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Poudel SS, Vaughan JA. POPULATION STRUCTURE AND BARTONELLA QUINTANA IN HEAD AND BODY LICE IN POKHARA, NEPAL (ANOPLURA: PEDICULIDAE). J Parasitol 2023; 109:559-564. [PMID: 38018745 DOI: 10.1645/23-64] [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] [Indexed: 11/30/2023] Open
Abstract
This study examined the population structure of head and body lice infesting a random sample of people in Pokhara, Nepal during 2003, 2004, and 2005. A total of 106 participants (6 to 72 yr old, median = 12) volunteered to have lice collected from their heads and clothing. Most participants (70%) harbored only head lice, some (15%) had only body lice, and some (15%) had concurrent infestations of head and body lice (dual infestations). A total of 1,472 lice was collected. Significantly more nymphs were collected than adult lice. Louse populations were generally small (geometric mean = 8.8 lice per person) but a few participants harbored larger louse populations (maximum = 65 lice). People with dual infestations harbored significantly more lice than people with single infestations; however, there was no difference in the infestation intensities between people infested with head lice only vs. those infested with body lice only. Male participants harbored significantly more lice than did females. There were no significant differences in infestation intensity due to participant age or their socioeconomic level. The sex ratio of adult lice was increasingly female biased with increasing adult louse density. Infection of lice with Bartonella quintana was low (ca. 1.5%). Pediculosis is a common problem in urban Nepal.
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Affiliation(s)
- Shreekanta S Poudel
- Biology Department, University of North Dakota, Grand Forks, North Dakota 58202
| | - Jefferson A Vaughan
- Biology Department, University of North Dakota, Grand Forks, North Dakota 58202
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2
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Sasaki T, Matsuoka M, Sawabe K, Isawa H, Shibayama K, Kobayashi M. Detection of Bartonella quintana (Hyphomicrobiales: Bartonellaceae) Among Day Laborers in Osaka, Japan, 2009-2010. JOURNAL OF MEDICAL ENTOMOLOGY 2023; 60:408-411. [PMID: 36708061 DOI: 10.1093/jme/tjad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Indexed: 06/18/2023]
Abstract
Bartonella quintana is a gram-negative bacterium causing trench fever, an illness historically acquired by soldiers during World War I. More recently, outbreaks of trench fever have been reported in those experiencing homelessness in the United States, France, Russia, and Tokyo, as well as in children in Nepal and persons in Ethiopia. Reports of B. quintana infection outside of Tokyo are rare in Japan. The aim of this study was to examine body lice and blood obtained from people staying in shelters in Osaka (2009-2010) for B. quintana via polymerase chain reaction and enzyme-linked immunosorbent assays. Day laborers were defined as homeless individuals and shelter residents in this study. We detected genes of B. quintana in body lice by PCR and antibodies against B. quintana. The positive rate of B. quintana genes was 6/10 (60%) in body lice and the seroprevalence (IgG) of B. quintana was 4/10 (40%). This demonstrates that trench fever was endemic in people staying in shelters in Osaka in 2009-2010.
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Affiliation(s)
- Toshinori Sasaki
- Department of Medical Entomology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Mayumi Matsuoka
- Department of Bacteriology II, National Institute of Infectious Diseases, Gakuen 4-7-1, Musashi-Murayama, Tokyo 208-0011, Japan
| | - Kyoko Sawabe
- Department of Medical Entomology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Haruhiko Isawa
- Department of Medical Entomology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Keigo Shibayama
- Department of Bacteriology, Drug Resistance and Pathogenesis, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Mutsuo Kobayashi
- Department of Medical Entomology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan
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3
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Sasaki T, Adachi T, Itoh K, Kubota M, Yamagishi T, Hirao M, Isawa H, Oishi K, Shibayama K, Sawabe K. Detection of Bartonella quintana infection among the Homeless Population in Tokyo, Japan, from 2013-2015. Jpn J Infect Dis 2021; 74:411-415. [PMID: 33518618 DOI: 10.7883/yoken.jjid.2020.505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several outbreaks of trench fever caused by Bartonella quintana, occurred in soldiers during World Wars I and II. Although the number of trench fever cases has been decreasing worldwide, the disease has been reported among the homeless population in both developing and developed countries. The current prevalence of B. quintana infection in Japan is unclear. We collected blood and body louse (Pediculus humanus humanus) samples from homeless inpatients who had body lice at the time of emergency hospitalization in Tokyo from January 2013 to March 2015. Patients were tested for B. quintana infections using culture method, polymerase chain reaction, and indirect immunofluorescence assay (IFA). Among the 29 patients tested, the presence of Bartonella spp. was confirmed by genomic sequencing of DNA extracted from the samples from 2 patients (blood culture performed for 13 out of 15 patients), and from body louse samples of 20 patients (69%). Immunoglobulin G against B. quintana was detected in 10 patients (34.5%) at a cut-off titer of 1:256 in IFA. B. quintana infection was detected in samples obtained between 2013 and 2015 in Tokyo and needs to be on the list of differential diagnoses performed for febrile homeless individuals.
