Authors’ Reply

Sir,

We thank the reader for the interest shown in our article: “Paederus dermatitis: An outbreak, increasing incidence or changing seasonal pattern?” In our article we have only surmised that an alteration in the seasonal pattern as evidenced by the delay in onset of monsoon in Kolkata in 2011 could have played a role in the outbreak of paederus dermatitis. This was based on the observation that the insects thrive in a moist atmosphere.[1] Hence, due to the arid conditions prevailing outside they could have moved indoors in search of the moist environs. Our study compared the statistics for only 3 years. There have been outbreaks in earlier years but we have not checked whether the onset of monsoon was delayed in those years.

Interestingly, the authors have raised the issue of human migration disturbing the resident paederus population and causing the attack. There are reports of outbreaks of paederus dermatitis occurring in the roving population in a medical mission boat in the Amazon[2] and among army personnel on field duty.[3] However, our study was conducted among patients visiting our hospital. They were all residents of the catchment area of our hospital which comprises principally of urban and semi-urban localities and there was no evidence that any of them had migrated from other areas. This was similar to observations in other studies.[4,5]

Hence, we believe that though “shift of the human community invading to the area which is the habitat of the insect” may be the causative factor in some outbreaks this was not so in our study.