Wound myiasis in Western Europe: prevalence and risk factors in a changing climate scenario

Erika Andreatta,Luigi Bonavina

doi:10.1007/s10353-021-00730-y

Erika Andreatta, Luigi Bonavina

Open Access

https://doi.org/10.1007/s10353-021-00730-y

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Abstract

Summary Background Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe. Methods A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review. Results Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma. Conclusion Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.

Highlights

Climate change is widely regarded as one of greatest challenges facing ecological systems and biosecurity in the coming century
Over the past two decades, cutaneous myiasis in Western Europe has mostly been imported by returning travelers
The incidence of myiasis in Europe could rise in the future due to the effects of climate change and to the migration of fly species from tropical and subtropical countries

Summary

Introduction

Climate change is widely regarded as one of greatest challenges facing ecological systems and biosecurity in the coming century. The planet is warming from the north to the south pole, and the global average temperature has increased by approximately 1 °C over the past century. Climate changes have led some animal species including mosquitos, ticks, and flies to thrive and, as a consequence, to spread diseases such as malaria and Zika virus infection. Contrary to other insect species, flies are predicted to increase in this warming scenario Myasis (from the Greek, myia, meaning fly), first described by Hope in 1840, refers to a condition where fly larvae (maggots) infest the skin of a living human or vertebrate animals, feeding on dead or living tissues [1]. The prevalence of this infestation is related to the latitude and

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