelomic cavity.
The first indication that an animal is infected is exudation of serum and matting of the hair coat over the site of penetration. In light-skinned animals, a small inflammatory area, with a tiny hole visible in the center or to one side, is noticeable. These lesions may be palpated as they develop. On the third or fourth day, the larvae are 1.5–2 cm long and produce abscess-like lesions resembling those of Hypoderma spp in cattle.
Lesions vary in size, shape, position, and the number of larvae they contain. The hair coat often becomes parted over the summit of the lesions and reveals an opening 2–3 mm in diameter. The caudal aspect of the larva is visible in these openings, through which it breathes. Openings are generally circular and well-defined; however, if several larvae are present in a single lesion, the shape of the opening is quite variable. Small animals infected with ≥5 larvae for several days become emaciated, and the skin becomes dry and loses its luster.
The penetration of the skin by the larvae, their development in the subcutaneous tissues, and secondary bacterial infection produce intense irritation and inflammation. Attempts by the animal to remove the larvae or relieve the irritation tend to aggravate the condition. Young animals may die from exhaustion. It has also been suggested that the larvae may produce toxic secretions. W vigil has been isolated from the skin of young children, particularly infants.
Diagnosis of Gray Flesh Flies of Animals
Adult gray flesh flies are nonparasitic and as a result will probably not be seen by owners or veterinarians. They are large grayish flies (~13 mm long), about twice the size of a house fly. The dorsal surface of the thorax is marked with three longitudinal bands, and the dorsal surface of the abdomen has three well-defined rows of oval black spots that are confluent with one another.
The presence of a dermal swelling with a central opening may lead to a tentative diagnosis of myiasis due to W vigil. A definitive diagnosis can be made only after extraction and identification of a typical larva. Extensive descriptions and dichotomous keys for the three larval stages are available. A tentative diagnosis may often be made by a history of either residence in or travel to a geographic area endemic for W vigil.
The identification of adult flies and their associated larval stages should be left to an entomologist.
Treatment and Control of Gray Flesh Flies of Animals
Extraction of larvae from the skin
Control and prevention is based on elimination of the reservoirs maintaining W vigil
Larvae must be extracted from the skin. In suspect cases, the extracted larva should be submitted to an entomologist for definitive diagnosis. Applying heavy oil, liquid paraffin, or petrolatum jelly to the opening of the lesions will occlude the airway of the larvae. Applying a small amount of chloroform or ether to the opening may be helpful before removing larvae with forceps. Lidocaine hydrochloride can also be injected into the furuncular lesion to facilitate extraction. Great care should be taken during the extraction process to avoid rupturing larvae in situ, although anaphylaxis has not been reported. Antimicrobials should be prescribed.
W vigil often infects young mink. A teaspoon of ronnel can be placed in the bedding of mink nest boxes as a control measure; however, ronnel should not be used in the bedding of kits < 3 days old. Protection can be provided by using wire gauze to keep flies out of cages.
Rabbits and rodents are implicated in maintaining populations of W vigil. Control of rabbit and rat populations should be considered in management of W vigil on farms.
African Tumbu Flies
(Mango Fly, Skin Maggot Fly, Ver du Cayor, Worms of Cayor)
The African tumbu fly, Cordylobia anthropophaga, is responsible for another boil-like (furuncular) myiasis in both humans and animals in Africa, particularly in the sub-Saharan regions.
The adult flies are nonparasitic and as a result are not seen by owners or veterinarians. They are stout, compact flies, 6–12 mm long. They are light brown, with diffuse blue-gray patches on the thorax and dark gray on the caudal part of the abdomen. The face and legs are yellow. The second- and third-stage larvae are the stages usually seen in the animal’s skin.
Second-stage larvae are slightly club-shaped and exhibit large, black cuticular spines directed caudally and distributed irregularly over segments 3–8. Segments 9–11 are almost bare when compared with the preceding segments. The segments have a few rows of small, pale spines caudally. Segment 12 is densely covered with these spines. Segment 13 is indistinctly demarcated, lacking spines but possessing two pair of short processes. Each tracheal tube opens through two slightly bent slits. The second-stage larvae are 2.5–4 mm long. The size of advanced second-stage larvae varies greatly, as does the size of third-stage larvae. Fully mature larvae are 1.3–1.5 cm long. The body is cylindrical with 12 identifiable segments. Curved spines that are directed caudally are densely arranged at least up to segment 7; the last 5 segments may be either partially or densely covered with spines.
