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Hashim O, Toubaté B, Charvet CL, Ahmed AAE, Neveu C, Dimier-Poisson I, Debierre-Grockiego F, Dupuy C. Identification and Spatiotemporal Expression of a Putative New GABA Receptor Subunit in the Human Body Louse Pediculus humanus humanus. Genes (Basel) 2024; 15:844. [PMID: 39062625 PMCID: PMC11275251 DOI: 10.3390/genes15070844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
The human louse (Pediculus humanus) is an obligatory blood feeding ectoparasite with two ecotypes: the human body louse (Pediculus humanus humanus), a competent vector of several bacterial pathogens, and the human head louse (Pediculus humanus capitis), responsible for pediculosis and affecting millions of people around the globe. GABA (γ-aminobutyric acid) receptors, members of the cys-loop ligand gated ion channel superfamily, are among the main pharmacological targets for insecticides. In insects, there are four subunits of GABA receptors: resistant-to-dieldrin (RDL), glycin-like receptor of drosophila (GRD), ligand-gated chloride channel homologue3 (LCCH3), and 8916 are well described and form distinct phylogenetic clades revealing orthologous relationships. Our previous studies in the human body louse confirmed that subunits Phh-RDL, Phh-GRD, and Phh-LCCH3 are well clustered in their corresponding clades. In the present work, we cloned and characterized a putative new GABA receptor subunit in the human body louse that we named HoCas, for Homologous to Cys-loop α like subunit. Extending our analysis to arthropods, HoCas was found to be conserved and clustered in a new (fifth) phylogenetic clade. Interestingly, the gene encoding this subunit is ancestral and has been lost in some insect orders. Compared to the other studied GABA receptor subunits, HoCas exhibited a relatively higher expression level in all development stages and in different tissues of human body louse. These findings improved our understanding of the complex nature of GABA receptors in Pediculus humanus and more generally in arthropods.
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Affiliation(s)
- Omar Hashim
- BioMAP, UMR ISP 1282 INRAe, Université de Tours, 37200 Tours, France; (O.H.); (B.T.); (I.D.-P.); (F.D.-G.)
- Department of Pharmacology, University of Gezira, Wad Madani 21111, Sudan
| | - Berthine Toubaté
- BioMAP, UMR ISP 1282 INRAe, Université de Tours, 37200 Tours, France; (O.H.); (B.T.); (I.D.-P.); (F.D.-G.)
| | - Claude L. Charvet
- MPN, UMR ISP 1282 INRAe, Université de Tours, 37380 Nouzilly, France; (C.L.C.); (C.N.)
| | - Aimun A. E. Ahmed
- Department of Pharmacology, Albaha University, Al Baha 65799, Saudi Arabia;
- Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman 14415, Sudan
| | - Cédric Neveu
- MPN, UMR ISP 1282 INRAe, Université de Tours, 37380 Nouzilly, France; (C.L.C.); (C.N.)
| | - Isabelle Dimier-Poisson
- BioMAP, UMR ISP 1282 INRAe, Université de Tours, 37200 Tours, France; (O.H.); (B.T.); (I.D.-P.); (F.D.-G.)
| | | | - Catherine Dupuy
- BioMAP, UMR ISP 1282 INRAe, Université de Tours, 37200 Tours, France; (O.H.); (B.T.); (I.D.-P.); (F.D.-G.)
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Feldmeier H. Head lice as vectors of pathogenic microorganisms. Trop Med Health 2023; 51:53. [PMID: 37730694 PMCID: PMC10510260 DOI: 10.1186/s41182-023-00545-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/09/2023] [Indexed: 09/22/2023] Open
Abstract
Body lice and head lice are the most common ectoparasites of humans. Head lice (Pediculus humanus capitis) occur worldwide in children and their caretakers, irrespective of their social status. In contrast, body lice (Pediculus humanus corporis) are confined to marginalized population groups in countries of the Global South, homeless people, and refugees. Body lice are known to transmit an array of bacterial pathogens, such as R. prowazekii, R. rickettsii, C. burneti, B. quintana, B. recurrentis, and Y. pestis. The vector capacity of head lice is still a matter of debate. The objective of the review was to scrutinize the existing evidence on the vector capacity of head lice for the transmission of bacterial pathogens. The PUBMED database was searched using a combination of the terms "pediculus humanus" OR "body lice" OR "head lice" AND "pathogen" OR "Rickettsia prowazekii" OR "Bartonella quintana" OR "Borrelia recurrentis" OR "Coxiella burneti" without a time limit. Data from epidemiological studies as well as historical observations demonstrate that body lice and head lice can carry the same array of pathogens. Since the presence of a bacterial pathogen in an arthropod is not sufficient to state that it can be transmitted to humans, and since experimental models are lacking, as yet one cannot conclude with certainty that head lice serve as vectors, although this review presents circumstantial evidence that they do. Adequately designed experimental and epidemiological studies are needed to ascertain the exact transmission potential of head lice.
