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Treatment requires keeping the person from being repeatedly bitten and possible symptomatic use of antihistamines and corticosteroids (either topically or systemically). There however is no evidence that medications improve outcomes and symptoms usually resolve without treatment in 1–2 weeks.
Avoiding repeated bites can be difficult, since it usually requires eradicating bed bugs from a home or workplace; eradication frequently requires a combination of pesticide and non pesticide approaches. Pesticides that have historically been found to be effective include pyrethroids, dichlorvos and malathion. Resistance to pesticides has increased significantly over time and there are concerns of negative health effects from their usage. Mechanical approaches such as vacuuming up the insects and heat treating or wrapping mattresses have been recommended.
Surgical excision or cryosurgery is the treatment of choice. Treatment with antifungals has been considered ineffective, but the use of clofazimine and dapsone in patients with leprosy and lobomycosis has been found to improve the latter. This treatment regimen, with concomitant itraconazole, has been used to prevent recurrence after surgery.
Various strategies targeting the mollusc and avian hosts of schistosomes, have been used by lakeside residents in recreational areas of North America to deal with outbreaks of swimmer's itch. In Michigan, for decades, authorities used copper sulfate as a molluscicide to reduce snail host populations and thereby the incidence of swimmer's itch. The results with this agent have been inconclusive, possibly because:
- Snails become tolerant
- Local water chemistry reduces the molluscicide's efficacy
- Local currents diffuse it
- Adjacent snail populations repopulate a treated area
More importantly, perhaps, copper sulfate is toxic to more than just molluscs, and the effects of its use on aquatic ecosystems are not well understood.
Another method targeting the snail host, mechanical disturbance of snail habitat, has been also tried in some areas of North America and Lake Annecy in France, with promising results. Some work in Michigan suggests that administering praziquantel to hatchling waterfowl can reduce local swimmer's itch rates in humans. Work on schistosomiasis showed that water-resistant topical applications of the common insect repellent DEET prevented schistosomes from penetrating the skin of mice. Public education of risk factors, a good alternative to the aforementioned interventionist strategies, can also reduce human exposure to cercariae.
Rainscald normally heals on its own, however as the condition can spread to involve large areas, prompt treatment is recommended. Although some cases can be severe, most rain scald is minor and can be easily and cheaply treated at home naturally.
First groom the affected parts carefully, to remove any loose hair. Be extremely gentle, the area is very sore itchy and horses will very quickly get fidgety. Next shampoo the area, use warm water and a soft cloth or brush, and massage the lather through the coat as much as the horse will tolerate. It is best to use Neem shampoo here, as this will treat as well as clean, but any mild shampoo is fine. Remove as much water as possible and dry the horse off, either use a hair drier or let him/her stand in the sun until completely dry. It is important not to let the horse roll! The rain scald bacteria may be picked up from the soil.
When the horse is completely dry, gently brush off any more loose hair. Next apply a salve or cream containing a high percentage of neem oil, or even pure neem oil, to liberally coat the affected area. Rub it in using fingertips, massage the area as much as the horse will tolerate. This will be very greasy. Smooth the hair back down and apply a rug to keep the horse dry, this prevents the neem being washed off as well as protecting from more dampness issues. Turn the horse out as normal.
Check it every day, and reapply the neem salve/cream if it seems to have dried away. The area should remain greasy with neem. Every 2–3 days or so, go through and scrape/pick off as much of the scabs as possible without upsetting the horse or making it bleed, then reapply the neem. Typically there will be improvement in a few days, and in a week there'll be some sign of new hair growing back. More severe rain scald may take longer.
Once all the scabs are gone and there is new hair fuzz growing in all over, use neem shampoo to clean the area of greasy residue, and dry well. Keep the horse covered for some time after rain scald has been treated, particularly in wet weather. Do not allow the skin to remain damp. It is advisable to shampoo the horse after riding or exercising, to remove sweat, which may encourage rain scald conditions, and make sure the coat is completely dry afterwards.