After fertilization, female flies produce 100–500 banana-shaped eggs, usually depositing them in dry, shady, sandy soil that has often been contaminated by urine or feces. Eggs are never deposited on the skin of the host. Eggs hatch after 1–3 days, and the larvae are initially 0.5–1 mm long. Larvae can survive up to 15 days while waiting for a host and can penetrate the host in as little as 25 seconds. After penetration, larvae reside in a cavity in the dermis and hypodermis. This cavity communicates to the external environment by means of a central breathing pore, which corresponds to the caudal end of the larva with its spiracles. A single larva is found in each cavity, within which the larva develops to the second and third stages. Larvae take 7–15 days to mature and then emerge through the breathing pore and drop to the ground, where they pupate. Adult flies emerge 10–20 days later, and the cycle begins again.
Rats and dogs are the usual definitive host; however, humans, mice, monkeys, mongooses, squirrels, leopards, boars, antelopes, cats, goats, pigs, rabbits, guinea pigs, and chickens can be infested.
Pathology of African Tumbu Flies of Animals
Clinically, the infestation is characterized by a small erythematous papule that appears 2–3 days after larval penetration. Within days, the papule enlarges until it becomes a nodule that resembles a boil (furuncle); hence, the description furunculoid myiasis. At the center of the nodule is a pore through which serous fluid oozes. This fluid can be hemorrhagic or purulent and contains larval feces.
Dogs with thin, soft skin seem to be more suitable hosts for larval development than dogs with thick skin. Preferential sites of infestation are the feet, genitals, tail, and axillae. In endemic areas, mild infestations in dogs do not produce clinical distress. Massive infestation may induce marked swelling and edema, especially if larvae are in close proximity to each other. Larvae can penetrate deep into tissues and cause considerable damage and even death.
Diagnosis of African Tumbu Flies of Animals
The presence of a dermal swelling with a central opening may lead to a tentative diagnosis of myiasis due to C anthropophaga. A definitive diagnosis can be made only after extraction and identification of typical larvae. The identification of adult flies and their associated larval stages should be left to an entomologist.
A tentative diagnosis may often be made by a history of either residence in or travel to a geographic area endemic for C anthropophaga. However, the parasite has also been diagnosed in travelers and their accompanying pets from geographic areas where the parasite is not found.
Treatment and Control of African Tumbu Flies of Animals
Larval removal using light pressure at the edges of the lesions
Control of reinfection by preventing flies from depositing eggs in sandy soil contaminated by feces or urine and management of vermin
Larvae can be removed by coating the breathing pore with a thick, viscous compound, such as heavy oil, liquid paraffin, sticking plaster, or petrolatum jelly. Clogging the pore causes the larva to become hypoxic and leave the cavity in search of oxygen. Light pressure at the edge of the lesion also aids in larval removal.
Lidocaine hydrochloride can be injected into the furuncular lesion to facilitate larval extraction with thumb forceps. Surgical excision is usually unnecessary and unwarranted while the larvae are alive but is used to remove dead or decaying larvae. Great care should be taken during the extraction process to avoid rupturing larvae in situ, although anaphylaxis has not been reported. Antimicrobials should be prescribed.
Adult flies should be killed if seen indoors. Larvae should be removed from animals entering the house and destroyed. All rats should be killed and burned. Prevention of an infestation depends on cleanliness and regular disinfection of the animal’s sleeping quarters. In the case of valuable animals (eg, Angora rabbits), flies may be kept out of rabbit pens using wire gauze.
Because the adult female flies lay eggs in sandy soil contaminated by feces or urine, the parasite can be controlled in the pet’s environment by prompt removal of the pet’s feces and by covering urination sites on the premises with a layer of dirt.
For More Information