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Affiliation(s)
- Hermann Feldmeier
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
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Deng YP, Fu YT, Yao C, Shao R, Zhang XL, Duan DY, Liu GH. Emerging bacterial infectious diseases/pathogens vectored by human lice. Travel Med Infect Dis 2023; 55:102630. [PMID: 37567429 DOI: 10.1016/j.tmaid.2023.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.
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Affiliation(s)
- Yuan-Ping Deng
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Yi-Tian Fu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China; Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Chaoqun Yao
- Department of Biomedical Sciences and One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
| | - Renfu Shao
- Centre for Bioinnovation, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Xue-Ling Zhang
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - De-Yong Duan
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Guo-Hua Liu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China.
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Ouarti B, Fonkou DMM, Houhamdi L, Mediannikov O, Parola P. Lice and lice-borne diseases in humans in Africa: a narrative review. Acta Trop 2022; 237:106709. [PMID: 36198330 DOI: 10.1016/j.actatropica.2022.106709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 01/18/2023]
Abstract
Lice are host-specific insects. Human lice include Pediculus humanus humanus (body lice) which are known to be vectors of serious human bacterial infectious diseases including epidemic typhus, relapsing fever, trench fever and plague; Pediculus humanus capitis (head lice) that frequently affect children; and Pthirus pubis, commonly known as crab lice. In Africa, human infections transmitted by lice remained poorly known and therefore, underestimated, perhaps due to the lack of diagnostic tools and professional knowledge. In this paper we review current knowledge of the microorganisms identified in human lice in the continent of Africa, in order to alert health professionals to the importance of recognising the risk of lice-related diseases.
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Affiliation(s)
- Basma Ouarti
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
| | | | - Linda Houhamdi
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, Marseille, France; IRD, AP-HM, MEPHI, Aix Marseille University, Marseille, France.
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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Hashim O, Charvet CL, Toubaté B, Ahmed AAE, Lamassiaude N, Neveu C, Dimier-Poisson I, Debierre-Grockiego F, Dupuy C. Molecular and Functional Characterization of GABA Receptor Subunits GRD and LCCH3 from Human Louse Pediculus Humanus Humanus. Mol Pharmacol 2021; 102:116-127. [PMID: 35858760 PMCID: PMC11037462 DOI: 10.1124/molpharm.122.000499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/21/2022] [Accepted: 05/12/2022] [Indexed: 11/22/2022] Open
Abstract
Human louse Pediculus humanus is a cosmopolitan obligatory blood-feeding ectoparasite causing pediculosis and transmitting many bacterial pathogens. Control of infestation is difficult due to the developed resistance to insecticides that mainly target GABA (γ-aminobutyric acid) receptors. Previous work showed that Pediculus humanus humanus (Phh) GABA receptor subunit resistance to dieldrin (RDL) is the target of lotilaner, a synthetic molecule of the isoxazoline chemical class. To enhance our understanding of how insecticides act on GABA receptors, two other GABA receptor subunits were cloned and characterized: three variants of Phh-grd (glycine-like receptor of Drosophila) and one variant of Phh-lcch3 (ligand-gated chloride channel homolog 3). Relative mRNA expression levels of Phh-rdl, Phh-grd, and Phh-lcch3 revealed that they were expressed throughout the developmental stages (eggs, larvae, adults) and in the different parts of adult lice (head, thorax, and abdomen). When expressed individually in the Xenopus oocyte heterologous expression system, Phh-GRD1, Phh-GRD2, Phh-GRD3, and Phh-LCCH3 were unable to reconstitute functional channels, whereas the subunit combinations Phh-GRD1/Phh-LCCH3, Phh-GRD1/Phh-RDL, and Phh-LCCH3/Phh-RDL responded to GABA in a concentration-dependent manner. The three heteromeric receptors were similarly sensitive