Evacuation of an Aboriginal community in response to an outbreak of blistering dermatitis induced by a beetle (Paederus australis)

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Abstract
Objective: To describe an outbreak of dermatitis induced by the beetle Paederus australis and the public health measures implemented to control it. Setting: A remote Aboriginal community in the Northern Territory of Australia. Methods: Inspection of the community and interviews with residents to document skin lesions, sleeping locations and beetle activity. Samples of the beetle were collected for identification. Results: The community was affected by a plague of beetles. All 40 residents reported painful, blistering, skin lesions. Four required hospitalisation for treatment of an extensive exfoliating and ulcerating dermatitis. The community was evacuated to allow skin lesions to heal and the beetle plague to decline. Conclusion: This is the first reported en masse outbreak of Paederus dermatitis in Australia. Paederus dermatitis should be considered as a differential diagnosis of vesicular dermatitis in tropical Australia.