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Affiliation(s)
- Toshinori Sasaki
- Department of Medical Entomology, National Institute of Infectious Diseases, Japan
| | | | | | - Mayumi Kubota
- Department of Bacteriology II, National Institute of Infectious Diseases, Japan
| | - Takuya Yamagishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | | | - Haruhiko Isawa
- Department of Medical Entomology, National Institute of Infectious Diseases, Japan
| | - Kazunori Oishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Japan
| | - Kyoko Sawabe
- Department of Medical Entomology, National Institute of Infectious Diseases, Japan
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4
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Pietri JE, Yax JA, Agany DD, Gnimpieba EZ, Sheele JM. Body lice and bed bug co-infestation in an emergency department patient, Ohio, USA. IDCases 2020; 19:e00696. [PMID: 31988849 PMCID: PMC6970161 DOI: 10.1016/j.idcr.2020.e00696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 12/17/2022] Open
Abstract
Body lice and bed bugs are hematophagous insects that parasitize humans. Body lice are established vectors of several bacterial pathogens (e.g. Bartonella quintana, Borrelia recurrentis). Bed bugs are biologically competent vectors of some of the same agents, but their vectorial capacity for these in nature is unclear. In particular, a lack of exposure to louse-borne pathogens in bed bugs in the field could be a factor that limits their contribution to transmission. Here, we describe a case of a patient seen in an urban emergency department who was suffering from infestation with both body lice and bed bugs. Insects were collected from the patient and tested for the presence of louse-borne bacterial pathogens using 16S rRNA gene amplicon sequencing. Although no Bartonella, Borrelia, or Rickettsia were detected, this case provides evidence of ecological overlap between body lice and bed bugs and highlights several potential risk factors for co-infestation. The ecological relationships between bed bugs, body lice, and louse-borne bacteria should be further investigated in the field to determine the frequency of co-infestations and identify possible instances of pathogen infection in bed bugs.
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Affiliation(s)
- Jose E. Pietri
- University of South Dakota, Sanford School of Medicine, Division of Basic Biomedical Sciences, Vermillion, SD, United States
| | - Justin A. Yax
- University Hospitals Cleveland Medical Center, Division of Population Health, Department of Emergency Medicine, Cleveland, OH, United States
| | - Diing D.M. Agany
- University of South Dakota, Biomedical Engineering Program, Sioux Falls, SD, United States
| | - Etienne Z. Gnimpieba
- University of South Dakota, Biomedical Engineering Program, Sioux Falls, SD, United States
| | - Johnathan M. Sheele
- Mayo Clinic, Department of Emergency Medicine, Jacksonville, FL, United States
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5
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Nara A, Nagai H, Yamaguchi R, Makino Y, Chiba F, Yoshida KI, Yajima D, Iwase H. An unusual autopsy case of lethal hypothermia exacerbated by body lice-induced severe anemia. Int J Legal Med 2015; 130:765-9. [PMID: 26384507 DOI: 10.1007/s00414-015-1266-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022]
Abstract
Pediculus humanus humanus (known as body lice) are commonly found in the folds of clothes, and can cause skin disorders when they feed on human blood, resulting in an itching sensation. Body lice are known as vectors of infectious diseases, including typhus, recurrent fever, and trench fever. An infestation with blood-sucking body lice induces severe cutaneous pruritus, and this skin disorder is known as "vagabond's disease." A body lice infestation is sometimes complicated with iron deficiency anemia. In the present case, a man in his late 70s died of lethal hypothermia in the outdoors during the winter season. The case history and autopsy findings revealed that the cause of the lethal hypothermia was iron deficiency anemia, which was associated with a prolonged infestation of blood-sucking body lice. Also, he had vagabond's disease because the skin on his body was abnormal and highly pigmented. This is an unusual autopsy case since the body lice contributed to the cause of the death.
