Barring any disturbances to the cocoon, an adult flea will emerge from the puparium after 9–15 days.In the adult phase, the flea will occasionally feed on unsuspecting animals. Only once the female burrows into the skin can reproduction occur, as the male and female show no interest in each other in the wild. The male flea dies after copulation. The female flea continues in vivo ectodevelopment, described in stages by the Fortaleza classification of tungiasis. Fortaleza classification
In a seminal paper on the biology and pathology of Tunga penetrans, Eisele et al. (2003) provided and detailed the five stages of tungiasis, thereby detailing the in vivo development of the female chigoe flea for the first time. In dividing the natural history of the disease, the Fortaleza Classification formally describes the last part of the female fleas life cycle where it burrows into its hosts skin, expels eggs, and dies. Due to the nature of the discussion, overlap with other sections, particularly the one on symptoms, is unavoidable.Stage 1 is characterized by the penetration of the skin by the female chigoe flea. Running along the body, the female uses its posterior legs to push its body upward by an angle of 45–90 degrees. Penetration then starts, beginning with the proboscis going through the epidermis.By stage 2 (day 1–2), penetration is complete and the flea has burrowed most of its body into the skin. Only the anus, the copulatory organs, and four rear air holes in fleas called stigmata remain on the outside of the epidermis.
Since the chigoe flea technically has no reservoir species and the female will cause tungiasis to any mammalian organism it can penetrate, this means the flea will have a relatively large number of hosts and victims. Epidemiologically, this is important as tungiasis often causes secondary infections. History
Tungiasis had been endemic in pre-Columbian Andean society for centuries before discovery of  T. penetrans as native to the West Indies. The first case of tungiasis was described in 1526 by Gonzalo Fernández de Oviedo y Valdés, where he discussed the skin infection and its symptoms on crew members from Columbuss Santa Maria after they were shipwrecked on Haiti. Through ship routes and further expeditions, the chigoe flea was spread to the rest of the world, particularly to the rest of Latin America and Africa. The spread to greater Africa occurred throughout the 17th and 19th centuries, specifically in 1872 when the infected crewmen of the ship Thomas Mitchell introduced it into Angola by illegal dumping of sand ballast, having sailed from Brazil. References
External links

Muehlstaedt, Michael (2008). "Periungual Tungiasis". New England Journal of Medicine. 359 (24): e30. doi:10.1056/NEJMicm074290. PMID 19073971.