The Body Louse as a Vector of Reemerging Human Diseases

Abstract

The body louse, Pediculus humanus humanus, is a strict human parasite, living and multiplying in clothing. Louse infestation is associated with cold weather and a lack of hygiene. Three pathogenic bacteria are transmitted by the body louse. Borrelia recurrentis is a spirochete, the agent of relapsing fever, recently cultured on axenic medium. Historically, massive outbreaks have occurred in Eurasia and Africa, but currently the disease is found only in Ethiopia and neighboring countries. Bartonella quintana is now recognized as an agent of bacillary angiomatosis bacteremia, trench fever, endocarditis, and chronic lymphadenopathy among the homeless. Rickettsia prowazekii is the agent of epidemic typhus. The most recent outbreak (and the largest since World War II) was observed in Burundi. A small outbreak was also reported in Russia in 1997. Louse infestation appears to become more prevalent worldwide, associated with a decline in social and hygienic conditions provoked by civil unrest and economic instability.

Detection of multiple Bartonella species in digestive and reproductive tissues of fleas collected from sympatric mammals

“…In a study of blood-sucking flies, 100% of pupae tested positive for Bartonella DNA (Halos et al, 2004), but we are unaware of any such reports in fleas. Bartonellae may also be transmitted through arthropod feces; louse feces have been shown to support B. quintana and are implicated in inoculating humans with this pathogen (Raoult and Roux, 1999). Adult flea feces can support Bartonella (Finkelstein et al, 2002) and are an important food source for larvae.…”

Update on Rickettsioses in Slovakia

“…The case-fatality rate for highly virulent rickettsiae ranges from 2% to more than 30% (Azad, 2007;Raoult and Maurin, 2002;Raoult and Roux, 1997a). Epidemic typhus R. prowazekii usually manifests after an incubation period of 10-14 days.…”

“…A variety of names have been attributed to the disease it causes e.g. scalp eschar and neck lymphadenopathy after tick bites (SENLAT) (Angelakis et al, 2010), tick-borne lymphadenopathy (TIBOLA) (Lakos, 1997(Lakos, , 2002Lakos et al, 2012), or Dermacentor-borne necrosis erythema and lymphadenopathy (DEBONEL) (Ibarra et al, 2006;Oteo et al, 2004;Raoult et al, 1997a;Selmi et al, 2008). This illness commonly occurs in Slovakia (Sekeyova et al, 2012c).…”

Rickettsia prowazekiiand Real-time Polymerase Chain Reaction

“…This disease can be fatal and, without treatment with doxycycline, will cause death in up to 30% of cases ( 1 – 3 ). More than 30 million cases of epidemic typhus occurred during and immediately after World War I, resulting in an estimated 3 million deaths ( 1 ).…”

“…This disease can be fatal and, without treatment with doxycycline, will cause death in up to 30% of cases ( 1 – 3 ). More than 30 million cases of epidemic typhus occurred during and immediately after World War I, resulting in an estimated 3 million deaths ( 1 ). Although the incidence of epidemic typhus is low today, the infection could reemerge in epidemic form in human populations, as recently reported in Burundi ( 4 ), Russia ( 5 ), and Algeria ( 6 ).…”