Caterpillar dermatitis with urticaria was assigned as the likely diagnosis and the cadets were given symptomatic treatment with oral antihistamines and topical steroids. On examination, large areas of urticaria and inflammation were seen as shown in the first two figures. None of the cadets claimed direct contact with any insects or disturbed any possible nesting sites. At least 21 of these cadets required an after-hours clinic visit at the Duntroon Health Centre due to intractable pruritus and insomnia, excoriation and pain. This rapidly spread to involve 54 ADFA and 49 RMC cadets (a majority of those present) and some of the directing staff.
Suddenly several of the cadets began to develop severe itching and skin irritation. They were occupied with maps while in the open air under trees at the Majura Training Area. A company of officer cadets were participating in a field training exercise without troops.
We report an epidemic of processionary caterpillar dermatitis with urticaria which occurred in officer cadets at the Australian Defence Force Academy (ADFA) and the Royal Military College (RMC), Duntroon ACT in February 2016. Accurate diagnosis coupled with symptomatic treatment is usually sufficient to calm an affected unit and get them back to duty. Psychological problems may arise during war time if such outbreaks are imagined to be due to blisterĪgents such as mustard gas or other toxic exposures. Causes of epidemic dermatitis with urticaria and pruritus are few and can usually be traced to some natural source. In a similar way, an outbreak of dermatitis triggers a search for some contact exposure and is usually limited to one or only a few persons with a fairly obvious source to incriminate. Outbreaks of gastroenteritis trigger a search for enteric infections as outbreaks of respiratory symptoms trigger screening for infections such as influenza. Many illnesses can rapidly incapacitate a military unit but it is particularly disturbing when the agent is unknown or unsuspected. Key words: dermatitis, epidemic, processionary caterpillars Caterpillar dermatitis occurs commonly but only rarely does it present as a unit incapacitating epidemic of severe dermatitis with urticaria. At least 103 ADFA and RMC cadets were affected with large areas of dermatitis with an urticarial rash, about 30 seriously enough to require topical steroids. The risk of caterpillar dermatitis was unappreciated by those on a map exercise near Majura, despite seeing such insects in the field. We report an epidemic of processionary caterpillar dermatitis occurring in military officer cadets participating in a field exercise. Not all epidemics are due to infectious diseases. D Randell, M Fett, H Jenner, S Frances, D Shanks
0 kommentar(er)