to the antagonistic effect of picrotoxin and fipronil, whereas Phh-GRD1/Phh-RDL and Phh-LCCH3/Phh-RDL were respectively about 2.5-fold and 5-fold more sensitive to ivermectin than Phh-GRD1/Phh-LCCH3. Moreover, the heteropentameric receptor constituted by Phh-GRD1/Phh-LCCH3 was found to be permeable and highly sensitive to the extracellular sodium concentration. These findings provided valuable additions to our knowledge of the complex nature of GABA receptors in human louse that could help in understanding the resistance pattern to commonly used pediculicides. SIGNIFICANCE STATEMENT: Human louse is an ectoparasite that causes pediculosis and transmits several bacterial pathogens. Emerging strains developed resistance to the commonly used insecticides, especially those targeting GABA receptors. To understand the molecular mechanisms underlying this resistance, two subunits of GABA receptors were cloned and described: Phh-grd and Phh-lcch3. The heteromeric receptor reconstituted with the two subunits was functional in Xenopus oocytes and sensitive to commercially available insecticides. Moreover, both subunits were transcribed throughout the parasite lifecycle.
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Affiliation(s)
- Omar Hashim
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Claude L Charvet
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Berthine Toubaté
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Aimun A E Ahmed
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Nicolas Lamassiaude
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Cédric Neveu
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Isabelle Dimier-Poisson
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Françoise Debierre-Grockiego
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
| | - Catherine Dupuy
- INRAE, Université de Tours, ISP, BioMAP, 37200, Tours, France (O.H., B.T., I.D.-P., F.D.-G., C.D.); Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Wad Madani, Sudan (O.H.); INRAE, Université de Tours, ISP, MPN, 37380, Nouzilly, France (C.L.C., N.L., C.N.); Department of Pharmacology, Albaha University, Alaqiq, Saudi Arabia (A.A.E.A.); and Department of Pharmacology and Toxicology, Omdurman Islamic University, Omdurman, Sudan (A.A.E.A.)
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The Diadenylate Cyclase CdaA Is Critical for Borrelia turicatae Virulence and Physiology. Infect Immun 2021; 89:IAI.00787-20. [PMID: 33846120 PMCID: PMC8316131 DOI: 10.1128/iai.00787-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/22/2021] [Indexed: 12/16/2022] Open
Abstract
Relapsing fever (RF), caused by spirochetes of the genus Borrelia, is a globally distributed, vector-borne disease with high prevalence in developing countries. To date, signaling pathways required for infection and virulence of RF Borrelia spirochetes are unknown. Cyclic di-AMP (c-di-AMP), synthesized by diadenylate cyclases (DACs), is a second messenger predominantly found in Gram-positive organisms that is linked to virulence and essential physiological processes. Although Borrelia is Gram-negative, it encodes one DAC (CdaA), and its importance remains undefined. To investigate the contribution of c-di-AMP signaling in the RF bacterium Borrelia turicatae, a cdaA mutant was generated. The mutant was significantly attenuated during murine infection, and genetic complementation reversed this phenotype. Because c-di-AMP is essential for viability in many bacteria, whole-genome sequencing was performed on cdaA mutants, and single-nucleotide polymorphisms identified potential suppressor mutations. Additionally, conditional mutation of cdaA confirmed that CdaA is important for normal growth and physiology. Interestingly, mutation of cdaA did not affect expression of homologs of virulence regulators whose levels are impacted by c-di-AMP signaling in the Lyme disease bacterium Borrelia burgdorferi Finally, the cdaA mutant had a significant growth defect when grown with salts, at decreased osmolarity, and without pyruvate. While the salt treatment phenotype was not reversed by genetic complementation, possibly due to suppressor mutations, growth defects at decreased osmolarity and in media lacking pyruvate could be attributed directly to cdaA inactivation. Overall, these results indicate CdaA is critical for B. turicatae pathogenesis and link c-di-AMP to osmoregulation and central metabolism in RF spirochetes.