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Affiliation(s)
- Akina Nara
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | - Hisashi Nagai
- Department of Legal Medicine (Forensic Medicine), Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Fumiko Chiba
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Ken-ichi Yoshida
- Department of Forensic Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Daisuke Yajima
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
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6
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Desenclos JC, Laporte A, Brouqui P. Les infections humaines transmises par les poux. Med Mal Infect 2011; 41:295-300. [DOI: 10.1016/j.medmal.2011.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 12/13/2010] [Accepted: 02/07/2011] [Indexed: 11/28/2022]
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7
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Bartonella species and their ectoparasites: selective host adaptation or strain selection between the vector and the mammalian host? Comp Immunol Microbiol Infect Dis 2011; 34:299-314. [PMID: 21616536 DOI: 10.1016/j.cimid.2011.04.005] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 04/16/2011] [Accepted: 04/21/2011] [Indexed: 11/22/2022]
Abstract
A wide range of blood-sucking arthropods have either been confirmed or are suspected as important vectors in Bartonella transmission to mammals, including humans. Overall, it appears that the diversity of Bartonella species DNA identified in ectoparasites is much broader than the species detected in their mammalian hosts, suggesting a mechanism of adaptation of Bartonella species to their host-vector ecosystem. However, these mechanisms leading to the fitness between the vectors and their hosts still need to be investigated.
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8
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Brouqui P. Arthropod-borne diseases associated with political and social disorder. ANNUAL REVIEW OF ENTOMOLOGY 2011; 56:357-374. [PMID: 20822446 DOI: 10.1146/annurev-ento-120709-144739] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The living conditions and the crowded situations of the homeless, war refugees, or victims of a natural disaster provide ideal conditions for the spread of lice, fleas, ticks, flies and mites. The consequence of arthropod infestation in these situations is underestimated. Along with louse-borne infections such as typhus, trench fever, and relapsing fever, the relationship between Acinetobacter spp.-infected lice and bacteremia in the homeless is not clear. Murine typhus, tungiasis, and myiasis are likely underestimated, and there has been a reemergence of bed bugs. Attempted eradication of the body louse, despite specific measures, has been disappointing, and infections with Bartonella quintana continue to be reported. The efficacy of ivermectin in eradicating the human body louse, although the effect is not sustained, might provide new therapeutic approaches. Arthropod-borne diseases continue to emerge within the deprived population. Public health programs should be engaged rapidly to control these pests and reduce the incidence of these transmissible diseases.
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Affiliation(s)
- Philippe Brouqui
- Faculté de Médecine, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, CNRS-IRD UMR 6236/198, 13385 Marseille cedex 5, France.
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9
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Update on Emerging Infections: News From the Centers for Disease Control and Prevention. Ann Emerg Med 2010; 55:280-2; discussion 282-3. [DOI: 10.1016/j.annemergmed.2009.12.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Bonilla DL, Kabeya H, Henn J, Kramer VL, Kosoy MY. Bartonella quintana in body lice and head lice from homeless persons, San Francisco, California, USA. Emerg Infect Dis 2009; 15:912-5. [PMID: 19523290 PMCID: PMC2727331 DOI: 10.3201/eid1506.090054] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Bartonella quintana is a bacterium that causes trench fever in humans. Past reports have shown Bartonella spp. infections in homeless populations in San Francisco, California, USA. The California Department of Public Health in collaboration with San Francisco Project Homeless Connect initiated a program in 2007 to collect lice from the homeless to test for B. quintana and to educate the homeless and their caregivers on prevention and control of louse-borne disease. During 2007-2008, 33.3% of body lice-infested persons and 25% of head lice-infested persons had lice pools infected with B. quintana strain Fuller. Further work is needed to examine how homeless persons acquire lice and determine the risk for illness to persons infested with B. quintana-infected lice.