This treatment works in many ways. First, shampooing cleans the area of any contaminants, remove a lot of loose hair and scabs, and the rubbing stimulates the circulation. The neem is an antifungal agent, and works to eliminate the bacteria that cause the infection. It soothes the irritation in the area, and its greasiness provides the ideal environment for the raw skin to heal and grow new hair. It also helps to soften and lift the scabs. The new hair cannot grow in until those scabs are removed from the surface, but they are very painful to pick and remove, and most horses are intolerant of this procedure. After the neem has soaked into these scabs they will come away much more freely, and soon new hair will grow through.
In conventional treatment, scabs are softened with benzoyl peroxide and chlorhexidine and removed in order to speed the healing process. In severe or chronic cases, penicillin and streptomycin are injected into the horse to kill the bacteria.
Typically the disease is not life-threatening, nor does it impact the welfare of the horse, so treatments are more for the owner's sake of mind and cosmetic appeal of the animal.
This applies once an infestation is established. In many circles the first response to cutaneous myiasis once the breathing hole has formed, is to cover the air hole thickly with petroleum jelly. Lack of oxygen then forces the larva to the surface, where it can more easily be dealt with. In a clinical or veterinary setting there may not be time for such tentative approaches, and the treatment of choice might be more direct, with or without an incision. First the larva must be eliminated through pressure around the lesion and the use of forceps. Secondly the wound must be cleaned and disinfected. Further control is necessary to avoid further reinfestation.
Livestock may be treated prophylactically with slow release boluses containing ivermectin which can provide long-term protection against the development of the larvae.
Sheep also may be dipped, a process which involves drenching the animals in persistent insecticide to poison the larvae before they develop into a problem.
There is no known cure for little cherry disease and tolerance breeding programs have not yielded any cultivars able to withstand the effects of the disease for more than a few seasons. Thus, prevention of spread has been the focal point in combating the disease.
In pet rabbits, myxomatosis can be misdiagnosed as pasteurellosis, a bacterial infection which can be treated with antibiotics. By contrast, there is no treatment for rabbits suffering from myxomatosis, other than palliative care to ease the suffering of individual animals, and the treatment of secondary and opportunistic infections, in the hopes the treated animal will survive. In practice, the owner is often urged to euthanize the animal to end its suffering.
In order to prevent rainscald, it is important to stop the spread of the bacteria. Tick and insect control is an effective way to stop the spread of the bacteria from one animal to another. As well, separating infected animals will help to stop the spread of the bacteria. Keeping the animal in a dry, well-ventilated area out of the rain and wet conditions will stop the bacteria from growing. This dry environment includes dry ground as well as dry air.
To reduce the itching, an application of anti-itch cream containing hydrocortisone, calamine, or benzyl benzoate is often used (though calamine has been shown not to be effective). Hydrogen peroxide and capsaicin cream has also been effective. Another good way to relieve itching is to apply heat—either by using a hand held shower with water hot as one can stand, or by heating the bite with a hair dryer. The heat method will relieve itching for about four hours and will require repeating.
In some cases, the chigger is still present when the bite appears. A 10× magnifier can be used to see the chigger and it may be removed with fine-tipped tweezers. Once it is gone, covering the bite with nail polish, calamine lotion, vaseline or other petroleum jelly, baby oil, or anything else may help the pain and itching, but will neither suffocate the chigger nor help the bites heal any faster. Medication such as antihistamines or corticosteroid creams may be prescribed by doctors, and might help in some instances.
There are very few things that can be done to control the spread of bacterial soft rots, and the most effective of them have to do with simply keeping sanitary growing practices.
Storage warehouses should be removed of all plant debris, and the walls and floors disinfected with either formaldehyde or copper sulfate between harvests. Injury to plant tissues should be avoided as much as possible, and the humidity and temperature of the storage facility should be kept low using an adequate ventilation system. These procedures have proven themselves to be very effective in the control of storage soft rot of potato in Wisconsin.