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Kahlig P, Neumayr A, Paris DH. Louse-borne relapsing fever-A systematic review and analysis of the literature: Part 2-Mortality, Jarisch-Herxheimer reaction, impact on pregnancy. PLoS Negl Trop Dis 2021; 15:e0008656. [PMID: 33705387 PMCID: PMC7951929 DOI: 10.1371/journal.pntd.0008656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Louse-borne relapsing fever (LBRF) is a classical epidemic disease, which in the past was associated with war, famine, poverty, forced migration, and crowding under poor hygienic conditions around the world. The disease's causative pathogen, the spirochete bacterium Borrelia recurrentis, is confined to humans and transmitted by a single vector, the human body louse Pediculus humanus corporis. Since the disease was at its peak before the days of modern medicine, many of its aspects have never been formally studied and to date remain incompletely understood. In order to shed light on some of these aspects, we have systematically reviewed the accessible literature on LBRF since the recognition of its mode of transmission in 1907, and summarized the existing data on mortality, Jarisch-Herxheimer reaction (JHR), and impact on pregnancy. Publications were identified by using a predefined search strategy of electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of LBRF published in English, French, German, and Spanish since 1907 were included. Data extraction followed a predefined protocol and included a grading system to judge the certainty of the diagnosis of reported cases. The high mortality rates often found in literature are confined to extreme scenarios. The case fatality rate (CFR) of untreated cases is on average significantly lower than frequently assumed. In recent years, a rise in the overall CFRs is documented, for which reasons remain unknown. Lacking standardized criteria, a clear diagnostic threshold defining antibiotic treatment-induced JHR does not exist. This explains the wide range of occurrence rates found in literature. Pre-antibiotic era data suggest the existence of a JHR-like reaction also in cases treated with arsenicals and even in untreated cases. LBRF-related adverse outcomes are observed in 3 out of 4 pregnancies.
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Affiliation(s)
- Pascal Kahlig
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Kahlig P, Paris DH, Neumayr A. Louse-borne relapsing fever-A systematic review and analysis of the literature: Part 1-Epidemiology and diagnostic aspects. PLoS Negl Trop Dis 2021; 15:e0008564. [PMID: 33705384 PMCID: PMC7951878 DOI: 10.1371/journal.pntd.0008564] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Louse-borne relapsing fever (LBRF) is a classical epidemic disease, which in the past was associated with war, famine, poverty, forced migration, and crowding under poor hygienic conditions around the world. The disease's causative pathogen, the spirochete bacterium Borrelia recurrentis, is confined to humans and transmitted by a single vector, the human body louse Pediculus humanus. Since the disease has had its heyday before the days of modern medicine, many of its aspects have never been formally studied and to date, remain incompletely understood. In order to shed light on some of these aspects, we have systematically reviewed the accessible literature on LBRF, since the recognition of its mode of transmission in 1907, and summarized the existing data on epidemiology and diagnostic aspects of the disease. Publications were identified by using a predefined search strategy on electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of LBRF published in English, French, German, and Spanish since 1907 were included. Data extraction followed a predefined protocol and included a grading system to judge the certainty of the diagnosis of reported cases. Historically, Ethiopia is considered a stronghold of LBRF. The recognition of LBRF among East African migrants (originating from Somalia, Eritrea, and Ethiopia) arriving to Europe in the course of the recent migration flow from this region suggests that this epidemiological focus ostensibly persists. Currently, there is neither evidence to support or refute active transmission foci of LBRF elsewhere on the African continent, in Latin America, or in Asia. Microscopy remains the most commonly used method to diagnose LBRF. Data are lacking on sensitivity and specificity of most diagnostic methods.
