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In 3b, the chitin exoskeleton of tergites 2 and 3 increase in thickness and gives the structure the look of a mini caldera. Egg release is common in substage 3b, as are fecal coils. The eggs tend to stick to the skin. At about the 3rd week after penetration, stage 4 begins, which is also divided into
705:
By stage 2 (days 1–2), penetration is complete and the flea has burrowed most of its body into the skin. Only the anus, the copulatory organs, and four rear air holes in fleas called stigmata remain on the outside of the epidermis. The anus will excrete feces that is thought to attract male fleas for
733:
and appears near death. As a result, the lesion shrinks in size, turns brown, and appears wrinkled. The death of the flea marks the beginning of substage 4b (around day 25 post-penetration) as the body begins to eliminate the parasite through skin repair mechanisms (e.g. shedding and subsequent skin
617:
About six to eight days after hatching, the larva pupates and builds a cocoon around itself. Because it lives mostly on and below the surface of sand, sand is used to stabilize the cocoon and help to promote its development. An environmental disturbance such as rain or a lack of sand have been shown
806:
There are no drugs currently available with proven effectiveness. Surgical extraction still remains the treatment of choice in patients with a low parasite load, such as tourists returning from endemic areas. The only approach to reduce tungiasis-associated morbidity in heavily affected individuals
797:
after they were shipwrecked on Haiti. Through ship routes and further expeditions, the chigoe flea was spread to the rest of the world, particularly to the rest of Latin
America and Africa. The spread to greater Africa occurred throughout the 17th and 19th centuries, specifically in 1873 when the
613:
After hatching, the flea will progress through two instar phases. This is unique in that most fleas go through three. Over the course of that development, the flea will first decrease in size from its just-hatched size of 1.5 mm to 1.15 mm (first instar) before growing to 2.9 mm (second instar).
693:
development of the female chigoe flea for the first time. In dividing the natural history of the disease, the
Fortaleza Classification formally describes the last part of the female flea's life cycle where it burrows into its host's skin, expels eggs, and dies.
357:. First, it has a wide distribution: some 88 countries, in the Caribbean, Central and South America, tropical (sub-Saharan) Africa, and India. Second, it can infest a wide variety of hosts: at least 26 different species in over five different orders of mammals.
706:
mating, described in a later section. The hypertrophic zone between tergites 2 and 3 in the abdominal region begins to expand a day or two after penetration and takes the appearance of a life belt. During this time, the flea begins to feed on the host's blood.
716:
Due to the expanding flea, the outer layer of the skin is stretched thin, resulting in the appearance of a white halo around the black dot (rear end of the flea) at the center of the lesion. The black dot is the flea's exposed hind legs, respiratory
697:
Stage 1 is characterized by the penetration of the skin by the female chigoe flea. Running along the body, the female uses its posterior legs to push its body upward by an angle between 45 and 90 degrees. Penetration then starts, beginning with the
338:. Mites penetrate the skin and feed on skin cells that are broken down through an enzyme they secrete from their mouth, but they will then leave the host. The adult and the larval forms both feed on other animals. This is not the case with
618:
to decrease incidence, most likely due to decreasing the environmental factors (i.e., sand) on which the flea depends for overall growth. Barring any disturbances to the cocoon, an adult flea will emerge from the puparium after 9–15 days.
1064:
Linardi, P. M.; Calheiros, C. M. L.; Campelo-junior, E. B.; Duarte, E.M.; Heukelbach, J.; Feldmeier, H. (2010). "Occurrence of the off-host life stages of Tunga penetrans (Siphonaptera) in various environments in Brazil".
313:
or irritation which then passes as the area around the flea calluses and becomes insensitive. As the flea's abdomen swells with eggs later in the cycle, the pressure from the swelling may press neighbouring nerves or
1389:
651:
Tungiasis lesions almost always occur on the feet (97%), but may occur on any part of the body. The toes are afflicted over 70% of the time, with periungual folds (around the toenail) a preferred site.
1211:
Eisele, Margit; Heukelbach, Jörg; Van Marck, Eric; Mehlhorn, Heinz; Meckes, Oliver; Franck, Sabine; Feldmeier, Hermann (2003). "Investigations on the biology, epidemiology, pathology and control of
655:
Only once the female burrows into the skin can reproduction occur, as the male and female show no interest in each other in the wild. The male flea dies after copulation. The female flea continues
1157:
Nagy, N.; Abari, E.; D’Haese, J.; Calheiros, C.; Heukelbach, J.; Mencke, N.; Feldmeier, H.; Mehlhorn, H. (2007). "Investigations on the life cycle and morphology of Tunga penetrans in Brazil".
