Thursday, September 17, 2009

More Infectious Disease


Here is the mandatory warning that this blog post is not for the squeamish and may leave you with unsavory images for some time (it certainly has me). We have been experimenting with some more infectious disease here that we would like to share with you (just via the web). In addition to more giardia and some sort of nasty cold that is circulating (don’t want to ignore the run-of-the-mill infections), one of the girls had noticed some increased anal itching, so her sister did an inspection. We found them trying to wipe away dozens of visible small white worms crawling in and out of the sphincter. We think it was either hookworm or whipworm (we’re not too good at our helminth identification). The females apparently crawl out the anus at night to lay 10-20,000 eggs before slipping back in to a comfy evening of sucking blood or secretions from the intestinal wall. We treated the entire family just to be on the safe side and haven’t had a problem since.

I have had my first encounter with the dreaded mango worm. The kids not too infrequently find one on the dog and pop them out like a giant zit (somewhat satisfying). We have been well cautioned to make sure that we iron all clothes (yes, particularly underclothes) to prevent infestation/infection with mango worms, which we have done faithfully. Nevertheless , I somehow ended up with 5 gradually enlarging lesions on my forearm which I initially took for mosquito bites that had become infected. As the days passed the pain increased, at times feeling like small knives stabbing my arm. Eventually I was able to “pop” one out along with the rest. “Cordylobia anthropophaga, the mango fly, tumbu fly, putzi fly or skin maggot fly is a species of blow-fly common in East and Central Africa. It is a parasite of large mammals (including humans) during its larval stage. At the site of penetration, a red papule forms and gradually enlarges. At first the host may experience only intermittent, slight itching, but pain develops and increases in frequency and intensity as the lesions develop into a furuncle. The furuncle's aperture opens, permitting fluids containing blood and waste products of the maggot to drain.” (Isn’t that a tasty description- For more information, see ) The lesions are gradually resolving, but all told it will be about 6 weeks of sporadic intense itching and pain. Here's some photos I managed to take:

On a sadder note, we had been thoroughly enjoying the surprise addition of 2 new kittens to our household. (You may remember we had tried to prevent her from becoming pregnant by asking our neighbour vet friend to help us- Apparently you can trick a cat’s hormones into thinking that it has been bred by use of a thermometer. Use your imagination, but let me just say that it was an experience I will never forget and I was not even on the business end of the thermometer.) Last week one of the kittens fell ill and died within 36 hours. A couple of days later the mother did the same. The vets seemed a bit baffled- kind of an uncommon presentation. Yesterday, just when we thought that the other kitten was out of the woods and not going to be sick, it also became ill and we expected it to follow the same course, but by this morning it very surprisingly seems to be well on the way to a full recovery, so we are hopefully optimistic at this point. Although the kitten had been promised to another family, they have graciously offered to let us keep this kitten that has survived.

School and work continue well. A team from Abuja (the capital) will be coming next week to do a quality assurance inspection tour of the HIV clinic in Vom. I’m sure we will learn a lot. Here are some pictures of our staff and a mom with her daughter (“Joy”) who said I can show their picture. Nvou, our clinic attendant, is in the sweater, who is doing her best to teach me some Birom, the local tribal language. She said to tell people that this is a picture of a "very fine Nigerian woman". Dr. Bot is our medical superintendent and my boss/support who works incredibly hard to keep everything running (from surgery to administration to clinic to filling the generator with fuel). Our pharmacy staff (Deborah, Dinatu, and Cabala) have some of the nicest smiles around. I'll leave you with a final image of "Joy" for this blog entry.