Avian Ecto Parasite Infestation in the Hospital

Abstract

This paper reports 2 episodes of pigeon mite infestation in Andhra Pradesh, India. The first episode involved operation theatre (OT) technicians who complained of severe itching after putting on their uniforms. Ten members of the staff had severe skin allergy (urticaria), and 1 staff member had anaphylactic (asthma-like) symptoms that required treatment. Examination of uniforms revealed small mites, identified as pigeon mites, crawling all over the linen. The source of infestation was traced to pigeon droppings that had entered the staff room through a crack in the roof. In response, the roof was repaired, and the staff room area was washed repeatedly over a 1-week period with soap and water and disinfected with bleach. All of the uniforms were sent to the laundry. The second episode occurred 6 months later; similar complaints were received from staff members who experienced allergic reactions subsequent to changing bed sheets in a patient room. On examination, a line of mites was discovered making their way down the wall to the bed from the air conditioning duct. On inspection, pigeon droppings were found in the duct; the pigeons had accesses to the duct through a broken outlet. The duct was cleaned and disinfected with bleaching powder. The point where the duct was being accessed was covered with mesh to prevent the entry of pigeons. This study highlights the need for hospitals to keep in mind the possibility of infestation with such mites, either in healthcare workers or in patients, and to report such outbreaks immediately to prevent nosocomial infestation.