Alexandra Heminsley tells of how she was bitten while on a holiday in Kenya two years ago, after leaving her wet swimwear hanging off the edge of her chair to dry.
On her way to the airport, Ms Heminsley noticed what she thought was a mosquito bite on her arm and felt very, very sick. The bite grew larger and appeared infected... but then the horror - it started to moved!!
Alexandra Heminsley's Story:
'A Bikini Bug Ate Me Alive'
Two years ago, after a soggy British summer, a friend suggested a last-minute break for some winter sun. I'd just signed my first book deal and leapt at the chance. We chose Kenya. It was affordable, it was sunny, and it didn't involve anything remotely like hard work.
We had a wonderful time: afternoons spent reading by the pool, a couple of days on safari and a boat trip for some snorkelling.
(until she was bitten by a female African tumbu fly)
Ever the holiday geek, I was careful throughout: I had all the requisite jabs, spent a small fortune on anti-malarial pills and was almost constantly doused in half a can of mosquito repellent. I even wore an old T-shirt while snorkelling to make sure my back did not get burned.
The trip was a great success, and as I took the taxi to the airport I was pleased to see that I had only one mosquito bite. It was on the inside of my left upper arm, by the seam of my T-shirt. Never mind, I thought, it's not even itchy: it will be kept cool in the plane's air conditioning and will be almost gone by the time I'm back.
The reality was somewhat different. Within a few hours of arriving home, I was being violently sick.
Food poisoning or a bug from the plane, I decided. After 24 sleepless hours, I noticed that the bite was getting larger. By now, it was the size of a grain of rice. I also worried that it had become infected, because it was yellow and hard.
Two days later, I was no longer ill, but the bite was so uniquely painful that I was exhausted by it. It was relentless. It was now very raised, and very yellow. I was as repulsed as I was pained by it.
On my third night back, the pain was so intense that I was again unable to sleep. It was a sharp pain, as if someone had put a knitting needle in the freezer and was jabbing it into my arm. It was sporadic, coming in waves. Every time I thought it was abating and nearly fell asleep, it came back stronger than before.
At about 4am, I had turned the light on and was staring at the bite. Suddenly, it seemed to be moving. I must be very, very tired, I reasoned.
There was now a hole at the top of the bite, with what looked like pus; I wiped it clean with a piece of disinfected cotton wool. The pain abated. Twenty minutes later, more movement, more yellow stuff, more agony.
The next morning, I headed to a meeting in North London.
This time, I was in so much pain I was doing short, shallow breaths through my mouth and could barely stand on the train. Other passengers must have thought I was having contractions.
As the train passed the stop for Hampstead, very close to the Royal Free Hospital, I decided on the spur of the moment to have it dressed by a professional.
A triage nurse saw me quickly. I explained that I'd been bitten by a mosquito in Kenya, and it now seemed infected. I tried to add nonchalantly that I thought the area was wriggling. I didn't want to be the 'crazy lady' of the day.
I needn't have worried. As I rolled up my sleeve to show the nurse, it became immediately clear to both of us that it was not a mosquito bite. Out of the - now larger - hole popped what appeared to be a small maggot, accompanied by the now familiar wave of pain. I widened my eyes in horror.
'Please, can I lead you into this room?' she said in a very, very calm voice. She shut me into a small room with a foot-wide, securely sealed door. 'I'm getting someone to come and see you,' she mouthed from the other side.
(Click to Enlarge)
I lay down on the bed in the room. I was crying with pain and now panicked by what was wriggling out of my arm. After about half an hour, a doctor from the tropical disease unit came to see me. After looking at my arm, he said he thought he knew what it was, but needed a second opinion.
An hour later, the head of department arrived. By this time, I'd had to turn the light out in the room as I was in so much pain. I'd had no sleep for three days and was in no state to meet the most devastatingly handsome doctor I had ever seen, but there he was. I was swooning with pain, but I swooned some more.
Dr Jake knew exactly what it was and confirmed it with a series of questions. Had I been in Africa? Had I worn a damp T-shirt while there? Had the 'bite' started out like a small red bump? Yes, yes and yes.
It was the larva of the tumbu fly, found anywhere in the tropics from South America and India, through to Australasia and Thailand, and I had a condition known as myiasis, when larvae live and feed on a host. It sounded disgusting. Worse still, it's relatively rare in humans.
Jake told me the female tumbu fly likes to lay its eggs on damp clothing or linen. (I remembered leaving my wet T-shirt hanging off the edge of my sunlounger to dry.) If those clothes are then worn, the eggs penetrate the skin. After two or three days, the larvae hatch beneath the skin.
Once 'born', the larvae need air so they eat their way out. I realised, with horror, that the pain was the larva munching its way out of my arm.
I was told that, in fact, I was one of the lucky ones, as my bug was smart enough to head out of my arm. Dr Jake - who had seen the condition while doing missionary work in Africa - explained that some burrow farther inwards by mistake, making the process of removal much more difficult.
In the tropics, he told me, it's important not to wear damp clothes that have been outside. Your clothes should be tumble-dried or, if they are left to dry outside, ironed. The intense heat kills the eggs.
The same is true for swimming costumes. Don't leave them hanging on your hotel balcony to dry in the sun while you take a nap.
The treatment was almost as grotesque as the problem. You must not gouge the larva out. It has to be lured out by suffocating it: in its search for air, it wriggles out.
Apparently, in Africa, bacon is used. In the Royal Free, they went for Vaseline. Half a tub was slathered over the area, then a clear, airtight plastic dressing was fixed on top. 'Go shopping and come back in three hours,' I was told.
There is not much that makes me Definitely Not Feel Like Shopping, but strutting around Hampstead with an African maggot chewing its way out of my body really put me off.
When I returned to the Royal Free, a teaching hospital, a room was ready for me - as were about 25 student doctors and curious nurses. With digital cameras. And a jar. 'We're so excited!' they said. 'We never thought we'd see something like this in North London.'
Dr Jake was masterful. Tweezers at the ready, he whipped off the dressing and plucked the larva out in seconds. Everyone leaned forward, then gasped. The most intense pain I have ever known was followed by exquisite relief.
A bug around the size of a pencil nib was put in a jar, sealed and passed around. The students were mesmerised. I, however, was far more mesmerised by the clean hole in my arm. Now I understood why maggots were used to clean wounds in the past: it was immaculate.
The pain was over. No dressing was needed. I simply have a neat, perfectly round scar, the circumference of a small pea, in my arm.
I haven't been back to Africa, but I am not afraid to. I am very diligent about tumble-drying my bikinis. And I iron a lot.