A flea-borne outbreak of dermatitis.

In April 1986, an outbreak of pruritic rash occurred among workers in a warehouse in Jurong and affected 18 out of the 46 workers within one week. The rash was papular and distributed mainly over the thighs, abdomen and the upper limbs. Epidemiological investigations were carried out to determine the cause of the outbreak and the mode of transmission. As the warehouse was colonised by a local species of wild birds (Mynahs) and badly littered with bird-droppings during the outbreak period, samples of bird excreta and feathers were sent for identification of tick, mite, flea and other ectoparasites. The aetiology of the outbreak was confirmed when a flea caught from the body of one of the affected workers was identified as Ceratophyllus gallinae (Schrank), a bird-flea. Furthermore, when the bird-droppings were cleaned up and the premises fogged with insecticide and made bird-proof, no further case of dermatitis was reported. This is the first documented report of a bird-flea causing an outbreak of dermatitis in Singapore.