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eggs, on average, are 0.6 mm long, The larva will hatch from the egg within one to six days, assuming the environmental conditions (e.g., moisture, humidity, etc.) are favorable.
581:
For the most part, the chigoe flea lives 2–5 cm below sand, an observation which helps explain its overall distribution. The temperature is generally too hot for the
666:, which it releases through the caudal orifice to fall to the ground when ready to hatch. The flea then dies and is often the cause of infection as the body
670:
under the thick scales its body chemistry created to protect it. The eggs mature into adult fleas within three to four weeks and the process begins anew.
839:
1466:
Joseph J.; Bazile J.; Mutter J.; Shin S.; Ruddle A.; Ivers L.; Lyon E.; Farmer P. (2006). "Tungiasis in rural Haiti: a community-based response".
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species infest only rodents. Two dedicate themselves to armadillos, one to sloths, and another prefers only cattle. Only one,
588:
In a study of off-host stages, samples were taken from the top of the soil (to a maximum depth of 1 cm). The presence of
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layer of the skin, it may reach up to 1 cm across. During the first day or two of infestation, the host may feel an
1787:
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Stage 3 is divided into two substages, the first of which being 2–3 days after penetration is complete. In 3a, maximum
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1772:
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deformation. These seem to be commonplace especially where heavy infestations combine with unsanitary conditions and
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159:
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like other fleas, but the female flea burrows head-first into the host's skin, leaving the caudal tip of its
480:
318:. Depending on the exact site, this can cause sensations ranging from mild irritation to serious discomfort.
342:, as only the adults feed on mammals, and the mature female remains in the host for the rest of her life.
592:
in a soil sample was unaffected by soil temperature, air temperature or air humidity. No life stages of
233:. In its parasitic phase it has significant impact on its hosts, which include humans and certain other
1631:
1578:
924:
798:
infected crewmen of the Thomas
Mitchell's ship introduced it into Angola, having sailed from Brazil.
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991:
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43:
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Linardi, Pedro Marcos; Beaucournu, Jean-Claude; de Avelar, Daniel
Moreira; Belaz, Sorya (2014).
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1593:
1501:
Hoeppli R (1963). "Early references to the occurrence of Tunga penetrans in tropical Africa".
943:(Siphonaptera: Tungidae) II – neosomes, morphology, classification, and other taxonomic notes"
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474:
138:
862:
Jarocki, 1838 (Siphonaptera: Tungidae). I – Taxonomie, phylogénie, écologie, rôle pathogène"
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633:. This orifice allows the flea to breathe, defecate, mate and expel eggs while feeding from
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1653:
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If the flea is left within the skin, dangerous complications can occur including secondary
558:
8:
791:, where he discussed the skin infection and its symptoms on crew members from Columbus's
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Tungiasis was endemic in pre-Columbian Andean society for centuries before discovery of
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534:
486:
1583:"Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues"
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Beaucournu, J.-C.; Degeilh, B.; Mergey, T.; Muñoz-Leal, S.; González-Acuña, D. (2012).
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to develop on the surface of the sand and the deeper sand does not have enough oxygen.
258:
38:
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as native to the West Indies. The first
European description was published in 1526 by
379:, has also been found infesting humans as well as cows, but only in Ecuador and Peru.
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Over the next two weeks, its abdomen swells with up to several hundred to a thousand
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689:(2003) provided and detailed the five stages of tungiasis, thereby detailing the
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development, described in stages by the
Fortaleza classification of tungiasis.
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are only in the
Western hemisphere, and each only targets one or two specific
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Feldmeier H, Heukelbach J, Eisele M, Souza A, Barbosa L, Carvalho C (2002).
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Heukelbach, Jörg; Wilcke, Thomas; Harms, Gundel; Feldmeier, Hermann (2005).
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is the application of a repellent to prevent the penetration of sand fleas.
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1400:. Toledo: acostas del autor: por industrias del maestre Ramon de Petras.
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is most recognizable in its parasite phase. While embedded under the
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is achieved and the flea's midsection swells to the size of a pea.
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There is an observable drop in infestations during the wet season.
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Transactions of the Royal
Society of Tropical Medicine and Hygiene
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http://pediatrics.about.com/od/dermatologytopics/a/06_chiggers.htm
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issued a bulletin, published online 28 November 2008, entitled
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repair). At this phase, the lesion is seen as brown or black.