It also helps if plants are planted in well-drained soils, at intervals appropriate for adequate ventilation between plants. Few varieties are resistant to the disease and none are immune, so rotating susceptible plants with non-susceptible ones like cereals is a practice positive to limiting soft rot infection.
The control of specific insect vectors is also a good way of controlling disease spread in the field and in storage. Soil and foliage insecticide treatment helps controls the bugs that frequently cause wounds and disseminate the bacteria.
Few treatments are fully efficacious once lesions have appeared. The only effective form of treatment is preventitive - i.e. prevent further insect bites - so these techniques will also be discussed here. Treatments generally fall into one of the following categories:
1) Insecticides and Repellents: These may be applied to the horse or its environment. The most commonly used and effective are permethrins. and benzyl benzoate Citronella has been used, with variable effect. Some sources advocate draining of any stagnant water or pools, to reduce the local breeding potential of the insects. Midge numbers are often larger near water sources, for example ponds, bogs, and slow moving water. Moving the horse away from these areas may help to prevent further problems.
2) Barrier Techniques: Rugs etc., that prevent flies and midges settling on the animal's skin to bite. These include "Boett Rugs" and fly masks. In addition, thin screens may be placed over stable doors and windows to exclude biting insects. Stabling the horse at times of day when the midges are most prevalent is also quite effective.
3) Immunotherapy: A wide variety immunotherapy and desensitisation protocols have been trialled in attempts to reduce or modify the immune response, with considerable success rates. So far, there appear to a significant benefit in more than 80% of equine cases. This particular BioEos product is now available through The National Sweet Itch Centre in the UK and ProVet in the EU. The underlying immune modulation is now proven to shift the immune system from a Th2 to a Th1 mode. BioEos is a research and development company with worldwide patents derived from many years of research at University College London and the many applications are being developed for use in both human, agricultural and aquaculture treatments. Current clinical trials for the treatment of pancreatic cancers (Immodulon Therapeutics) and the treatment of other chronic immune deficiency disorders (ActinoPharma) are putting this research into practical effect.
4) Nutritional supplements: Various supplements may be effective in individuals, including fatty acid supplemantation and linseed oil. However, although owners perceived an improvement, this was not bourne out by objective statistical analysis.
5) Symptomatic Control: Control of symptoms to some degree can be achieved with antihistamines (especially hydroxyzine, and with corticosteroids, although the potential side effects (e.g. laminitis, immune suppression) make this a less preferred option. In addition, antibiotics may be required to manage any secondary infection.
6) Alternative Medicines: A wide variety of herbal, homeopathic and other alternative remedies have been suggested. Among the natural remedies suggested are sulfur, wild geranium (as the base for a shampoo), Lavender oil, Aloe vera (to reduce the itching).
Overall, the wide variety of treatments proposed leads to the conclusion that no one method is universally effective.
The first control method is preventive and aims to eradicate the adult flies before they can cause any damage and is called vector control. The second control method is the treatment once the infestation is present, and concerns the infected animals (including humans).
The principal control method of adult populations of myiasis inducing flies involves insecticide applications in the environment where the target livestock is kept. Organophosphorus or organochlorine compounds may be used, usually in a spraying formulation. One alternative prevention method is the sterile insect technique (SIT) where a significant number of artificially reared sterilized (usually through irradiation) male flies are introduced. The male flies compete with wild breed males for females in order to copulate and thus cause females to lay batches of unfertilized eggs which cannot develop into the larval stage.
One prevention method involves removing the environment most favourable to the flies, such as by removal of the tail. Another example is the crutching of sheep, which involves the removal of wool from around the tail and between the rear legs, which is a favourable environment for the larvae. Another, more permanent, practice which is used in some countries is mulesing, where skin is removed from young animals to tighten remaining skin – leaving it less prone to fly attack.
To prevent myiasis in humans, there is a need for general improvement of sanitation, personal hygiene, and extermination of the flies by insecticides. Clothes should be washed thoroughly, preferably in hot water, dried away from flies, and ironed thoroughly. The heat of the iron kills the eggs of myiasis-causing flies.
