Mite‐Transmitted Dermatoses and Infectious Diseases in Returning Travelers

Abstract

Mites are among the smallest arthropods with most barely visible without magnification. 1 Mites are closely related to ticks, but they are tissue‐juice feeders, not blood‐feeders, and do not transmit as broad a variety of infectious microbial diseases. 1 In fact, the only infectious diseases transmitted by mites are rickettsialpox and scrub typhus. 1 The most common ectoparasitic dermatoses caused by mites are chiggers and scabies. 1 Travelers are uniquely predisposed to contracting several mite‐transmitted dermatoses and infectious diseases including: (1) scabies mites from close personal contacts; (2) zoonotic scabies from domestic or wild animals and pets; (3) rickettsialpox from sleeping in or visiting mice‐infested dwellings; and (4) chiggers and scrub typhus after stumbling onto trombiculid larvae‐infested “mite islands” in endemic regions worldwide. This review will describe the epidemiology, clinical manifestations, and management of the most common mite‐transmitted dermatoses and infectious diseases in returning travelers. A MEDLINE search, 1966 to 2008, of the world's scientific literature of case reports, case series, original articles, reviews, and observational and longitudinal studies was conducted to determine the epidemiology, outcomes, clinical manifestations, preferred diagnostic interventions, and management for mite‐transmitted dermatoses and infectious diseases in returning travelers. In addition, a clinical classification of mite‐transmitted infestations and infections was developed to assist clinicians in assessing potential mite‐transmitted skin and systemic infectious diseases in travelers. ### Classification of Mites and Disease Ecology of Mite‐Transmitted Dermatoses and Infectious Diseases Mite infestations and infections were classified into the following distinct clinical and etiological categories: (1) the mite‐transmitted dermatoses caused by human mites: scabies and follicle mite infestations (also known as demodecidosis or demodicosis); (2) the mite‐transmitted dermatoses caused by non‐human mites: chiggers, zoonotic scabies, animal and plant and plant insect mite infestations, and dust mite allergies; and (3) the mite‐transmitted systemic infectious diseases: scrub typhus and rickettsialpox (Table 1). Only two non‐human, animal mites may transmit infectious diseases: (1) chiggers or trombiculid … Corresponding Author: James H. Diaz, MD, MPH&TM, Dr PH, Schools of Medicine and Public Health, Louisiana State University Health Sciences Center (LSUHSC), 1615 Poydras Street, Suite 1400, New Orleans, LA 70112, USA.E‐mail: jdiaz{at}lsuhsc.edu