A Maryland resident who traveled to El Salvador has been diagnosed with New World screwworm — the first reported U.S. case tied to travel to a country with a current outbreak.
The Centers for Disease Control and Prevention confirmed the diagnosis on Aug. 4. Federal health officials acknowledged the infection in an emailed statement Monday.
The person has recovered, and investigators found no trfansmission to any other people or animals, Maryland health officials said.
The CDC investigated the case in coordination with Maryland’s health department.
Here’s what to know.
What is New World screwworm?
New World screwworm (NWS) is a fly that lays its eggs in open wounds and body openings. The parasite is typically found in South America and the Caribbean.
It is rare in humans but has been a concern to ranchers, as cattle infestations have been moving northward through Central America and Mexico. The CDC is working with the U.S. Agriculture Department to prevent further spread, officials said.
The pest was a recurring problem for the American cattle industry for decades, with Florida and Texas known as hot spots, until the U.S. largely eradicated it in the 1960s and 1970s.
Given that history, the Maryland case is likely not first time an American has ever been diagnosed with it, said Max Scott, a North Carolina State University research who has studied it. But this appears to be the first case in a U.S. resident in quite a while, he said.
The name refers to a blue-green blowfly that became somewhat infamous after infestations were reported in the 19th century at the Devil’s Island penal colony off the coast of South America. Its Latin species name roughly translates to “man eater,” Scott said.
Female flies lay eggs in an open wound or in the nose, eyes or mouth of an animal or person, which quickly grow into larvae that eat the flesh.
The screwworm part of the name comes from those maggots, which can get up to two-thirds of an inch long and look like they are screwing themselves into the flesh.
“It’s a nasty parasite,” Scott said.
What are the risks and symptoms for people?
The larvae do not spread from person to person, and they pose a very low overall risk to the public, U.S. health officials said.
Those at higher risk of suffering from the condition include people living in rural areas in places where NWS is endemic, and where livestock are raised, as well as people with open sores or wounds, and vulnerable populations, the CDC says.
Symptoms can also include painful, unexplained wounds or sores that do not heal. One telltale sign is seeing maggots around open sores. Another is a foul-smelling odor from the affected part of the body.
How can it be prevented and treated?
To prevent an NWS infestation, the CDC urges people to prevent against insect bites, especially when visiting tropical areas and being outdoors. The agency also says open wounds should be clean and covered.
To treat it, doctors have to remove the larvae, sometimes through surgery.
“If you see or feel maggots (larvae) in or on a wound or other area of your body, contact your healthcare provider immediately,” the CDC says. “They will need to remove the larvae, sometimes through surgery. Do not try to remove or dispose of the maggots yourself.”
Are more human or animal cases expected in the U.S.?
It’s possible.
Scientists for decades were able to control the bug by releasing billions of sterilized male flies, but lapses in the that work and the migration of people and animals helped them spread northward into Central America and Mexico more recently.
There are new genetic techniques being developed to stop them, and the U.S. government is ramping up its work to control the parasites. But they remain a concern.
“I don’t know if it’s going to come back to the United States,” Scott said.
If it does, the Texas-Mexico border area is likely to be the first place to see it, he said.
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