When choosing a site for plantation establishment, it is typically good practice to ensure it exhibits good drainage and is non shaded. It should not be next to old Scotch pine stands, which could still hold the "Cyclaneusma". The trees in the plantation should have adequate spacing to allow for proper air circulation. Additionally, the owner should invest in tree stock which displays resistance or tolerance to "Cyclaneusma." After planting, attentive tree care must be undertaken, including nutrient management and water and weed control, to ensure robust, healthy trees. To scout for the disease, the threshold level is 20% of sampled trees showing signs. At this point, the owner should consider treating the entire plantation. In some areas, it is possible to control the disease through the silvicultural practice of thinning, selecting for trees with resistance to "Cyclaneusma".
"Cyclaneusma" presents somewhat of a challenge to manage, as infected needles remain part of the tree throughout the winter and spring months. The creation of spores as well as infection can occur in freezing temperatures with wet needles. Inoculated needles may not develop symptoms for up to a year from the infection date, proving difficult for the effectiveness of pesticides applied in the first season to be judged. Infected needles on or under the tree retain the ability to release spores any time during the growing season, so they should be removed as soon as possible. It is typically recommended to apply five treatments of fungicide, such as chlorothalonil or dodine, when the threshold level is met, beginning in March and continuing roughly every 5–6 weeks through October. If the infection level of a Christmas tree plantation is not yet too high, the aesthetics of the tree can be saved by using a leaf blower to remove infected needles from the tree.
Fungicidal agents such as azadirachtin and phytoallexin have been used against some muscardine pathogens. Silkworm breeders dust their cages with slaked lime to discourage fungal growth. In India a dust of chaff soaked in formalin is applied to the larvae.
There are many strategies to cultural management. Establishment of new trees that are disease free by trying to plant trees as soon as they are received from the nursery to reduce the amount of stress the tree undergoes to reduce the amount of dead tissue. Apply insecticides to prevent insects such as, peach tree borer to prevent disease causing conidia from entering wounded parts of the tree that the insects create. Prune trees appropriately and at the correct time when buds start to break to promote wide angled branching. Infection at pruning sites is less common when done during late spring because of the smaller amount of inoculum present at this time. Inspect trees occasionally and removed any dead branches to prevent infection at these sites. Training trees properly also helps foster decreased amount of disease. Training trees during the first season to have branches develop wide crotch angles to sustain long orchard life. Avoid excessive and late fertilization during cold season to avoid low temperature injury. Fertilize trees during the early spring to prevent cold-susceptible growth.
There is currently no treatment for AHS.
Control of an outbreak in an endemic region involves quarantine, vector control and vaccination. To prevent this disease, the affected horses are usually slaughtered, and the uninfected horses are vaccinated against the virus. Three vaccines currently exist, which include a polyvalent vaccine, a monovalent vaccine, and a monovalent inactivated vaccine. This disease can also be prevented by destroying the insect vector habitats using insecticides.
Various methods are applied.
- The most effective method is to plant peach trees against a house wall under an overhanging roof, possibly covered by a mat during the winter, to keep winter rain from the buds before they burst (and incidentally to delay blossoming until spring frosts are over), until the temperature exceeds in the spring, deactivating the fungus.
- Commercially, spraying the leaves with fungicides is the most common control method. The toxicity of these fungicides means they are not legally available to noncommercial growers in some countries. Spraying should be done in the winter well before budding. If trees are not sprayed early enough, treatment is ineffective. Copper-based mixtures (such as Bordeaux mixture) and lime sulfurs are two fungicides commonly used.
- Peach cultivars can be planted which show some resistance to peach leaf curl, or at least regenerate rapidly, such as Peach 'Benedicte'. No similarly resistant nectarine cultivar is yet known.
