Outfoxing a Rash: Clinical Example of Human–Wildlife Interaction

Abstract

Increasing human-wildlife contact can manifest in a variety of clinical conditions that may be overlooked by both human health and veterinary professionals. We report on an outbreak of scabies infection in a community, affecting both animals and humans, and representing the effects of an emerging infectious disease in a wildlife population. These cases underscore the potential importance of ''animal sentinel'' events for human, animal, and ecosystem health. The treatment given to the human cases of infection ranged from aggressive therapy to watchful waiting, with similar outcomes. There is a need for further collaborative, evidence-based research by human and veterinary health professionals into the optimal treatment and prevention of infections resulting from cross-species transmission.

Zoonotic Episodes of Scabies: A Global Overview

“…Regarding the benefits of applying an etiological treatment, Smith and Claypoole [28] reported a shorter resolution time in ZS patients receiving a single 24 h topical lindane treatment compared with untreated patients, but this was not tested in a randomized trial scheme. A relatively long resolution time (two weeks) was instead observed in an adult patient treated with 10% lindane lotion [44], and also failure to clear the rash was also reported after massive exposure to an infested fox [8]. Application of 5% permethrin cream represents another recommended treatment option [9,10,45], but the resolution times are unfortunately not available, with the exception of a single report that mentions clinical resolution in approximately one week after treatment application, which is less than the traditionally reported 2-3 weeks characterizing the spontaneous course of the disease [43].…”

“…Wildlife does not appear to be a common source of ZS, as only nine species in different parts of the globe have been found to be responsible for mite transmission to humans (Figure 2), although this might be another bias due to the infrequent skin-to-skin contacts between humans and wild animals. Red foxes were associated with human scabies in five cases [8,[33][34][35][36], in both urban and rural contexts. Worthy of note is an outbreak involving four people on a farm where a moribund fox with generalized lesions had sought shelter [34].…”

“…In this episode, people became infested through direct contact with different species of domestic animals (pigs, goats, dogs, horses, oxen) that, in turn, had previous contact with the scabietic fox. However, in other wildlife-derived ZS cases, the affected individuals were involved in wildlife-related occupations as keepers, veterinarians or specialized operators, or were private citizens who found themselves rescuing a scabietic animal or handling a fresh carcass [8,36,43,44,47,53,63]. Reportedly, wearing gloves did not guarantee protection in all cases [44,47], possibly due to the enormous number of mites crawling on the skin surface of source individuals affected by generalized crusted scabies.…”

“…It is commonly thought that animal variants of S. scabiei are unable to successfully reproduce and persist on human skin [5]. However, experimental human infections with scabies mites of dog origin resulted, in four of six volunteers, in a successful replication with hatching and development of mites [6,7], and several spontaneous ZS case reports have mentioned the persistence of symptoms for weeks until an effective acaricide treatment was applied [8][9][10]. These reports suggest that scabies mites' needs may be fulfilled in human skin, too.…”

Science–policy challenges for biodiversity, public health and urbanization: examples from Belgium

“…Another important consideration is that urbanization of foxes and associated zoonoses is in large part related to encroachment of human settlement on wildlife habitat and to urban environmental health management. For example, Rabinowitz and Gordon (2004) have reported on a case of zoonotic scabies infection (Sarcoptes scabiei) in the United States, associated with interactions with wild foxes originating with a sick fox found on a golf course. They suggest that identification of initial infection ahead of an outbreak-e.g.…”