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      Was kommt dort durch die Luft geflogen …? : Die Gefährdung des Menschen durch die Gifthaare des Eichenprozessionsspinners Translated title: What is Flying Through the Air There ...? : The Danger to Humans from the Poisonous Hairs of the Oak Processionary Moth

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          Abstract

          Die Larven des 4. bis 6. Stadiums des Eichenprozessionspinners sind mit Brennhärchen (Setae) bewehrt, welche bei Mensch und Tier heftige entzündliche Haut- und Schleimhautreaktionen (Lepidopterismus) hervorrufen. Die Übertragung erfolgt sehr häufig aerogen, oder durch direkten Kontakt. Durch den Befall von Bäumen im urbanen Grünbereich ist die Fallzahl – vor allem in Jahren mit Massenvermehrung des Forstparasiten – sehr groß. Da die Dunkelziffer sehr hoch ist, sollten Ärzte und Ärztinnen bei Patienten mit juckenden, asymmetrisch verteilten papulösen oder urtikariellen Exanthemen an die Möglichkeit des Vorliegens einer Raupendermatitis denken. Meiden der Befallsgebiete bzw. Tragen von persönlicher Schutzkleidung bei Außenarbeitern, stellen die besten präventiven Maßnahmen dar.

          Translated abstract

          Fourth to sixth instar larvae of the oak processionary moth protect themselves against predators by urticating hairs (setae). Setae may cause inflammatory reactions on skin as well as on mucous membranes (lepidopterism), both in humans and animals. People may get in touch with setae by direct contact or – more frequently – airborne. Frequency of lepidopterism is high due to the fact that the oak processionary moth infests the urban green, especially in years with mass gradation. Lepidopterismus, however, is under-diagnosed. In seasons of toxic larvae, doctors should therefore consider lepidopterism a differential diagnosis in patients with asymmetrically distributed, itchy papular rash or wheal formation. Preventive measures are avoidance of infested areas and use of protective equipment by outdoor workers at risk.

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          The oak processionary caterpillar as the cause of an epidemic airborne disease: survey and analysis.

          Thaumetopoea processionea L. (order Lepidoptera), the oak processionary moth, is found in oak forests in most European countries. Its third to sixth larval instars are armed with poisonous hairs (setae) containing an urticating toxin (thaumetopoein) potentially harmful to humans. Because T. processionea infests trees at the edges of forests or standing alone people frequently come into contact with its setae. In the woodland bordering on the western suburbs of Vienna conditions favouring its increase have led to frequent outbreaks of lepidopterism. To determine the incidence of lepidopterism in a suburban environment with three separate caterpillar-infested oak trees and to ascertain the frequency of the various symptoms of lepidopterism and the manner of contact with setae. We conducted a telephone survey of all the households/institutions located within 500 m of the infested trees. To gain more information on patients' symptoms and on situations likely to lead to increased contact with setae we asked those who reported cutaneous reactions to complete a questionnaire. As part of the environmental study we described the outbreak site, examined patients and, with tape-strip samples taken from the surface of the soil, looked for setae persisting in the environment. Of 1025 people surveyed 57 (5.6%) reported one or more symptoms of lepidopterism: 55 (96%) reported pruritus, 54 (95%) dermatitis, eight (14%) conjunctivitis, eight (14%) pharyngitis and two (4%) respiratory distress. The questionnaire was returned by 37 (69%) of the individuals with dermatitis. Of those, 16% had reacted with weal formation, 49% with papular rash and 22% with toxic irritant dermatitis. In 13% of respondents it was not possible to define the reaction. The risk factor analysis showed that airborne contamination was the most important cause: 97% of people had frequently passed an infested tree, 57% lived near a tree (in a neighbouring garden) and 32% had a tree in their own garden. Direct contact with larvae was of minor importance (38%). In four of the tape-strip samples intact setae were identified 1 year after the infestation. Lepidopterism caused by T. processionea is a public health problem of increasing significance. In years with outbreaks of the pest it can reach epidemic proportions in communities located near infested trees. Contact with airborne setae was mainly responsible for the occurrence of the disease.
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            Anaphylaxis to a pine caterpillar.

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              Outbreak Report of Airborne Caterpillar Dermatitis in a Kindergarten

              Background: The oak processionary caterpillar is found in several European countries. The larva of Thaumetopoea processionea Lepidoptera from the third to sixth larval instar develops poisonous hair (setae), filled with an urticating toxin that could lead to serious dermatitis, conjunctivitis and pulmonary problems (summarized as lepidopterism) on contact. Objectives: To determine the incidence of caterpillar dermatitis in a kindergarten population with three infested oak trees located in its enclosure. Methods: We made a survey by the use of a questionnaire that was handed out to all parents with children regularly visiting that kindergarten. Results: Twenty-four out of 47 (51%) questionnaires were returned and 10/24 (42%) children showing symptoms of lepidopterism were reported: 8/10 (80%) dermatitis, 5/10 (50%) pruritus, 5/10 (50%) respiratory distress, 4/10 (40%) malaise and/or fever and 1/10 (10%) conjunctivitis. Seven out of 10 visited a physician but the correct diagnosis was not posed in any case. Four out of 7 received medication (topical and/or systemic antihistaminics and/or steroids). Conclusions: Lepidopterism, an airborne disease caused by the setae of the processionary caterpillar, is a growing public health problem because of the increasing numbers of outbreaks, and it is still underestimated. Children seem to suffer more often from general symptoms and airway affection than adults.
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                Author and article information

                Contributors
                hautnah.dr.maier@gmail.com
                Journal
                hautnah
                Hautnah Dermatologie Und Allergologie Fu¨r A¨rzte Und Apotheker
                Springer Vienna (Vienna )
                1866-2250
                2192-6484
                18 February 2021
                18 February 2021
                : 1-6
                Affiliations
                GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Universitätsklinik für Dermatologie, , Medizinische Universität Wien, ; Währinger Gürtel 18–20, 1090 Wien, Österreich
                Article
                421
                10.1007/s12326-021-00421-1
                7890389
                d8ed85b6-75e0-42ee-9c28-590338c99a7a
                © The Author(s) 2021

                Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden.

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                History
                : 4 February 2021
                Funding
                Funded by: Medical University of Vienna
                Categories
                Raupendermatitis

                eichenprozessionsspinner,lepidopterismus,raupendermatitis,brennhaare (setae),urbaner grünbereich,oak processionary moth (caterpillar),lepidoperism,caterpillar dermatitis,urticating hairs (setae),urban green

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