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Affiliation(s)
- Pascal Kahlig
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H. Paris
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
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Abstract
Louse-borne relapsing fever (LBRF) is an epidemic disease with a fascinating history from Hippocrates’ times, through the 6th century ‘Yellow Plague’, to epidemics in Ireland, Scotland and England in the 19th century and two large Afro-Middle Eastern pandemics in the 20th century. An endemic focus persists in Ethiopia and adjacent territories in the Horn of Africa. Since 2015, awareness of LBRF in Europe, as a re-emerging disease, has been increased dramatically by the discovery of this infection in dozens of refugees arriving from Africa. The causative spirochaete, Borrelia recurrentis, has a genome so similar to B. duttonii and B. crocidurae (causes of East and West African tick-borne relapsing fever), that they are now regarded as merely ecotypes of a single genomospecies. Transmission is confined to the human body louse Pediculus humanus corporis, and, perhaps, the head louse P. humanus capitis, although the latter has not been proved. Infection is by inoculation of louse coelomic fluid or faeces by scratching. Nosocomial infections are possible from contamination by infected blood. Between blood meals, body lice live in clothing until the host's body temperature rises or falls, when they seek a new abode. The most distinctive feature of LBRF, the relapse phenomenon, is attributable to antigenic variation of borrelial outer-membrane lipoprotein. High fever, rigors, headache, pain and prostration start abruptly, 2–18 days after infection. Petechial rash, epistaxis, jaundice, hepatosplenomegaly and liver dysfunction are common. Severe features include hyperpyrexia, shock, myocarditis causing acute pulmonary oedema, acute respiratory distress syndrome, cerebral or gastrointestinal bleeding, ruptured spleen, hepatic failure, Jarisch–Herxheimer reactions (J-HR) and opportunistic typhoid or other complicating bacterial infections. Pregnant women are at high risk of aborting and perinatal mortality is high. Rapid diagnosis is by microscopy of blood films, but polymerase chain reaction is used increasingly for species diagnosis. Severe falciparum malaria and leptospirosis are urgent differential diagnoses in residents and travellers from appropriate geographical regions. High untreated case-fatality, exceeding 40% in some historic epidemics, can be reduced to less than 5% by antibiotic treatment, but elimination of spirochaetaemia is often accompanied by a severe J-HR. Epidemics are controlled by sterilising clothing to eliminate lice, using pediculicides and by improving personal hygiene.
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Ectoparasites. J Am Acad Dermatol 2020; 82:551-569. [DOI: 10.1016/j.jaad.2019.05.110] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
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El Hamzaoui B, Laroche M, Bechah Y, Bérenger JM, Parola P. Testing the Competence of Cimex lectularius Bed Bugs for the Transmission of Borrelia recurrentis, the Agent of Relapsing Fever. Am J Trop Med Hyg 2020; 100:1407-1412. [PMID: 30938280 DOI: 10.4269/ajtmh.18-0804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In recent years, bed bugs have reappeared in greater numbers, more frequently, and are biting humans in many new geographic areas. Infestations by these hematophagous insects are rapidly increasing worldwide. Borrelia recurrentis, a spirochete bacterium, is the etiologic agent of louse-borne relapsing fever. The known vectors are body lice, Pediculus humanus humanus. However, previous studies have suggested that bed bugs might also be able to transmit this bacterium. Adult Cimex lectularius were artificially infected with a blood meal mixed with bacterial suspension of B. recurrentis. They were subsequently fed with pathogen-free human blood until the end of the experiment. Bed bugs and feces were collected every 5 days to evaluate the capacity of bed bugs to acquire and excrete viable B. recurrentis using molecular biology, cultures, fluorescein diacetate and immunofluorescence assays. The feces collected on the day 5 and 10 postinfection contained viable bacteria. Immunofluorescence analysis of exposed bed bugs showed the presence of B. recurrentis in the digestive tract, even in bed bugs collected on day 20 after infection. Like human body lice, bed bugs can acquire, maintain, and excrete viable B. recurrentis that might infect humans through skin lesions. This preliminary work suggests that bed bugs might be competent vectors of B. recurrentis. Because bed bugs and body lice may share the same ecological niches, the role of bed bugs in transmitting recurrent fevers deserves further study.
