Eaten alive by maggots!

Two years ago a news story told the horrific tale of a paralysed Austrian man who died after being partially eaten by maggots.

The thought of a maggot feeding on flesh evokes deep visceral revulsion – the kind that fuels sensationalist internet myth. Like the following story, which periodically resurfaces in in-boxes:

!!**WARNING...NOT FOR SENSITIVE VIEWERS!!! BUT VERY IMPORTANT THAT U READ THE CONTENT...!!** This is the scariest thing I've ever seen. Ladies this could happen to you and Guys this could happen to your wife, so please BEWARE, and also warn others.

After anthropologist Susan McKinley returned home from an expedition in South America, she noticed a very strange rash on her left breast. Nobody knew what it was and she quickly dismissed it believing that the sores would leave in time.

Upon her return she decided to see a doctor after she started developing intense pains. The doctor, not knowing the exact severity of the case, gave her antibiotics and special creams.

As time elapsed the pain did not subside and her left breast became more inflamed and started to bleed. She decided to bandage her sores however as Susan's pain grew more intense she decided to seek help from a more certified doctor. Dr. Lynch could not diagnose the infection and told Susan to seek the aid of one of his colleagues who specialized in dermatology whom was sadly on vacation. She waited for two weeks and finally was able to reach the dermatologist.

To Miss McKinley's surprise, after she removed the bandages, they found larva growing and squirming within the pores and sores of her breast. Sometimes these wicked creatures would all together simultaneously move around into different crevices. What she didn't know was that the holes were in fact, deeper than she had originally thought for these larvae were feeding off the fat, tissue, and even milk canals of her bosom.

This was accompanied a successfully skin-crawl-inducing impression by a talented and seriously twisted computer graphics artist. But although the image is a fake, the story, like many effective rumours, does in fact bear a vague resemblance to the truth.

Flesh-eaters: the sober truth
Maggots, otherwise known as fly larvae, are, of course, famous for eating the flesh of dead animals, and in this they perform a vital, if unglamorous, cleansing function in nature. But also – less often – maggots can infest and feed on the flesh of live animals and humans, a phenomenon known as myiasis.

For those of us in temperate climes with access to good sanitation and medical care, myiasis, despite the horrible fascination it holds, really should be way down on our list of health concerns. However, if you’re planning a trip to a sub-tropical or tropical location in Africa or the Americas, then keep reading.

Parasitic flesh-eaters
The larvae of certain fly species live and feed parasitically on living tissue as part of their life cycle, and it is to this that our internet rumour (loosely) refers.

There are various ways these larvae can end up on us. Some species, such as the Tumbu or putsi fly in Africa, lay their eggs in soil or damp or dirty clothes hung outside to dry. The larvae then hatch and invade areas of skin in contact with the clothes. They invade different body parts – not necessarily the breast. This can happen, but it’s very rare: there are only a handful of documented cases. And parasitic maggots do not distinguish between Guys and Ladies.

The crafty botfly in central and South America lays its eggs on a blood-sucking insect, like a mosquito, which then carries them to you, where the larvae hatch and wriggle into your skin.

Once under the skin, the larvae produce an itchy spot that develops into a sore resembling a boil, which may ooze and be painful. They usually stay near the skin surface, because they have to breathe. (The "wicked creatures" squirming about in unison in the depths of the "bosom" is highly unlikely.)

Opportunistic flesh-eaters
Myiasis can also occur when a fly (sometimes even the humble housefly) deposits larvae in a wound or decaying flesh (e.g. in cases of gangrene). Some species of larvae remain within the decaying tissue, and this can even be useful in keeping the wound clean. Other species, though – called "opportunistic" – like the screwworm, mainly found in central and South America, enter the surrounding living tissue and can even burrow internally.

Accidental flesh-eaters
Very occasionally, myiasis happens by accident. Maggots can find their way into the human body when they are swallowed in contaminated food, or when they come into contact with the urogenital tract in cases of poor hygiene (flies are attracted by the smell of faeces and urine).

Opportunistic and accidental myiasis scenarios are rare, and generally occur where invalids have neglected wounds and otherwise poor hygiene. Myiasis in such cases can be easily prevented by decent basic health care and keeping the immediate environment clean and free from flies. And if you do happen to eat a maggot, the chances are slim that the poor thing is going to survive your teeth and digestive juices.

Bacon therapy and other remedies
Most cases of myiasis aren't serious, but all should receive medical attention. Parasitic larvae under the skin can usually be removed fairly easily, and will leave the human host when they mature (most people prefer not to wait around for this, though).

The larvae breathe through a small hole in the skin, so if this is covered e.g. with oil or vaseline, they are forced to wriggle out. Another method is to entice the larva out by putting a piece of meat over the site; this is actually referred to by medical entomologists as "bacon therapy".

Larvae can also be extracted with forceps or needle, but this should only be done by a medical professional because infection can result if part of the larva breaks off and remains in the body.

Make sure it doesn’t happen to you
If you’re travelling to an area where parasitic maggots occur, this nasty problem (and others) can be prevented as follows:

  • Maintain good personal hygiene
  • Avoid soil likely to be contaminated by human excreta
  • Wash and dry clothes thoroughly, and iron them if they’ve been hung outside
  • Don’t go barefoot
  • Avoid insect bites
  • Keep wounds clean and covered
  • Keep food covered
  • See your doctor if you’ve recently returned from endemic areas and you notice any unusual or persistent skin sores, itching or pain.
  • And finally – always take any medical information you read on the 'net with a large pinch of salt, unless you find it on a highly reputable health site, like this one.

(- Olivia Rose-Innes, Health24, updated October 2010) 

Adisa, CA and Mbanaso, A. Furuncular myiasis of the breast caused by the larvae of the Tumbu fly (Cordylobia anthropophaga). BMC Surgery. 2004 Feb 29;4(1):5.
Brewer T; Wilson M; Gonzalez E, et al. Bacon therapy and furuncular myiasis. JAMA. 1993; 270:2087-2088.
Kettle, D.S., 1995, Medical and Veterinary Entomology. CAB International, Wallingford, UK.
Robertson, Hamish. 2005. Director of Natural History, Department of Entomology, South African Museum. Personal Communication.
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