Internal ophthalmomyiasis and treatment by laser photocoagulation: a case report.

The clinical diagnosis, treatment management, and epidemiology of a case of unilateral posterior ophthalmomyiasis in a university farm manager are reported. Subretinal tracking was prominent, leading to vision abnormalities, which initially prompted the patient to seek medical evaluation. Identification of the organism based on study of photographs was judged to be a first-instar larva of a Cuterebra (rodent bot fly), although identification of first-instar (stage) myiasis-producing fly larvae is impossible. Inasmuch as the patient was a herdsman, it is likely that the larva is of the genus Hypoderma (cattle grub) or possibly Gasterophilus (horse bot). Laser treatment was effectively used to destroy and immobilize the organism. Subsequently, the patient's health remains satisfactory, and his vision has improved. This case is reported to confirm increasing frequency of ophthalmomyiasis and to improve awareness of its features. Early recognition of this condition, when tumors and other conditions remain suspect, would preclude unnecessarily invasive surgical procedures, including enucleation.

Atypical crusted "Norwegian" scabies: report of nosocomial transmission in a community hospital and an approach to control.

During August, 1981, a person with an unrecognized case of atypical Norwegian scabies was admitted to a community hospital in Chariton, Iowa. Twenty cases of symptomatic scabies were reported among hospital staff; mites were recovered from four. Subsequent evaluation confirmed scabies transmission to family and friends of this patient before hospitalization; twelve cases of symptomatic scabies, three of them slide positive, were identified in this group. The patient was treated sequentially with 1 percent lindane lotion, 10 percent crotamiton lotion, and 6 percent sulfur ointment to successfully eradicate the infestation. Secondary cases in the hospital and community were treated with 10 percent crotamiton which also was used to prophylactically treat exposed contacts. Control measures and patient management are presented.

A trichinosis outbreak in Iowa.

During December 1975 and January 1976, seventy-nine persons in Postville, Iowa, and nearby communities were infected with trichinosis by eating locally produced summer sausage made from a mixture of venison (provided by deer-hunting parties) and pork. More than 242 local residents and holiday visitors from five other states and Canada were exposed to the sausage, in which the venison was mixed in a 2:1 ratio with government-inspected and commercially obtained pork. Laboratory examinations of incriminated sausage samples showed one to 65 Trichinella larvae per 100 g and indicated that temperatures during processing had not exceeded 54 degrees C. Corrective measures centered on improving temperature monitoring during the smoking process at the sausage-preparation plant to ensure that adequate temperatures are achieved. Persons possessing the implicated sausage were advised to destroy it or to cook it adequately before eating it.

Western equine encephalomyelitis in horses in the Northern Red River Valley, 1975.

In mid-July, 1975, western equine encephalomyelitis (WEE) virus was isolated from mosquitoes collected in flooded areas of eastern North Dakota and western Minnesota. Inasmuch as clinical manifestations of WEE are usually observed in horses before human cases of encephalitis are recognized, surveillance of equine disease was initiated. Sixty-one practicing veterinarians from the are under surveillance reported 281 cases of WEE in horses from June through September, with peak incidence in late July. The high percentage of sero-positive, clinically normal, unvaccinated horses in one region suggested that many horses had developed non-clinical infections. The efficacy of vaccines used by the practitioners appears to have been execllent, as none of the horses vaccinated before the epizootic became ill during the period of surveillance. It was concluded that data collected from routine surveillance of encephalomyelitis in horses could be used to predict epidemics of WEE.