title: Outbreak report of airborne caterpillar dermatitis in a kindergarten.
abstract: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: University Children's Hospital, Saarland University, Homburg, Germany. kisgot@uniklinikum-saarland.de
authors.forename: Sven
authors.initials: S
authors.lastname: Gottschling
authors.forename: Sascha
authors.initials: S
authors.lastname: Meyer
authors.forename: Dorothee
authors.initials: D
authors.lastname: Dill-Mueller
authors.forename: Donald
authors.initials: D
authors.lastname: Wurm
authors.forename: Ludwig
authors.initials: L
authors.lastname: Gortner
mesh_terms: D017677:Age Distribution; D000393:Air Pollutants / Q000276:immunology*; D000818:Animals; D002656:Child Day Care Centers; D002675:Child, Preschool; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D004196:Disease Outbreaks; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007814:Larva / Q000276:immunology; D007915:Lepidoptera / Q000276:immunology*; D008297:Male; D009724:Nurseries, Infant; D011379:Prognosis; D017678:Sex Distribution; D011795:Surveys and Questionnaires
chemical_list: D000393:Air Pollutants