The role of deer keds (Diptera: Hippoboscidae: Lipoptena and Neolipoptena) in occupational and public health.

Deer keds (Diptera: Hippoboscidae: Lipoptena and Neolipoptena) are bloodsucking arthropods that primarily feed on deer (family Cervidae) but can occasionally bite humans. The knowledge of their potential harm to wildlife, livestock, and pets is fragmentary. These ectoparasites have been historically understudied, as they were only considered nuisances to various occupational groups and the public. However, there is also mounting evidence that they may be pathogen vectors as several infectious disease agents, including Acinetobacter, Anaplasma, Bartonella, Borrelia, Coxiella, Francisella, Mycoplasma, Rickettsia, Chlamydia-like organisms, Trypanosoma, Babesia, and viruses such as Sigmavirus lipoptenae and Thrombocytopenia Syndrome Virus, have been detected in deer keds. In this context, deer keds should be considered a highly probable vector for Bartonella schoenbuchensis. Persons at risk include anyone who travels or resides in the habitats of deer keds, primarily forests and their immediate surroundings in the Northern Hemisphere, whether for leisure or work purposes, particularly in temperate regions of Europe, Siberia, China, and North America. They also occur in Central and South America, the Russian Federation, South Korea, Thailand, Japan, Algeria, and Southern Spain. The ongoing rise in temperatures due to climate change is likely to favor the spread of deer keds, as it alters host distributions and increases their activity levels. Measures to prevent bites include avoiding areas with a high occurrence of deer keds, wearing protective clothing, including permethrin-treated clothing, and conducting a thorough body check for deer keds and bite sites after spending time or working in a risk area. Medical professionals should consider deer ked bites in their differential diagnoses. To ensure occupational and public health safety, it is crucial to educate and train at-risk workers (such as woodsman, foresters, employees of national parks, naturalists, farmers, and veterinarians) and those recreating in forests (such as walkers, hikers, hunters, or mushroom pickers) about deer ked bites, their symptoms, and possible zoonotic implications. This review summarizes the recent knowledge regarding the health risks posed by deer keds, applicable to both occupational groups and anyone who may encounter them within their geographic distribution.