Evidence map›Paper›PMID 27073878›Full record

ArticlePloS one2016

Population Explosions of Tiger Moth Lead to Lepidopterism Mimicking Infectious Fever Outbreaks.

Pallara Janardhanan Wills, Mohan Anjana, Mohan Nitin, Raghuveeran Varun, Parayil Sachidanandan, Tharaniyil Mani Jacob, Madhavan Lilly, Raghava Varman Thampan, Koyikkal Karthikeya Varma

Abstract readComparative Study
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. A study on the role of lepidopterism in seasonal fever outbreaks.Journal of family medicine and primary care · 2022
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Pallara Janardhanan WillsMIMS Research Foundation, Malabar Institute of Medical Sciences (Aster MIMS), Kozhikode, Kerala, India.
Mohan AnjanaMIMS Research Foundation, Malabar Institute of Medical Sciences (Aster MIMS), Kozhikode, Kerala, India.
Mohan NitinICFO-Institut de Ciències Fotòniques, Barcelona, Spain.
Raghuveeran VarunMIMS Research Foundation, Malabar Institute of Medical Sciences (Aster MIMS), Kozhikode, Kerala, India.
Parayil SachidanandanState Forensic Science Laboratory, Thiruvananthapuram, Kerala, India.
Tharaniyil Mani JacobDepartment of Statistics, Nirmala College, Muvattupuzha, Kerala, India.
Madhavan LillyMIMS Research Foundation, Malabar Institute of Medical Sciences (Aster MIMS), Kozhikode, Kerala, India.
Raghava Varman ThampanMIMS Research Foundation, Malabar Institute of Medical Sciences (Aster MIMS), Kozhikode, Kerala, India.
Koyikkal Karthikeya VarmaMIMS Research Foundation, Malabar Institute of Medical Sciences (Aster MIMS), Kozhikode, Kerala, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lepidopterism is a disease caused by the urticating scales and toxic fluids of adult moths, butterflies or its caterpillars. The resulting cutaneous eruptions and systemic problems progress to clinical complications sometimes leading to death. High incidence of fever epidemics were associated with massive outbreaks of tiger moth Asota caricae adult populations during monsoon in Kerala, India. A significant number of monsoon related fever characteristic to lepidopterism was erroneously treated as infectious fevers due to lookalike symptoms. To diagnose tiger moth lepidopterism, we conducted immunoblots for tiger moth specific IgE in fever patients' sera. We selected a cohort of patients (n = 155) with hallmark symptoms of infectious fevers but were tested negative to infectious fevers. In these cases, the total IgE was elevated and was detected positive (78.6%) for tiger moth specific IgE allergens. Chemical characterization of caterpillar and adult moth fluids was performed by HPLC and GC-MS analysis and structural identification of moth scales was performed by SEM analysis. The body fluids and chitinous scales were found to be highly toxic and inflammatory in nature. To replicate the disease in experimental model, wistar rats were exposed to live tiger moths in a dose dependant manner and observed similar clinico-pathological complications reported during the fever epidemics. Further, to link larval abundance and fever epidemics we conducted cointegration test for the period 2009 to 2012 and physical presence of the tiger moths were found to be cointegrated with fever epidemics. In conclusion, our experiments demonstrate that inhalation of aerosols containing tiger moth fluids, scales and hairs cause systemic reactions that can be fatal to human. All these evidences points to the possible involvement of tiger moth disease as a major cause to the massive and fatal fever epidemics observed in Kerala.

Indexed as

Disease OutbreaksAdolescentAdultAgedAged, 80 and overAnimalsCase-Control StudiesChildChild, PreschoolCommunicable DiseasesDermatitis, Allergic ContactExanthemaFemaleFeverHumansIndia

Identifiers

PMID27073878
PMCPMC4830441

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.