If a plant appears to have signs of leaf curl in a particular year, the disease will take its course, but precautions can be taken to sustain the tree or maximize crop yield: for example, treating with nitrogen and excess water to minimize stress on the tree; applying greasebands around the trunk to protect from insect infestation; and thinning the fruit. It is unclear whether removal of infected leaves from the tree is beneficial. Removing the infected leaves and fruit after they fall to the ground is sometimes also suggested but superfluous if, in the following winter, fungicides or rain protection are applied.
Ticks should be removed promptly and carefully with tweezers and by applying gentle, steady traction. The tick's body should not be crushed when it is removed and the tweezers should be placed as close to the skin as possible to avoid leaving tick mouthparts in the skin; mouthparts left in the skin can allow secondary infections. Ticks should not be removed with bare hands. Hands should be protected by gloves and/or tissues and thoroughly washed with soap and water after the removal process.
A match or flame should not be used to remove a tick. This method, once thought safe, can cause the tick to regurgitate, expelling any disease it may be carrying into the bite wound.
Bacterial leaf streak of wheat is not easily prevented, but can be controlled with clean seed and resistance. Some foliar products, such as pesticides and antibiotic compounds, have been tested for effectiveness, but have proven to have insignificant outcomes on the bacterial pathogen.
Using clean seed, with little infection, has yielded effective results for researchers and producers. The pathogen, being seed-borne, can be controlled with the elimination of contaminated seed, however, clean seed is not always a sure solution. Because the pathogen may still live in the soil, the use of clean seed is only effective if both the soil and seed are free of the pathogen. Currently, there are no successful seed treatments available for producers to apply to wheat seed for the pathogen.
Variety resistance is another option for control of the disease. Using cultivars such as Blade, Cromwell, Faller, Howard or Knudson, which are resistant to BLS may reduce the impact of the disease and potentially break the disease cycle. Avoiding susceptible cultivars such as Hat Trick, Kelby, and Samson may also reduce the presence of the disease and reduce the amount of bacterial residue in the soil. Using integrated pest management techniques such as tillage to turn over the soil and bury the infection as well as rotating crops may assist with disease management, but are not a definitive control methods. Depending on conditions, the bacteria may survive for up to 81 months. Because the bacteria is moisture driven, irrigation may also increase the risks of BLS infection.
As with many diseases in developing nations, (including trypanosomiasis and malaria) effective and affordable chemotherapy is sorely lacking and parasites or insect vectors are becoming increasingly resistant to existing anti-parasite drugs. Possibly due to the lack of financial return, new drugs are slow to emerge and much of the basic research into potential drug targets takes place in universities, funded by charitable organizations. Product Development Partnerships (PDPs) like Drugs for Neglected Diseases "initiatives" also work on the development of new treatments (combination treatments and new chemical entities) for visceral leishmaniasis.
The traditional treatment is with pentavalent antimonials such as sodium stibogluconate and meglumine antimoniate. Resistance is now common in India, and rates of resistance have been shown to be as high as 60% in parts of Bihar, India.
The treatment of choice for visceral leishmaniasis acquired in India is now Amphotericin B in its various liposomal preparations. In East Africa, the WHO recommended treatment is SSG&PM (sodium stibogluconate and paromomycin) developed by Drugs for Neglected Diseases "initiative" (DNDi)in 2010.
Miltefosine is the first oral treatment for this disease. The cure rate of miltefosine in Phase III clinical trials is 95%; Studies in Ethiopia show that is also effective in Africa. In HIV immunosuppressed people which are coinfected with leishmaniasis it has shown that even in resistant cases 2/3 of the people responded to this new treatment.
Miltefosine has received approval by the Indian regulatory authorities in 2002, in Germany in 2004 and in U.S.A. in 2014. It is now registered in many countries.
The drug is generally better tolerated than other drugs. Main side effects are gastrointestinal disturbance in the first or second day of treatment (a course of treatment is 28 days) which does not affect the efficacy. Because it is available as an oral formulation, the expense and inconvenience of hospitalization is avoided, and outpatient distribution of the drug becomes an option, making Miltefosine a drug of choice.
Incomplete treatment has been cited as a major reason of death from visceral leishmaniasis.
