El Tupe (Botfly) – Ecuador, South America

Preparations
I was smiling as the transparent serum penetrated my skin. When the nurse pulled the needle out, I felt elated. I left my $10.00 copay at the desk, the doctor handed me a big yellow paper that she signed and stamped. It was my yellow fever certificate, the last document I needed before the long awaited trip. I was good to go. I was all set to dive in the heart of the Amazon forest. Such a trip cannot be fully enjoyed alone, a companion is key, so my roommate was going to join me. She was as thrilled as I.

The trip was mind blowing. We experienced the jungle. We lived among various indigenous tribes in the midst of the emerald forest, revealing a fascinating new world. We brought back precious memories, extraordinary photos and much more.

Skin Drama
I returned with an itchy rash on my ankles and a sprained hip. I was scratching day and night. Only some allergy prescription medication could keep the itch under control and keep me from skinning myself alive. My roommate had blistered insect bites which, in the sweltering heat and humidity, got infected. Oozing lesions developed on her legs by the time we arrived home. They were purplish on the edge, deep red on the inside with yellow middle, and some fluid dripping down constantly. Our main activity became monitoring the evolution of these ulcers.

The living room resembled an emergency room: ointments, antibiotic pills, sanitary alcohol, gauze, sterile pads scattered everywhere. Every evening and morning, a cleansing ritual took place. Instead of a good morning or hello, I adapted my greeting to the situation, asking “How are your sores today?”. My afflicted roommate bore her lesions with dignity and optimism, oozing restlessly around the house with an impressive perseverance. It got so bad she started carrying a sheet around the house to cover whichever chair, bed or couch she sat on, to avoid spilling her juices.

In three weeks all the leaking pustules healed, leaving only brownish scars, as if the freckles from her face migrated down onto her calves. We were relieved and disease free.

A few days later, my roommate came into the kitchen with a frown.

“Can you take a look here, on the back of my leg, what’s that pimple? It’s hurting”.

I looked and saw a pretty fat and hefty blemish, a small volcano, not yet ready to erupt.

“It’s a boil.”

“It hurts so badly today, like somebody twisted a knife in my leg.”

“Well, it’s a boil, and boils hurt. No big deal, though.” I succeeded in appeasing her a bit.

With all the skin disorders we have been battling for the past weeks, we were obsessively observing even the most innocent pimple that popped up on our nose or shoulder. The next evening, while I was browsing the internet, my roommate came next to me, and flipped her skirt up.

“Look, what do you think?” I glanced at the exposed area, I saw two huge red spots, as large as a hand on her left leg.

“That’s odd. You should take antibiotics and put antibiotic cream on the area”.

The conversation stopped right there. We could not take any more skin drama. We were emotionally drained, plus we had severely disturbed stomachs after the experiences of the past three weeks. What if the red patches were a sign of yet another outbreak of tropical skin disorder? Acting wisely, we decided to wait and see if self treatment mixed with luck would work. It did. The next day the redness and swelling were gone, the boil had a white spot, meaning it was going to erupt soon. We were on the right path.

IT is El Tupe (botfly)
A new era started for my roommate, with daily activities concentrated on squeezing and smearing ointment on the miniature volcano. Everything was going smoothly until one morning, when loud and desperate-sounding knocks on my door woke me up. I groaned an annoyed “leave me alone”.

“It’s urgent.” The knocking continued. I opened the door, a distressed, white-faced roommate in underwear was trotting in front of me.

“I squeezed something out of my leg, it’s moving!” She disappeared into her room.

I found her on the bed, petrified, holding a piece of paper in her hand.

“Oh, shit!” was all I could say, rubbing my sleepy eyes to make sure I was seeing properly. A whitish three millimeter worm, with black hairy rings, was wiggling frenetically on the paper.

“I was cleaning the boil and squeezed it to get more stuff out. I saw a white dot and squeezed more. When the white stuff came out, I pinched it and pulled it out, it started moving in my hand!” She took an emotionally charged break which allowed both of us to breathe deeply and alleviate that feeling of disgust.

“Hey, you just had a baby! Congratulations!” I said half cheerfully, half in shock.

“How did it get in my leg? What is IT?” my roommate asked rhetorically, keeping the paper at her eye level and vaguely reminding me of a Shakespeare scene involving a man, a skull and a famous question.

It was a serious situation, a highly freakish, unusual case worthy of the X-Files. Were there others? I pictured things creeping out of my desperate roommate’s body, invading our apartment. I almost screamed out loud. I needed to be supportive, I had to act fast, we had no time to waste. I jumped on the computer and started a frantic and useless search of tropical disease doctors in New York City. The best solution remained going to the dermatologist.

We each went to our job, my roommate carrying IT in her bag. Useless to say, that morning was completely unproductive. We sat in our sorry dark cubicles trying to figure out what IT was, what should we do about IT. We searched the web in all the languages we knew, nothing resembled our IT.

An idea hit me. I was going to send a text message to Byron, our Ecuadorean guide who led us during the Amazon adventure.

I sent the message and thought, What if Byron was in the jungle with other tourists? A few minutes passed. Beep! Two messages and I had the answer. I called my roommate.

“Hey, Byron replied, it’s el tupe, no big deal”

El tupe? What is that?”

I had no idea what el tupe was, it sounded comforting, though. I googled the term immediately.

“It’s the botfly, usually nests in the skins of animals, like cows.”

We were relieved, my roommate was bitten by a fly which deposited an egg in her skin. For the past month, the egg became a little worm that fed on my roommate’s flesh and blood. Seeing the pictures on the internet, we realized our case was a lucky one, we got IT out when he was still a baby.

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