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1530:"Revision on tungiasis: treatment options and prevention"
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1113:"Seasonal variation of tungiasis in an endemic community"
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Linardi, Pedro Marcos; de Avelar, Daniel
Moreira (2014).
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456:
450:
402:
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1413:"Tungiasis in a young child adopted from South America"
1010:"Neosomes of tungid fleas on wild and domestic animals"
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849:
330:, a parasitical mite. However, the jigger is a type of
1117:
The
American Journal of Tropical Medicine and Hygiene
1337:
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in Brazil: I. Natural history of tungiasis in man".
930:
846:
681:In a seminal paper on the biology and pathology of
729:two substages. In 4a, the flea loses its signs of
353:is unusual for the 13 known species of the genus
1764:
1410:
1007:
326:The colloquial name jigger may be confused with
1527:
1386:
1340:"Evidence of tungiasis in pre-Hispanic America"
1338:Maco, V; Tantaleán, M; Gotuzzo, E (May 2011).
1106:
1104:
1067:Annals of Tropical Medicine & Parasitology
1057:
1003:
1001:
334:(Order Siphonaptera). The chigger is a minute
1299:"Bacterial superinfection in human tungiasis"
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1404:
1390:Sumario de la natural historia de las Indias
1303:Tropical Medicine & International Health
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843:Clin Dermatol. 2007 Mar-Apr;25(2):158-64.
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923:"Chiggers." About.com. 27 Feb. 2009 <
763:. Lingering effects may include loss of
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283:
249:, a type of mite. Jiggers are native to
1534:Expert Review of Anti-Infective Therapy
837:Cestari TF, Pessato S, Ramos-e-Silva M
360:In contrast, most of the 13 species of
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1459:
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673:
237:species. A parasitical infestation of
1592:
1591:
1411:Darmstadt GL, Francis JS (May 2000).
1193:
629:visible through an orifice in a skin
789:Gonzalo Fernández de Oviedo y Valdés
1145:
13:
596:were found in any outdoor sample.
345:
245:. Jiggers are often confused with
14:
1809:
1571:
484:(southern long-nosed armadillo),
279:
1430:10.1097/00006454-200005000-00024
1316:10.1046/j.1365-3156.2002.00904.x
1079:10.1179/136485910X12743554759902
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298:Jigger (sand flea) infested foot
42:
1798:Parasitic arthropods of mammals
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621:Males are still mobile after a
1262:Images in clinical medicine".
917:
741:from trapped bacteria such as
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321:
257:, and have been introduced to
1:
822:
702:going through the epidermis.
602:
1480:10.1016/j.trstmh.2005.11.006
1387:Oviedo y Valdes, F. (1526).
1344:Emerging Infectious Diseases
801:
7:
1793:Taxa named by Carl Linnaeus
878:10.1051/parasite/2012194297
810:
526:(Central American agouti),
10:
1816:
778:
1788:Insects described in 1758
1600:
1579:World Health Organization
1229:10.1007/s00436-002-0817-y
1171:10.1007/s00436-007-0683-8
1130:10.4269/ajtmh.2005.72.145
1026:10.1007/s00436-014-4081-8
478:(nine-banded armadillo),
144:
137:
39:Scientific classification
37:
28:
23:
1778:Insects of South America
1773:Insects of North America
1546:10.1586/14787210.4.1.151
1528:Jorg Heukelbach (2006).
1258:Muehlstaedt, M (2008). "
959:10.1051/parasite/2014067
562:(Brazilian guinea pig),
1417:Pediatr. Infect. Dis. J
487:Chaetophractus villosus
1356:10.3201/eid1705.100542
840:Tungiasis and myiasis.
299:
291:
1276:10.1056/nejmicm074290
1217:Parasitology Research
1159:Parasitology Research
1014:Parasitology Research
490:(big hairy armadillo)
297:
287:
270:Sarcopsylla penetrans
231:sub-tropical climates
1260:Periungual Tungiasis
1165:(Suppl 2): S233–42.
939:"Notes on the genus
538:(Temminck's mouse),
475:Dasypus novemcinctus
439:Potamochoerus porcus
1453:"Untitled Document"
723:reproductive organs
523:Dasyprocta punctata
276:, and many others.
760:Clostridium tetani
755:enterobacteriaceae
637:. It lives in the
383:Host species for
377:Tunga trimamillata
300:
292:
259:sub-Saharan Africa
182:also known as the
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1759:
1745:Open Tree of Life
1594:Taxon identifiers
1020:(10): 3517–3533.