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Affiliation(s)
- Basma El Hamzaoui
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Maureen Laroche
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Yassina Bechah
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean Michel Bérenger
- Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Philippe Parola
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
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Killing Clothes Lice by Holding Infested Clothes Away from Hosts for 10 Days to Control Louseborne Relapsing Fever, Bahir Dah, Ethiopia. Emerg Infect Dis 2019. [PMCID: PMC6346454 DOI: 10.3201/eid2502.181226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Louseborne relapsing fever (LBRF) was once a cosmopolitan disease, but it now occurs only in the Horn of Africa. Recent cases in refugees to Europe made LBRF topical again. Crowded boarding houses and church dwellings in Ethiopia are analogous to the crowded air-raid shelters of World War II. Thus, we might learn from experiments the London School of Tropical Hygiene and Medicine conducted during World War II. When the vector of Borrelia recurrentis (Pediculus humanus lice) was held away from the host for 10 days, 100% of nymphal and adult lice starved to death and 100% of eggs did not hatch. We hypothesize that holding infested clothes away from hosts in plastic shopping bags will kill enough lice to control LBRF in Ethiopia. Owning 2 sets of clothes might be useful; 1 set might be held in a plastic shopping bag for 10 days to kill lice and their eggs.
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Åstrand M, Cuellar J, Hytönen J, Salminen TA. Predicting the ligand-binding properties of Borrelia burgdorferi s.s. Bmp proteins in light of the conserved features of related Borrelia proteins. J Theor Biol 2018; 462:97-108. [PMID: 30419249 DOI: 10.1016/j.jtbi.2018.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/29/2018] [Accepted: 11/05/2018] [Indexed: 11/16/2022]
Abstract
Bacteria of the genus Borrelia cause vector-borne infections like the most important hard tick-borne disease in the northern hemisphere, Lyme borreliosis (LB), and soft tick or louse transmitted relapsing fevers (RF), prevalent in temperate and tropical areas. Borrelia burgdorferi sensu lato (s.l.) includes several genospecies and causes LB in humans. In infected patients, Borrelia burgdorferi sensu stricto (s.s.) expresses the BmpA, BmpB, BmpC and BmpD proteins. The role of these proteins in the pathogenesis of LB remains incompletely characterized, but they are, however, closely related to Treponema pallidum PnrA (Purine nucleoside receptor A), a substrate-binding lipoprotein of the ATP-binding cassette (ABC) transporter family preferentially binding purine nucleosides. Based on 3D homology modeling, the Bmp proteins share the typical fold of the substrate-binding protein family and the ligand-binding properties of BmpA, BmpB and BmpD are highly similar, whereas those of BmpC differ markedly. Nevertheless, these residues are highly conserved within the genus Borrelia and the inferred phylogenetic tree also reveals that the RF Borrelia lack BmpB proteins but has an additional Bmp protein (BmpA2) missing in LB-causing Borrelia burgdorferi s.l. Our results indicate that the Bmp proteins could bind nucleosides, although BmpC might have a different ligand-binding specificity and, therefore, a distinct function. Furthermore, the work provides a means for classifying the Bmp proteins and supports further elucidation of the roles of these proteins.
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Affiliation(s)
- Mia Åstrand
- Structural Bioinformatics Laboratory, Biochemistry, Faculty of Science and Engineering, Åbo Akademi University, Tykistökatu 6 A, Turku FI-20520, Finland
| | - Julia Cuellar
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku, Finland; Turku Doctoral Programme for Molecular Medicine, University of Turku, Turku, Finland
| | - Jukka Hytönen
- Institute of Biomedicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - Tiina A Salminen
- Structural Bioinformatics Laboratory, Biochemistry, Faculty of Science and Engineering, Åbo Akademi University, Tykistökatu 6 A, Turku FI-20520, Finland.
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Antinori S, Tonello C, Edouard S, Parravicini C, Gastaldi D, Grande R, Milazzo L, Ricaboni D, Fenollar F, Raoult D, Corbellino M, Mediannikov O. Diagnosis of Louse-Borne Relapsing Fever despite Negative Microscopy in Two Asylum Seekers from Eastern Africa. Am J Trop Med Hyg 2017; 97:1669-1672. [PMID: 29016302 DOI: 10.4269/ajtmh.17-0320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We report two cases of louse-borne relapsing fever observed at our Institution in June 2016. Both patients were young asylum seekers from Africa who had recently arrived in Milan, Italy. Notably, direct microscopic examination of peripheral blood smears was repeatedly negative for the presence of spirochetes and the diagnosis, supported by clinical and epidemiologic evidence, required molecular confirmation by polymerase chain reaction amplification of DNA extracted from blood and sequencing of the amplified products.
