Flea located under toenail - Tunga penetrans
The toe belongs to an employee of the USDA, Agricultural Research Service (ARS), who acquired the chigoe flea, Tunga penetrans L., while in Kenya doing training on a Near Infra-Red Spectroscopy (NIRS) technique to determine mosquito age and species. The employee unfortunately was wearing sandals throughout her time at the Kenya Entomological Medical Research Institute and U.S. Centers for Disease Control and Prevention (KEMRI/CDC) joint research laboratory. The flea was probably acquired during a weekend trip to visit friends working nearer the Ugandan border. The employee had a slightly ingrown toenail in the exact same place before the flea infested there.
The flea had to be removed by a surgeon since it was deeply imbedded under the toenail. It wasn't possible for the employee to just dig it out herself. The attending doctors had never seen one before, and originally wanted her to just let it live out its lifecycle. However, she wasn't wild about dropping the eggs everywhere and potentially contributing to an outbreak of chigoe fleas in Kansas. It was also becoming infected. The extracted flea was sent to the CDC in Atlanta, GA, to have the species identification confirmed.
Usually one can simply pull out/remove those fleas with forceps or squeezing, and then treat the wound to prevent secondary infection. Another Entomologist with the KEMRI/CDC lab, who had reportedly had multiple chigoe flea infestations while living in Uganda commented, "We would just pop them out and then keep it (the wound) clean."