Diagnostic problems

A problem that often occurs in the management of flea bites is that patients or parents may reject the diagnosis because one or more of the following:

• perceive flea bites as associated with poor personal hygiene - fleas are not selective who they bite
• only one person in the family appears to be affected - it may be that other family members have been bitten but have less vigorous reactions to the flea bites
• cleanliness of the house - some fleas will be killed by cleaning but not all. Vacuuming will kill about a quarter of larvae, half of the egss and approximately 95% of emerged adults (1)
• lack of fleas on their pet - generally incorrect; but also irrelevant because pupae can survive for months and will bite humans as they hatch
• pet has a flea collar - this is often irrelevant because flea collars have a limited duration of action; also not not all treatments will eradicate fleas from the environment
• absence of a pet in the household - fleas may relate to previous pet in the household; also there is the possibility that flea bites have been acquired in someone else's house

If there is doubt as regards a diagnosis of flea bites then a veterinary surgeon should examine the household pets or debris from their bedding and also should be involved in the discussion as to treatment of the household and pet.

Reference:

1. Dermatology in Practice (2003), 11 (5), 22-6.