565:Myoprocta acouchy
547:Rattus norvegicus
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130:T. penetrans
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568:(red acouchi),
553:Cavia porcellus
535:Mus musculoides
532:(house mouse),
442:(red river hog)
351:Tunga penetrans
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346:Genus and hosts
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307:stratum corneum
289:Tunga penetrans
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266:Tunga penetrans
171:Tunga penetrans
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960:
956:
952:
948:
944:
942:
933:
926:
920:
912:
905:
901:
896:
891:
887:
883:
879:
875:
871:
867:
863:
861:
852:
850:
842:
841:
834:
832:
827:
818:
815:
814:
808:
799:
796:
795:
790:
786:
776:
774:
770:
766:
762:
761:
756:
752:
751:
750:Streptococcus
746:
745:
740:
735:
732:
726:
724:
720:
714:
712:
707:
703:
701:
695:
692:
688:
684:
676:
671:
669:
665:
660:
658:
653:
649:
647:
644:
640:
636:
635:blood vessels
632:
628:
624:
619:
615:
611:
609:
600:
597:
595:
591:
586:
584:
571:
567:
566:
561:
560:
555:
554:
550:(brown rat),
549:
548:
544:(black rat),
543:
542:
541:Rattus rattus
537:
536:
531:
530:
525:
524:
519:
518:
513:
510:
507:
506:
501:
500:
495:
492:
489:
488:
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482:
477:
476:
471:
468:
465:
464:
463:Panthera onca
459:
458:
453:
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447:
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440:
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429:
428:
423:
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417:
416:
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405:
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399:
398:
393:
390:
389:
388:
387:
386:
385:T. penetrans'
380:
378:
374:
369:
367:
363:
358:
356:
352:
343:
341:
337:
333:
329:
319:
317:
316:blood vessels
312:
308:
304:
296:
290:
286:
277:
275:
271:
267:
264:Synonyms for
262:
260:
256:
255:South America
252:
248:
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240:
236:
232:
228:
224:
221:
217:
213:
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201:
197:
193:
189:
185:
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177:
173:
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161:
157:
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149:
143:
140:
139:Binomial name
136:
132:
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123:
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119:
118:
114:
111:
110:
107:
104:
101:
100:
97:
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67:
64:
61:
60:
57:
54:
51:
50:
45:
40:
36:
32:
27:
22:
19:
1601:
1537:
1533:
1523:
1506:
1502:
1496:
1471:
1467:
1461:
1447:
1423:(5): 485–7.
1420:
1416:
1406:
1388:
1382:
1347:
1343:
1333:
1306:
1302:
1292:
1267:
1264:N Engl J Med
1263:
1259:
1253:
1223:(2): 87–99.
1220:
1216:
1212:
1162:
1158:
1123:(2): 145–9.
1120:
1116:
1070:
1066:
1059:
1017:
1013:
950:
946:
940:
932:
919:
869:
865:
859:
838:
805:
793:
785:T. penetrans
784:
782:
758:
748:
742:
736:
727:
715:
708:
704:
696:
690:
686:
682:
680:
674:
661:
656:
654:
650:
646:dermal layer
643:subcutaneous
620:
616:
612:
608:T. penetrans
607:
606:
598:
594:T. penetrans
593:
590:T. penetrans
589:
587:
580:
563:
559:Cavia aperea
557:
551:
545:
539:
533:
529:Mus musculus
527:
521:
515:
508:sp. (baboon)
503:
499:Homo sapiens
497:
485:
479:
473:
461:
455:
449:
437:
433:Lama vicugna
431:
425:
419:
413:
409:Capra hircus
407:
401:
395:
392:Artiodactyla
384:
382:
381:
376:
372:
370:
366:warm-blooded
361:
359:
354:
350:
349:
340:T. penetrans
339:
325:
303:T. penetrans
302:
301:
288:
273:
269:
265:
263:
239:T. penetrans
238:
215:
211:
207:
203:
199:
195:
191:
187:
183:
170:
169:
168:
147:
145:
129:
128:
116:
96:Siphonaptera
24:Jigger flea
18:
1693:iNaturalist
1626:Wikispecies
1509:: 142–152.
1393: [
1270:(24): e30.
