Alergi yang disebabkan kupu-kupu

Kupu-kupu adalah serangga yang termasuk ordo LEPIDOPTERA yang memepunyai

sepasang sayap dan bersisik tebal. Stadium dewasa mempunyai bentuk mulut untuk menghisap
(shoponing), sedangkan stadium larva mempunyai bentuk mulut untuk menggigit. Kupu-kupu
mengalami metamorphosis lengkap dan dibagi dalam 2 golongan yaitu kupu-kupu siang
(butterfly) dan kupu-kupu malam (month).
Patologi dan gejala klinis
Larva kupu-kupu yang biasa disebut ulat bulu mempunyai bulu yang mengandung
toksin yang dapat menyebabkan kelainan pada manusia. Kelainan ini disebut erusisme. Gejalagejala erusisme atau dermatitis ulat (caterpillar dermatitis) adalah urikaria, nyeri, gatal dan rasa
panas. Hal ini disebabkan oleh toksin yang merusak sel-sel tubuh sehingga tubuh mengelurkan
histamine, serotonin dan heparin sebagai reaksi terhadap toksin larva kupu-kupu. Jika bulu ulat
mengenai mata dapat terjadi konjungtivitis atau ulkus kornea. Kupu-kupu dewasa dapat juga
menyebabkan kelainan bila manusia kontak dengan bulu yang terdapat dibagian ventral
abdomennya. Kelainan karena kupu-kupu dewasa disebut lepidopterisme. Gejala klinis
lepidopterisme berupa dermatitis yang mirip giant urrticaria oleh cacing schistosoma.
Beberapa spesies kupu-kupu yang larvanya mengandung bulu beracun adalah :
Megalopyge opercularis (di Amerika), Anaphe infracta (di Eropa), dan parasa hilarata (di
Asia). Contoh kupu-kupu penyebab lepidopterisme adalah heylesia spp.
Diagnosis
Diagnosis detetapkan bila terdapat gejala klinis diserati riwayat kontak dengan ulat
bulu atau kupu-kupu.

Pengobatan
Lesi yang timbul jangan digaruk karena dapat mempercepat penyebaran toksin.
Seluruh tubuh yang mengalami reaksi segera direndam dalam air untuk melarutkan toksin dan
bulu-bulu larva yang melekat pada kulit. Untuk pengobatan local dapat menggunakan larutan
yodium, kortikosteroid dan atihistamin topical, sedangkan untuk penderita pada keadaan berat,
obat-obat tersebut dapat diberikan secara oral atau parenteral.
Ada beberapa cara sederhana yang dapat di lakukan apabila terkena bulu beracun

Pertama, cucilah kulit kemerahan yang terkena bulu beracun dengan air
mengalir dan jangan lupa disabun. Cara tersebut bermanfaat untuk menghilangkan
bulu beracun yang menempel ditubuh anda.

Kedua, jangan pernah menyentuh atau menggaruk kulit kemerahan tersebut,

karena akan mempermudah memperluas keradangan atau bahkan membuat bulu
beracun dapat dengan mudah menembus pembuluh darah anda.

Ketiga, setelah dicuci maka segera keringkan dengan hair dryer. Jangan
mengeringkan dengan handuk karena bulu beracun dapat menempel di handuk
anda dan tertular ke orang lain yang menggunakan handuk yang sama.

Keempat, dinginkan kulit yang kemerahan tadi dengan kompres es secukupnya.

Kelima, anda dapat minum antihistamin oral, saya sarankan CTM 4 mg (karena
murah dan dijual bebas) dengan dosis dewasa 3 tablet sehari. Kalau anda tidak
ingin mendapatkan efek ngantuk CTM, anda bisa minum tablet Loratadin 10 mg,
dengan dosis satu tablet satu hari.

Keenam, anda dapat mengoleskan salep kortikosteroid bila area kulit yang
kemerahan tidak terlalu luas, saya sarankan menggunakan salep hidrokortison bila
gatal pada daerah wajah atau salep deksametason bila gatal di daerah tangan dan
kaki.

Ketujuh, bila disertai rasa sesak nafas segera hubungi RS terdekat.

Epidemiologi
Terdapatnya kasus erusisme dan lepidopterisme disuatu daerah dipengaruhi oleh
spesies kupu-kupu, keadaan daerah dan kebiasaan rakyat sebagai petani atau pekerja kebun.
Pencegahan dapat dilakukan dengan menghindari kontak langsung dengan ulat bulu atau kupukupu. Pemberantasan kupu-kupu dilakukan dengan insektisida terutama utuk stadium larvanya.

