Tungiasis is an infestation caused by the female Chigoe flea. Male and female fleas feed on mammalian blood but when it’s time to reproduce the female burrows into the skin. Limited jumping ability dictates that most infestations occur in the feet and lower legs, but if you are foolish enough to lie down in a Ugandan barnyard you are inviting the burrowing to occur anywhere.
Between the dermis and epidermis, the expectant mother sets up shop and her belly swells with eggs. Presumably as a result of cell mediated immunity a fibrous reaction develops around the swelling. The site of the swelling determines the degree of pain or itching it creates.
My own infestation occurred on the tip of the toe and caused no sensation until I spied it after a shower, thought “Hello, who are you??” and enjoyed the overall skin crawling shudder that accompanies the realization one has a critter boring into the skin.
When the flea’s plans are fully realized the abdominal egg sac approaches the surface of the skin and a black orifice develops through which the eggs are expelled to commence their maturation in the barnyard’s feces. I thwarted the process by dragging out my trusty pocket Buck knife and digging at my toe with the conviction of an exorcist, thus delivering hundreds of eggs into some tissue paper and subsequently into the toilet.
Note to son and son-in-law; never travel without your Buck knife.
After “cleaning” the resultant divot I monitored it for several hours and suspected that some organic structure not of my own provenance, was retained in the site. At my age it is hard to get the tip of your toe to within reading glasses range so I discussed it with my local guide, reapplied the blade of my knife and dug until he could tweezer some body parts out. He suggested some petroleum (Vaseline) to suffocate any remaining tissue.
The wound slowly healed over the next 5-6 days.
I am sure I picked this little mother up while walking through the Lake Bunyonyi neighborhood in southwestern Uganda. The data is unclear whether closed shoes significantly reduce the incidence of Tungiasis or not, but I was wearing my Keane sandals when heavy rains washed barnyard byproducts over my feet and I noticed the maturing lesion some two weeks later, consistent with the incubation period noted in one resource.
When lesions are multiple, secondarily infected or occur in limbs with compromised circulation then they can be dangerous to the host.
The toe is now healed and all seems well enough. However, I wore the same shoes to the Dame Daphne Shedrick Elephant Orphanage in Nairobi today, my trail shoes having been shredded in Isalo National Park. The baby elephant yard bore a strong, feculent, resemblance to the Bunyonyi barnyards. It makes my skin tingle to think about it.
Photos by Debbie