The nonprofit Institute for OneWorld Health has adopted the broad spectrum antibiotic paromomycin for use in treating VL; its antileishmanial properties were first identified in the 1980s. A treatment with paromomycin costs about $15 USD. The drug had originally been identified in the 1960s. The Indian government approved paromomycin for sale and use in August 2006.
Parasitic infections can usually be treated with antiparasitic drugs.
Albendazole and mebendazole have been the treatments administered to entire populations to control hookworm infection. However, it is a costly option and both children and adults become reinfected within a few months after deparasitation occurs raising concerns because the treatment has to repeatedly be administered and drug resistance may occur.
Another medication administered to kill worm infections has been pyrantel pamoate. For some parasitic diseases, there is no treatment and, in the case of serious symptoms, medication intended to kill the parasite is administered, whereas, in other cases, symptom relief options are used. Recent papers have also proposed the use of viruses to treat infections caused by protozoa.
Control of Leucostoma Canker is possible through a combination of pest and crop management techniques following life cycles of the trees. The strategy is implemented following techniques aimed at reducing number of pathogenic inoculum, minimizing dead or injured tissues to prevent infection, and improving tree health to improve rapid wound healing. Chemical controls have not been very effective at controlling this disease with no fungicides registered specifically for control of "Leucostoma" spp., and demethylation-inhibiting (DMI) fungicides having almost no effect on "L. persoonii".
Both over-the-counter and prescription medications are available for treatment of pubic lice infestations. A lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide can be used to treat pubic ("crab") lice. These products are available over-the-counter without a prescription at a local drug store or pharmacy. These medications are safe and effective when used exactly according to the instructions in the package or on the label. Effectiveness of treatment is increased when the pediculicide is left on the skin and hair for at least an hour A second round of treatment is recommended within the following seven to ten days to kill newly hatched nymphs. Lindane is a second line treatment due to concerns of toxicity. The Centers for Disease Control and Prevention (CDC) states that lindane should not be used by persons who have extensive dermatitis, women who are pregnant or lactating or children aged under two years. The FDA similarly warns against use in patients with a history of uncontrolled seizure disorders and cautious use in infants, children, the elderly, and individuals with other skin conditions (e.g., atopic dermatitis, psoriasis) and in those who weigh less than 110 lbs (50 kg).
Bedding and clothing is laundered and sexual contact should be avoided until no signs of infestation exists. A second treatment is occasionally required if not improved after 3 to 7 days.
Pubic lice are primarily spread through sexual intercourse. Therefore, all partners with whom the patient has had sexual contact within the previous 30 days should be evaluated and treated, and sexual contact should be avoided until all partners have successfully completed treatment and are thought to be cured. Because of the strong association between the presence of pubic lice and classic sexually transmitted infections (STIs), patients may be diagnosed with other STIs.
Because the crab louse needs hair to attach its eggs to, shaving the pubic area denies them this opportunity and should be enough to eliminate an infestation. However, the eyelids should be checked as well and treated accordingly.
Infections of the eyelashes may be treated with either petroleum jelly applied twice daily for 10 days or malathion, phenothrin, and carbaryl.
There are no treatment modalities for acute and chronic chikungunya that currently exist. Majority of treatment plans use supportive and symptomatic care like analgesics for pain and anti-inflammatories for inflammation caused by arthritis. In acute stages of this virus, rest, antipyretics and analgesics are used to subside symptoms. Most use non-steroidal anti-inflammatory drugs (NSAIDs). In some cases, joint pain may resolve from treatment but stiffness remains.
No specific treatment for CTF is yet available. The first action is make sure the tick is fully removed from the skin, then acetaminophen and analgesics can be used to help relieve the fever and pain. Aspirin is not recommended for children, as it has been linked to Reye’s syndrome in some viral illnesses. Salicylates should not be used because of thrombocytopenia, and the rare occurrence of bleeding disorders. People who suspect they have been bitten by a tick or are starting to show signs of CTF should contact their physicians immediately.