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Affiliation(s)
- Denise L Bonilla
- California Department of Public Health, Vector-Borne Disease Section, Richmond, California 94804, USA.
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11
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Billeter SA, Levy MG, Chomel BB, Breitschwerdt EB. Vector transmission of Bartonella species with emphasis on the potential for tick transmission. MEDICAL AND VETERINARY ENTOMOLOGY 2008; 22:1-15. [PMID: 18380649 DOI: 10.1111/j.1365-2915.2008.00713.x] [Citation(s) in RCA: 210] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Bartonella species are gram-negative bacteria that infect erythrocytes, endothelial cells and macrophages, often leading to persistent blood-borne infections. Because of the ability of various Bartonella species to reside within erythrocytes of a diverse number of animal hosts, there is substantial opportunity for the potential uptake of these blood-borne bacteria by a variety of arthropod vectors that feed on animals and people. Five Bartonella species are transmitted by lice, fleas or sandflies. However, Bartonella DNA has been detected or Bartonella spp. have been cultured from numerous other arthropods. This review discusses Bartonella transmission by sandflies, lice and fleas, the potential for transmission by other vectors, and data supporting transmission by ticks. Polymerase chain reaction (PCR) or culture methods have been used to detect Bartonella in ticks, either questing or host-attached, throughout the world. Case studies and serological or molecular surveys involving humans, cats and canines provide indirect evidence supporting transmission of Bartonella species by ticks. Of potential clinical relevance, many studies have proposed co-transmission of Bartonella with other known tick-borne pathogens. Currently, critically important experimental transmission studies have not been performed for Bartonella transmission by many potential arthropod vectors, including ticks.
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Affiliation(s)
- S A Billeter
- Center for Comparative Medicine and Transitional Research, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina 27606, USA
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12
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Abstract
Homeless people are particularly exposed to ectoparasite. The living conditions and the crowded shelters provide ideal conditions for the spread of lice, fleas, ticks, and mites. Body lice have long been recognized as human parasites and although typically prevalent in rural communities in upland areas of countries close to the equator, it is now increasingly encountered in developed countries especially in homeless people or inner city economically deprived population. Fleas are widespread but are not adapted to a specific host and may occasionally bite humans. Most common fleas that parasite humans are the cat, the rat, and the human fleas, Ctenocephalides felis, Xenopsylla cheopis, and Pulex irritans, respectively. Ticks belonging to the family Ixodidae, in particular, the genera Dermacentor, Rhipicephalus, and Ixodes, are frequent parasites in humans. Sarcoptes scabiei var. hominis is a mite (Arachnida class) responsible for scabies. It is an obligate parasite of human skin. The hematophagic-biting mite, Liponyssoides sanguineus, is a mite of the rat, mouse, and other domestic rodents but can also bite humans. Finally, the incidence of skin disease secondary to infestation with the human bedbug, Cimex lectularius, has increased recently. Bacteria, such as Wolbacchia spp. have been detected in bedbug. The threat posed by the ectoparasite in homeless is not the ectoparasite themselves but the associated infectious diseases that they may transmit to humans. Except for scabies all these ectoparasites are potential vectors for infectious agents. Three louse-borne diseases are known at this time. Trench fever caused by Bartonella quintana (B. quintana), epidemic typhus caused by Rickettsia prowazekii, and relapsing fever caused by the spirochete Borrelia recurrentis. Fleas transmit plague (Xenopsylla cheopis and Pulex irritans), murine typhus (Xenopsylla cheopis), flea-borne spotted rickettsiosis on account of the recently described species Rickettsia felis (C. felis), and occasionally cat scratch disease on account of Bartonella henselae (C. felis). The role of fleas as potential vector of B. quintana has recently been suggested. Among the hematophagic-biting mites, L. sanguineus, is responsible for the transmission of Rickettsia akari, the etiologic agent of rickettsialpox. Virtually, no data are available on tick-borne disease in this population. This article will deal with epidemiology, diagnosis, prevention, and treatment of these ectoparasite and the infectious diseases they transmit to the homeless people.