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Affiliation(s)
- Spinello Antinori
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy.,Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Cristina Tonello
- Pathology Unit, Ospedale L. Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Sophie Edouard
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Carlo Parravicini
- Pathology Unit, Ospedale L. Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | - Romualdo Grande
- Clinical Microbiology, Virology and Bioemergence Diagnostics, Ospedale L Sacco, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Laura Milazzo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Davide Ricaboni
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France.,III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Florence Fenollar
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
| | - Mario Corbellino
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Oleg Mediannikov
- Unité de Recherche sur le Maladies Infectieuses et Tropicales Émergentes (URMITIE) IRD198, CNRS 7278, INSERM 1095, Institute Hospitalo-Universitarie (IHU) Méditerranée-Infection, Aix-Marseille Université, Faculté de Médecine, Marseille, France
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Marosevic D, Margos G, Wallich R, Wieser A, Sing A, Fingerle V. First insights in the variability of Borrelia recurrentis genomes. PLoS Negl Trop Dis 2017; 11:e0005865. [PMID: 28902847 PMCID: PMC5612729 DOI: 10.1371/journal.pntd.0005865] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/25/2017] [Accepted: 08/10/2017] [Indexed: 11/21/2022] Open
Abstract
Background Borrelia recurrentis is the causative agent of louse-borne relapsing fever, endemic to the Horn of Africa. New attention was raised in Europe, with the highest number of cases (n = 45) reported among migrants in 2015 in Germany and sporadically from other European countries. So far only one genome was sequenced, hindering the development of specific molecular diagnostic and typing tools. Here we report on modified culture conditions for B. recurrentis and the intraspecies genome variability of six isolates isolated and cultured in different years in order to explore the possibility to identify new targets for typing and examine the molecular epidemiology of the pathogen. Methodology/Principal findings Two historical isolates from Ethiopia and four isolates from migrants from Somalia (n = 3) and Ethiopia (n = 1) obtained in 2015 were cultured in MPK-medium supplemented with 50% foetal calf serum. Whole DNA was sequenced using Illumina MiSeq technology and analysed using the CLC Genomics Workbench and SPAdes de novo assembler. Compared to the reference B. recurrentis A1 29–38 SNPs were identified in the genome distributed on the chromosome and plasmids. In addition to that, plasmids of differing length, compared to the available reference genome were identified. Conclusions/Significance The observed low genetic variability of B. recurrentis isolates is possibly due to the adaptation to a very conserved vector-host (louse-human) cycle, or influenced by the fastidious nature of the pathogen and their resistance to in vitro growth. Nevertheless, isolates obtained in 2015 were bearing the same chromosomal SNPs and could be distinguished from the historical isolates by means of whole genome sequencing, but not hitherto used typing methods. This is the first study examining the molecular epidemiology of B. recurrentis and provides the necessary background for the development of better diagnostic tools. Louse-borne relapsing fever, as the name suggests, is the only relapsing fever transmitted by lice, and caused by the spirochaete Borrelia recurrentis. Today it is endemic to the Horn of Africa, but due to the cosmopolitan nature of the vector, the pathogen still bears epidemic potential to spread globally among vulnerable populations. The most recent account of that has been observed among migrants arriving to Europe in 2015. Up to date, only one strain was sequenced, thus hampering the development of species-specific typing tools. We employed state-of-the-art high-throughput sequencing to six B. recurrentis isolates obtained at different time-points and currently available in culture. Our aim was to address the question of genome variability of this pathogen at the highest resolution and provide information necessary for the development of specific typing tools. B. recurrentis has highly conserved genomes, differing in 29–38 SNPs compared to the reference genome B. recurrentis A1, all identified outside the loci currently developed and used for relapsing fever Borrelia typing. Therefore, applying these typing methods would render them indistinguishable, while at the SNP level we found a distinction between isolates obtained in 2015 from migrants and the two historical isolates. Our data provide first insights in the genome variability and baseline information necessary for further studies of the molecular epidemiology of the pathogen and for the development of improved diagnostic tools.
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Affiliation(s)
- Durdica Marosevic
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
- European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden
- * E-mail:
| | - Gabriele Margos
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | | | - Andreas Wieser
- Department of Bacteriology, Max von Pettenkofer Institute (LMU), Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Andreas Sing
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Volker Fingerle
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
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