Penyakit yang disebabkan karena ulat bulu, di dunia kedokteran dikenal sebagai
Caterpillars Dermatitis (radang kulit karena ulat bulu). Gejalanya khas, biasanya ditandai dengan
kulit yang bentol-bentol berwarna merah (mirip biduren) pada wajah, tangan, kaki, dan leher
bagian belakang yang dekat dengan kerah baju. Keluhan yang dominan biasanya adalah rasa
gatal yang terus-menerus. Pada penderita Caterpillars Dermatitis biasanya matanya berair dan
ada radang kemerahan di kedua matanya. Apabila bulu-bulu ulat yang terbang bersama angin
terhirup oleh hidung kita, komplikasi yang paling mungkin terjadi adalah sesak nafas karena
penyempitan jalan nafas (bronchospasm). Kalau sudah dalam stadium tersebut (sesak nafas)
segera bawa penderita tersebut ke pusat pelayanan kesehatan terdekat (di sarankan ke UGD RS).

http://www.waldwissen.net/technik/holzernte/arbeit/wsl_schmetterlingsra

URL:

upen_brennhaare/index_EN
Original

Burri,

article:

Brennhaaren. Merkblatt zu Arbeitssicherheit und Gesundheitsschutz in

den

M.,

Schniepper,

M.

(2006):

Strassenunterhaltsdiensten.

Schmetterlingsraupen

Herausgegeben

von

mit

der

Koordinationsgruppe Arbeitssicherheit im Strassenunterhalt (KGr AS

SUD). www.nationalstrassen.ch
Author(s):
Online

Status: 16.09.2009

version:
Editorial
office:

Monika Burri, Maja Schniepper (Gruner AG)

WSL, CH

Beware of caterpillars with urticating hairs

Fig. 1 - Oak processionary moth caterpillars.

Photo: Entomology (WSL)

Fig. 2 - Pine processionary moth

caterpillars.
Photo: Entomologie (WSL)

Fig. 3 - Gold tail moth caterpillar.

Photo: Beat Fecker (WSL)

Some species of caterpillars have urticating hairs which can cause extreme
itching, skin irritations and damage to eyes and the respiratory system. Therefore care
must be taken during work being carried out along the edge of forests, on embankments or
whilst tending trees.
Occasionally during the course of maintenance work being carried out along the edge
of forests or on street embankments health problems caused by three species of moths can occur.
Contact with the stinging hairs of these caterpillars can lead to skin irritation and/or allergic
reactions of the skin, mucus membranes or respiratory systems. The species in question are the
following:
The oak processionary moth (Thaumetopoea processionea)
The pine processionary moth (Thaumetopoea pityocampa)
The gold tail moth (Euproctis chrysorrhoea)
Why can these caterpillars be dangerous?
Most of us regard butterflies as colourful messengers of summer. Some people are
aware that caterpillars can eat voraciously. For instance, the cabbage white dines in the vegetable
garden. The mottled umber can damage fruit plantations by eating buds, leaves and blossom. The
orchard ermine wraps up the left over bare wood and its surrounding area in white webs. Asian
gypsy moth caterpillars manage to defoliate whole forests during their rare mass outbreaks and
are a nuisance to people living near by when they move into gardens and houses by the hundreds
or even thousands.

All of these species catch our eyes with their webs, nests and intense defoliation, but
although they cause a certain amount of damage to cultivated plants they are however harmless
from a health point of view.
The three aforementioned species are also noticeable thanks to their nests, webs,
defoliation and caterpillar processions but they can also cause health problems. These caterpillars
have stinging hairs which can cause itching, skin irritation and also eye problems or damage to
the respiratory system.
What are urticating hairs and what is their function?

Urticating hairs protect the caterpillars and their later stages of development (Pupae,
moth, egg) from predators.

They are tiny: 0.1 0.2 mm (This is only true of the processionary moth the gold
tail moth has easily visible golden brown hairs.)

They are abundant: 600,000 per caterpillar.

They stick: in the nest, on the bark, in the grass, in foliage and on clothes.

They snap off when the caterpillar feels threatened and keep their potency over many
years.
How does one come into contact with the hairs?
By being near to or in the general surroundings of infested bushes or trees. The hairs

drift in the air and can be blown over a distance of 200 m.

