External Ophthalmomyiasis Caused by a Rare Infesting Larva, Sarcophaga argyrostoma.

Purpose. External ophthalmomyiasis (EO) is caused by infesting larvae belonging to various species of flies. Most documented cases result from sheep (Oestrus ovis) and Russian (Rhinoestrus purpureus) botfly larvae, but we recently discovered a rare case of EO caused by flesh fly (Sarcophaga argyrostoma) larvae. Here, we report the case of a patient with EO who had been hospitalized and sedated for 1 week because of unrelated pneumonia. Methods. Case report. Results. A total of 32 larvae were removed from the adnexae of both eyes. Larvae identification was confirmed through DNA analysis. Treatment with topical tobramycin resulted in complete resolution of EO. Conclusion. EO can be caused by S. argyrostoma, and the elderly and debilitated may require extra ocular protection against flies during sedation.

Molecular characterization of Borrelia persica, the agent of tick borne relapsing fever in Israel and the Palestinian Authority.

The identification of the Tick Borne Relapsing Fever (TBRF) agent in Israel and the Palestinian Authority relies on the morphology and the association of Borrelia persica with its vector Ornithodoros tholozani. Molecular based data on B. persica are very scarce as the organism is still non-cultivable. In this study, we were able to sequence three complete 16S rRNA genes, 12 partial flaB genes, 18 partial glpQ genes, 16 rrs-ileT intergenic spacers (IGS) from nine ticks and ten human blood samples originating from the West Bank and Israel. In one sample we sequenced 7231 contiguous base pairs that covered completely the region from the 5'end of the 16S rRNA gene to the 5'end of the 23S rRNA gene comprising the whole 16S rRNA (rrs), and the following genes: Ala tRNA (alaT), Ile tRNA (ileT), adenylosuccinate lyase (purB), adenylosuccinate synthetase (purA), methylpurine-DNA glycosylase (mag), hypoxanthine-guanine phosphoribosyltransferase (hpt), an hydrolase (HAD superfamily) and a 135 bp 5' fragment of the 23S rRNA (rrlA) genes. Phylogenic sequence analysis defined all the Borrelia isolates from O. tholozani and from human TBRF cases in Israel and the West Bank as B. persica that clustered between the African and the New World TBRF species. Gene organization of the intergenic spacer between the 16S rRNA and the 23S rRNA was similar to that of other TBRF Borrelia species and different from the Lyme disease Borrelia species. Variants of B. persica were found among the different genes of the different isolates even in the same sampling area.

[Personal protection measures against blood-sucking insects and ticks].

Blood-sucking arthropods are major vectors of various pathogens like viruses, bacteria, protozoa and nematodes. Preventing exposure to the vector is imperative especially when vaccine and prophylactic treatments are not available. Personal protection measures (PPM) are essential and often the only means available when dealing with blood-sucking disease transmitting arthropods. Awareness of the risk in the specific areas of travel is the first step to be taken before and while traveling. PPM include preventive personal behavior, suitable clothing, application of insect repellents to the skin, the use of space repellents, impregnation of clothing, camping gear and bed nets and, when necessary, ground spraying of insecticides. The registered and recommended active ingredients for skin application are Deet, picaridin (icaridin), p-menthane-3,8-diol (PMD) and IR3535. Volatile pyrethrins are used as space repellents while pyrethroids, especially permethrin, are employed for impregnation and for ground spraying. It is recommended to purchase only products registered in Israel or other developed countries. These products should have a detailed label specifying the concentration of the active ingredient, application instructions and the duration of protection.

Oral myiasis: a case report and literature review.

Myiasis is the infestation of tissues and organs of animals and humans by certain Dipteran fly larvae. This phenomenon is well documented in the skin, especially among animals and people in tropical and subtropical areas. Oral myiasis is a rare condition and can be caused by several species of Dipteran fly larvae and may be secondary to serious medical conditions. Upon removal of the larvae, the tissues seem to recover with no subsequent complications and with no need for further treatment. Here we describe a case of oral myiasis within the gingiva of a healthy young man caused by the larvae of Wohlfahrtia magnifica (Family Sarcophagidae), in which infection may have been due to ingestion of infested flesh. Reviewing the literature revealed that most cases of oral myiasis tend to be multiple and to occur in anterior segments of the jaws rather than in posterior segments as in the case we describe here.

Attempts to control sand flies by insecticide-sprayed strips along the periphery of a village.

The customary method for controlling leishmaniasis and sand fly bites in Israel is the spraying of large quantities of residual insecticides on walls of houses and neighboring surfaces. However, the high summer temperatures, strong radiation, and dust limit the efficacy of the method. The sand fly vectors of Leishmania appeared to come uphill to the village of Kfar Adumim. Therefore, to block their path and improve control, beta-cyfluthrine or DDT were repeatedly sprayed on a strip of cloth that was stretched on the ground along and near the peripheral houses. The efficacy of the treatments was examined by comparing the proportions of sand flies that had been caught before and after the treatments, below and above the belt. The capture near the houses of sand flies that had been marked by colored sugar baits below the protective belt indicated that they were moving uphill and crossing the strip. The catches showed a gradual uphill decrease, up to the houses, in the number of sand flies. However, the proportions of sand flies caught in the different sites were similar before and after insecticide treatments showing that the belt was ineffective. Laboratory tests of pieces of the sprayed strip and exposure of sand flies to similar pieces indicated that the lack of effect was not caused by deficiency of insecticides.