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Tumbu fly and a visit to Kuje prisons

The discussion of tumbu fly today was necessitated by a special request from a friend in Lagos. I diagnosed him of tumbu fly, outside Kuje prisons in Abuja. We had visited the inmates on a social excursion. He was astounded and dumbfounded that at his level he could contract such a bug associated with dirty linens.

My colleague from Lagos had complained of two persistent boils at his back, as we left Kuje prisons. The doctors he consulted in Lagos had told him they were ordinary boils, and prescribed ampiclox and ciproxin respectively. When the boils persisted he became alarmed. I then took him back to the bus that brought us, asked him to remove his upper clothes. Then I went to the women “frying akara”, under the trees, and collected red palm oil, since we had no petroleum jelly(vaseline). The man thought I was a native doctor.  I rubbed the oil on the punctums(mouths), of the boils and “voalaa”- there were movements below the oil and tumbu fly was diagnosed. With tissue and gentle manipulation I extruded two larvae of tumbu fly. Everybody was flabbergasted.

. Do you know that most of us have un-extruded calcified scars, resulting from infection of the larvae of tumbu fly. Please if you experience any multiple persistent boil consult your doctor. First of all let us get a little bit educated on what tumbu fly is all about. The funny aspect was that when I told the man “I think you have tumbu fly”. He retorted in alarm “what is Tinubu fly” “I did not say Tinubu fly”, I remonstrated, “I said tumbu fly”.

What is tumbu fly

   Tumbu fly is a specie called Cordylobia anthropophaga. It’s other names are – mango fly, tumba fly, putzi fly and skin maggot. Tumbu fly is a parasite of large mammals(including humans) during its larval stage. It has been endemic with jiggar in Africa for more than 135 years, and is a common cause of myasis (invasion of living tissue) in humans. The specific epithet – anthropophaga is derived from the Greek word anthropophaga which means “human eater”.

What is the mode of infection of tumbu fly?

   a) Tumbu fly lays it’s eggs on the ground, clothes, mats, blankets or household linens soiled with human urine or faeces.

   b) The larvae, known generally as “Cayer Worms”, crawl all over the ground, mats, clothes especially under wears spread out to dry. Get attached to them.

   c) When the clothes are worn, or when someone lies down on the mats and blankets, the larvae(worms) penetrate the skin, and lie in the subcutaneous tissue, causing the formation of tumours(boils).

d) On reaching full growth the larvae turn to pupa(maggots), then leave the host, fall to the ground, then burrow and bury themselves into the soil or discarded wastes, then pupate fully and turn to flies.

Life cycle of a tumbu fly.

1) Female tumbu flies deposit 100 to 300 eggs in the soil, mats or domestic linens, often contaminated with animal or human urine and faeces.

2)The hatched larva can remain viable for 9 – 15 days.

3) On penetration it takes 8 – 12 days to develop to pre-pupal stage. It then drops to the soil, buries itself and takes another 5 – 14 days to develop into a fly.

What are the signs and symptoms of tumbu fly?

1)  Successful penetration results in furuncular(boil-like) myasis, typically on the backs, arms, waist, lower back or buttocks.

2)  A red papule(swelling) at the site of penetration which gradually enlarges.

3) At the outset there is intermittent slight itching, but pain increases in intensity as lesions develop into a furuncle(big boil).

4) The furuncle’s aperture opens, permitting fluids, containing blood and waste products of the maggot to drain.

How do we treat tumbu fly.

1) The punctum(breathing hole of the boil), is covered with petroleum jelly(vaseline) or palm oil, this cuts off the air supply, and forces the maggot to the surface, by gentle pressure it is extruded with tissue.

2) Local anesthesia can be administered and an incision made to widen the punctum and remove the maggot.

3) Antiseptic and antibiotics may be useful to prevent bacteria infection after the removal of the maggot.

Public health and prevention strategies!

Tumbu fly commonly infects humans, by laying it’s egg on wet clothes left out to dry on strings or ground. A prevention method is to iron all clothes, including underwear, the hot iron kills the eggs and larvae of the tumbu fly. Be medically guided.

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