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Affiliation(s)
- Philippe Brouqui
- Unité des rickettsies, CNRS UMR 6020, IFR 48, Faculté de médecine, 27 bd, J Moulin, 13385 Marseille, cedex 5, France.
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Sasaki T, Poudel SKS, Isawa H, Hayashi T, Seki N, Tomita T, Sawabe K, Kobayashi M. First molecular evidence of Bartonella quintana in Pediculus humanus capitis (Phthiraptera: Pediculidae), collected from Nepalese children. JOURNAL OF MEDICAL ENTOMOLOGY 2006; 43:110-2. [PMID: 16506456 DOI: 10.1093/jmedent/43.1.110] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Trench fever is a body louse-borne disease caused by Bartonella quintana Brenner. The recent status of louse infestation in Nepalese children is not well known. We collected head and body lice, Pediculus humanus capitis De Geer and Pediculus humanus humanus L., respectively, from 30 children, including 11 cases of double infestation with both head and body lice. Detection of B. quintana in both louse species identified was carried out by polymerase chain reaction (PCR). PCR products with B. quintana DNA sequences were detected in both head and body lice from two children as well as in body lice derived from two other children. These results demonstrate that head lice may also play a role in the transmission of trench fever.
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Affiliation(s)
- Toshinori Sasaki
- Department of Medical Entomology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo, Japan
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14
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Abstract
Bites, stings and infestations can be fatal. Anaphylaxis to vespids and bees can be prevented with immunotherapy. Patients should be referred to an allergist. The acute care and prevention of arthropod injury is discussed below.
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Affiliation(s)
- Dirk M Elston
- Department of Dermatology, Geisinger Medical Center, Danville, PA 17821, USA.
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15
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Brouqui P, Stein A, Dupont HT, Gallian P, Badiaga S, Rolain JM, Mege JL, La Scola B, Berbis P, Raoult D. Ectoparasitism and vector-borne diseases in 930 homeless people from Marseilles. Medicine (Baltimore) 2005; 84:61-68. [PMID: 15643300 DOI: 10.1097/01.md.0000152373.07500.6e] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Homeless people are particularly exposed to ectoparasites, but their exposure to arthropod-borne diseases has not been evaluated systematically. A medical team of 27 persons (7 nurses, 6 infectious disease residents or fellows, 2 dermatologists, and 12 infectious disease specialists) visited the 2 shelters in Marseilles, France, for 4 consecutive years. Homeless volunteers were interviewed, examined, and received care; and blood was sampled for cell counts and detection of bacteremia, antibodies to louse-borne (Rickettsia prowazekii, Bartonella quintana, and Borrelia recurrentis), flea-borne (R. typhi, R. felis), mite-borne (R. akari), and tick-borne (R. conorii) bacterial agents. We selected sex- and age-adjusted controls among healthy blood donors. Over 4 years, 930 homeless people were enrolled. Lice were found in 22% and were associated with hypereosinophilia (odds ratio, 5.7; 95% confidence intervals, 1.46-22.15). Twenty-seven patients (3%) with scabies were treated with ivermectin. Bartonella quintana was isolated from blood culture in 50 patients (5.3%), 36 of whom were treated effectively. The number of bacteremic patient increased from 3.4% to 8.4% (p = 0.02) over the 4 years of the study. We detected a higher seroprevalence to Borrelia recurrentis, R. conorii, and R. prowazekii antibodies in the homeless. Our study shows a high prevalence of louse-borne infections in the homeless and a high degree of exposure to tick-borne diseases and scabies. Despite effective treatment for Bartonella quintana bacteremia and the efforts made to delouse this population, Bartonella quintana remains endemic, and we found hallmarks of epidemic typhus and relapsing fever. The uncontrolled louse infestation of this population should alert the community to the possibility of severe re-emerging louse-borne infections.
