Abstract

Of the three lice (head, body, and pubic louse) that infest humans, the body louse is the species involved in epidemics of louse-borne typhus, trench fever, and relapsing fever, but all the three cause pediculosis. Their infestations occur today in many countries despite great efforts to maintain high standards of public health. In this review, literature searches were performed through PubMed, Medline, Google Scholar, and EBSCOhost, with key search words of “Pediculus humanus”, “lice infestation”, “pediculosis”, and “treatment”; and controlled clinical trials were viewed with great interest. Removing lice by hand or with a lice comb, heating infested clothing, and shaving the scalp were some of the oldest methods of controlling human lice. Despite the introduction of other resources including cresol, naphthalene, sulfur, mercury, vinegar, petroleum, and insecticides, the numbers of lice infestation cases and resistance have increased. To date, viable alternative treatments to replace insecticides have been developed experimentally in vitro. Today, the development of new treatment strategies such as symbiotic treatment and synergistic treatment (antibiotics + ivermectin) in vitro has proved effective and is promising. Here, we present an overview on managing and treating human lice and highlight new strategies to more effectively fight pediculosis and prevent resistance.

Highlights

  • Lice and Their Public Health ImpactA rapid multiplex realtime PCR assay was established that differentiates between head and body lice with 100% specificity and sensitivity [53]

  • Eggs are laid in the folds of clothing for body lice and in the hair for head lice; they are held in place by an adhesive produced by the mother’s accessory gland [13]

  • Louse-borne diseases are associated with a high prevalence of body louse infestation and have recently reemerged in jails and refugee camps in central and eastern Africa [15], in rural communities in the Peruvian Andes [57], in rural populations in Russia [58], and in homeless populations living in poor hygiene conditions in developed countries [59,60,61,62,63]

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Summary

Lice and Their Public Health Impact

A rapid multiplex realtime PCR assay was established that differentiates between head and body lice with 100% specificity and sensitivity [53] Based on these studies, we can suggest that the clade A head louse has a deleted genome and originated from the body louse. DNA from B. quintana was found in head lice from Nepalese children in 2006 [71], from homeless individuals in the USA in 2009 [65], and from the local population in Congo, Madagascar, and Senegal [72] It was found in head louse nits from a homeless person in Marseille, France [73], and in head lice from Ethiopian [74] and Senegalese [75] patients. DNA from A. baumannii was detected in 33% and 3% of the head lice collected from schoolchildren in Paris, France [76], and Diankabou, Mali, respectively [77]

Diagnosis of Lice Infestations
Treatment Strategies
Study Methods
New Approaches
Findings
Future Efforts
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