Onchocerciasis in New York City. The Moa-Manhattan connection.

When faced with a patient with travel-associated dermatitis, clinicians often diagnose and treat for a suspected hypersensitivity reaction or infestation with an ectoparasite. We studied a small cluster of travelers from New York, NY, to the Moa River in Sierra Leone who developed dermatitis caused by Onchocerca volvulus. Our patients had relatively long stays in an endemic area and numerous bites by blackflies. Such patients represent a subset of travelers in whom dermatitis should prompt evaluation for onchocerciasis.