If the nests or caterpillars are touched.
If work is being carried out and caterpillar hairs which are present on the ground are
stirred up: e.g. by raking up leaves, mowing, or clearing up trimmings.
When bark in which there was once a processionary moth nest is touched or worked.
(The nest of the oak processionary moth is mainly to be found on the trunk, whilst the nests of
the pine processionary moth and the gold tail moths are in the periphery areas of the crown.)
The urticating hairs of the golden tail moth, although less aggressive, are however
used for protection in every stage of development: the hairs which are produced only by the
caterpillars are woven into the pupae cocoons the female then strokes them onto her abdomen
from where they make their way into the egg clutches during egg laying.
Symptoms and precautions
Skin irritations (caterpillar dermatitis)

One reaction after contact with stinging hairs of the gold tail moth may be extreme
itching; this can occur hours after contact, but may continue over several days. Although only a
slight rash occurs after contact with the gold tail caterpillar extreme itching can prevent a person
sleeping. After contact with the stinging hairs of oak processionary or pine processionary moths
the following symptoms may also occur:

Redness, swelling, inflammation of the skin

Inflammation of the conjunctiva and eyes

Redness, aversion to light, swelling of the eyelids, inflammation of the inside of

the eye (extreme case)

Inflammation of the upper respiratory system

Inflammation of the throat, swelling of the mucus membrane in the nose,

bronchitis, asthma like symptoms, allergic shock reaction (extreme case)

In the case of processionary moths a further complication is that increased caterpillar

contact increases the sensitivity and therefore the intensity of reaction of the affected person.

Fig. 5 - Possible results of contact with the stinging hairs of processionary moths.
Immediate measures to be taken when affected

Shower immediately, wash hair (rinse with soap, do not rub), change clothes.

Do not scratch; free possible contaminated areas of skin using adhesive tape.

Contaminated clothes should be stored in an air tight container and washed

separately at 60 C, or even hotter.

The affected areas can be treated with antihistamine (E.g. Fenistil).

Should there be extreme itching or if other conspicuous symptoms should appear a

doctor should be consulted and he should be informed that the person has been in contact with
caterpillar hairs.

In Switzerland health problems caused by caterpillars are treated by health insurance

companies as accidents (analogue with tick bites).
Measures to be taken in infested areas
a) Assessment of the situation
What species is involved? Does it have urticating hairs?
Conflict potential in the area: how often and how urgently must the area be entered?
After a situation has been assessed and it is clear that there is an infestation of
caterpillars with urticating hairs then a plan of action will be prepared using the following guide
lines:
Work should be finished with protective clothing or put on hold
The area should be cordoned off and information made available for probable users
The case should be recorded and documented (map, photos) for the cantonal security
representative and as a basis for long term measures
Control measures for caterpillars or plans for long term preventative measures should
be planned together with experts.
b) Prevention measures
In areas infested by gold tail or pine processionary moths the total removal of all
possible winter nests can provide infestation free areas which should last at least up until the
following autumn.
Non dangerous species without urticating hairs

Fig. 6 - Small eggar.

Fig. 7 - Ermine moth.

Photo: Beat Wermelinger (WSL)

Photo: Beat Wermelinger (WSL)

armless species which have a similar biology and whose population could be
endangered should not be controlled:

a) Small eggar
Wide spread in the canton of Wallis, otherwise sporadic in the cantons of Tessin,
Bndner Rhine Valley, the area around Zrich, and in the Walensee area. Due to its rarity it
should be protected. Nests should never be removed!
Feeding plants: Birch, blackthorn, sweet chestnut, sweet cherry
Difference to gold tail moth: the up to 20 cm large nest hangs like a bag
Difference to the pine processionary moth: the species does not go onto pine trees
b) Ermine moths
Nine very similar species, generally very widespread.
Feeding plants: spindle tree, fruit trees, willow and other bushes
Similarities: complete defoliation of bushes (in June)
Differences: after defoliation veil like webs cover whole plants.
Distribution and occurrence
The three species with urticating hairs were at one time more widely spread in
Switzerland and more common. Their population was drastically reduced by the thoughtless use
of insecticides in agriculture. In Switzerland and in near by neighbouring countries they are now
once again on the increase. This increase is being encouraged by global warming. Distribution
maps can be found in the leaflets (see download).
The pine processionary moth has been observed for some time in several areas in
southern Switzerland. Since the beginning of the 1990s there has been an increase in the
appearance of the oak processionary moth and the dark gold tail moth: with the oak
processionary moth occurring more rarely than the dark gold tail moth. All three species are
capable of mass reproduction