794:Santa Maria
711:hypertrophy
677:development
577:Environment
572:(porcupine)
481:D. hybridus
457:Felis catus
424:(peccary),
322:Distinction
200:chigoe flea
188:jigger flea
1767:Categories
858:"Le genre
823:References
739:infections
623:blood meal
603:Life cycle
436:(vicuña),
427:Lama glama
415:Ovis aries
397:Bos taurus
241:is called
218:. It is a
204:chigo flea
76:Arthropoda
1503:Acta Trop
967:1776-1042
886:1252-607X
817:Tungiasis
802:Treatment
719:spiracles
700:proboscis
685:, Eisele
639:cutaneous
502:(human),
470:Cingulata
446:Carnivora
430:(llama),
418:(sheep),
243:tungiasis
235:mammalian
220:parasitic
212:sand flea
124:Species:
62:Kingdom:
56:Eukaryota
1711:10577884
1611:Wikidata
1554:16441216
1515:13963854
1488:16516941
1439:10819355
1374:21529395
1325:12100437
1284:19073971
1245:34842884
1237:12756541
1187:23745194
1179:17823833
1139:15741550
1087:20659395
1044:25141814
985:25514594
947:Parasite
904:23193514
866:Parasite
811:See also
765:toenails
731:vitality
512:Rodentia
466:(jaguar)
412:(goat),
362:Tungidae
336:arachnid
268:include
247:chiggers
227:tropical
156:Linnaeus
102:Family:
72:Phylum:
66:Animalia
52:Domain:
1737:1491254
1685:5051118
1617:Q133413
1562:6854468
1365:3321756
1095:8385878
1035:4172993
976:4270284
895:4898135
779:History
773:poverty
691:in vivo
675:In vivo
657:in vivo
627:abdomen
570:Hystrix
494:Primate
460:(cat),
454:(dog),
406:(pig),
400:(cow),
368:hosts.
328:chigger
311:itching
251:Central
176:species
112:Genus:
92:Order:
86:Insecta
82:Class:
1724:214035
1698:308601
1672:TUNGPE
1659:704514
1560:
1552:
1513:
1486:
1437:
1372:
1362:
1323:
1282:
1243:
1235:
1185:
1177:
1137:
1093:
1085:
1042:
1032:
983:
973:
965:
953:: 68.
902:
892:
884:
757:, and
687:et al.
631:lesion
583:larvae
371:Seven
223:insect
192:chigoe
184:jigger
1783:Fleas
1750:33079
1706:IRMNG
1646:59LSL
1558:S2CID
1397:]
1241:S2CID
1183:S2CID
1091:S2CID
941:Tunga
860:Tunga
505:Papio
373:tunga
355:Tunga
214:, or
208:nigua
196:chigo
174:is a
117:Tunga
1732:OBIS
1719:NCBI
1680:GBIF
1667:EPPO
1577:The
1550:PMID
1511:PMID
1484:PMID
1435:PMID
1370:PMID
1321:PMID
1280:PMID
1233:PMID
1175:PMID
1135:PMID
1083:PMID
1040:PMID
981:PMID
963:ISSN
927:>
900:PMID
882:ISSN
767:and
721:and
668:rots
664:eggs
641:and
332:flea
253:and
229:and
180:flea
160:1758
1654:EoL
1641:CoL
1542:doi
1476:doi
1472:100
1425:doi
1360:PMC
1352:doi
1311:doi
1272:doi
1268:359
1225:doi
1167:doi
1163:101
1125:doi
1075:doi
1071:104
1030:PMC
1022:doi
1018:113
971:PMC
955:doi
890:PMC
874:doi
769:toe
178:of
1769::
1747::
1734::
1721::
1708::
1695::
1682::
1669::
1656::
1643::
1628::
1613::
1556:.
1548:.
1536:.
1532:.
1507:20
1505:.
1482:.
1470:.
1433:.
1421:19
1419:.
1415:.
1395:es
1368:.
1358:.
1348:17
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1342:.
1319:.
1305:.
1301:.
1278:.
1266:.
1239:.
1231:.
1221:90
1219:.
1195:^
1181:.
1173:.
1161:.
1147:^
1133:.
1121:72
1119:.
1115:.
1103:^
1089:.
1081:.
1069:.
1038:.
1028:.
1016:.
1012:.
1000:^
979:.
969:.
961:.
951:21
949:.
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898:.
888:.
880:.
870:19
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864:.
848:^
830:^
775:.
753:,
747:,
725:.
648:.
514::
496::
448::
394::
272:,
261:.
210:,
206:,
202:,
198:,
194:,
190:,
186:,
158:,
1564:.
1544::
1538:4
1517:.
1490:.
1478::
1455:.
1441:.
1427::
1376:.
1354::
1327:.
1313::
1307:7
1286:.
1274::
1247:.
1227::
1189:.
1169::
1141:.
1127::
1097:.
1077::
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1024::
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957::
906:.
876::
162:)
154:(
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