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Affiliation(s)
- Philippe Brouqui
- From Maladies Infectieuses et Tropicales (P Brouqui), Service des Urgences (SB), Service de Dermatologie (P Berbis), CHU Nord, AP-HM; Unité des Rickettsies (P Brouqui, AS, HTD, JMR, JLM, BLS, DR), CNRS UMR 6020, IFR 48, Faculté de Médecine; Service des Maladies Infectieuses (AS, HTD), CHU Conception, AP-HM; Centre National de Transfusion Sanguine (PG); Marseilles, France
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16
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Abstract
The 3 major lice that infest humans are Pediculus humanus capitis (head louse), Pthirus pubis (crab louse), and Pediculus humanus humanus (body louse). Patients with louse infestation present with scalp pruritus, excoriations, cervical lymphadenopathy, and conjunctivitis. A hypersensitivity rash, or pediculid, may mimic a viral exanthem. Head lice infestation crosses all economic and social boundaries, whereas body lice infestation preferentially affects the homeless and displaced. Body lice are major vectors of diseases such as typhus, trench fever, and relapsing fever. Pubic lice infestation often is acquired as a sexually transmitted disease and may be a marker to screen for other sexually transmitted diseases. Treatment of louse infestation can be challenging. Mechanical measures, such as combing, are helpful as adjunctive measures, but most studies suggest they are not as effective as chemical agents. Resistance to chemical agents is a growing problem. Major types of resistance include knock-down resistance, glutathione-S-transferase-based resistance, and monooxygenase-based resistance. Research is needed to identify new effective treatments.
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Affiliation(s)
- Christine J Ko
- Department of Dermatology, University of California at Irvine, USA
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17
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Abstract
Current research on human louse biology has focused on the long-standing debate about speciation of head and body lice but using new tools of DNA and enzyme analysis. These studies have indicated that head and body lice from the same geographical zone may be more closely allied than insects inhabiting the same ecological niche in other regions. However, the majority of research over the past decade has involved clinical aspects including transmission, treatment, and the appearance and identification of resistant strains within populations of lice. Despite advances, there is a need for a better understanding of louse biology, as existing therapies fail and lice remain potential vectors of disease for millions of people.
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Affiliation(s)
- Ian F Burgess
- Insect Research & Development Limited, Cambridge Road, Fulbourn, Cambridge CB1 5EL, United Kingdom.
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18
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KASAI S, MIHARA M, TAKAHASHI M, AGUI N, TOMITA T. An artificial blood feeding system for body louse, Pediculus humanus. ACTA ACUST UNITED AC 2003. [DOI: 10.7601/mez.54.343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Shinji KASAI
- Department of Medical Entomology, National Institute of Infectious Diseases
| | - Minoru MIHARA
- Department of Environmental Biology, Japan Environmental Sanitation Center
| | - Masakazu TAKAHASHI
- Department of Medical Entomology, National Institute of Infectious Diseases
| | - Noriaki AGUI
- Department of Medical Entomology, National Institute of Infectious Diseases
| | - Takashi TOMITA
- Department of Medical Entomology, National Institute of Infectious Diseases
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KASAI S, MIHARA M, TAKAHASHI M, AGUI N, TOMITA T. Rapid evaluation of human louse susceptibility to phenothrin. ACTA ACUST UNITED AC 2003. [DOI: 10.7601/mez.54.31_1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Shinji KASAI
- Department of Medical Entomology, National Institute of Infectious Diseases
| | - Minoru MIHARA
- Department of Environmental Biology, Japan Environmental Sanitation Center
| | - Masakazu TAKAHASHI
- Department of Medical Entomology, National Institute of Infectious Diseases
| | - Noriaki AGUI
- Department of Medical Entomology, National Institute of Infectious Diseases
| | - Takashi TOMITA
- Department of Medical Entomology, National Institute of Infectious Diseases
| |
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