A clinical review and history of pubic lice.

The ectoparasite Pthirus pubis (PtP), commonly known as the crab or pubic louse, has plagued primates from prehistoric apes to Homo sapiens. We combed the literature from antiquity to the present day, reviewing the pubic louse's origins, its evolution with mankind, and its presentation and management. MEDLINE and EMBASE provided the greatest yield of literature compared with other databases. Estimates for PtP incidence range from 0.3% to 4.6% and for prevalence around 2% in adults. War, disasters and overcrowding support lice transmission, but modern pubic hair grooming has reduced the incidence of PtP in recent years. PtP, is usually found on pubic hair, but may infest scalp and body hair, eyebrows and eyelashes. Reports suggest the possibility of PtP as a vector for Bartonella spp. and Acinetobacter spp., which require further study. Transmission of PtP is via close contact, so sexual abuse and concomitant sexually transmitted infections should be considered. Symptoms and signs of infestation include pruritus, red papules and rust/brown deposits from feeding or faecal matter. Visualization of live lice confirms the diagnosis. Traditional treatments include hand-picking and combing, but in modern times pediculicidal products may generate faster resolution. Permethrin or pyrethrins are the first-line recommendations. Resistance to pediculicides is common with head lice and is presumed likely with PtP, although data are lacking. Pseudoresistance occurs as a result of poor compliance, incorrect or ineffective dosing, and reinfestation. In true resistance, a different pediculicide class should be used, e.g. second-line agents such as phenothrin, malathion or ivermectin. Lice have existed long before humans and given their adaptability, despite habitat challenges from fashion trends in body hair removal, are likely to continue to survive.

Bartonella quintana, past, present, and future of the scourge of World War I.

During World War I, a mysterious new disease affected soldiers on both sides of battle field. The first reports described a relapsing fever of unknown origin with body lice being suggested as the vector. The outbreak affected >1 000 000 people, mostly soldiers fighting in front-line trenches. Shortly afterward, the illness was known as Trench fever, of which the causal infectious agent is currently classified as Bartonella quintana.

Ancient treatment for lice: a source of suggestions for carriers of other infectious diseases?

Louse infestation is one of the oldest contagious pestilential diseases of humankind, which has recently re-emerged in several developing countries as well as in homeless individuals and migrants. The present work provides the first phase of an historical excursus of louse remedies based on the classics of pharmaceutical literature, codes, pharmacopoeia and treatises. The second phase involves a literature search, based on the principal medical databases (SciFinder, Pubmed, Google Scholar, ISI-Web of Science and Scopus), to match ancient raw materials and active principles for the treatment of pediculosis and their possible applications, with other current infectious pathologies transmitted by different carriers. In this regard, Rhododendron tomentosum has revealed repellent insect activity, particularly against Aedes aegypti, responsible for Dengue fever, Chikungunya, Zika fever, Mayaro, yellow fever and other infectious diseases. Petroselinum crispum is an insecticide employed for resistant strains of A. aegypti. In the case of Delphinium staphisagria, the phytochemical profile was further investigated with the identification of further molecules in addition to delphinine. The latter shows interesting activities against Trypanosoma cruzi and Leishmania. Anthemis pyrethrum, now renamed as Anacyclus pyrethrum, although not containing pyrethrins present in several plants of the genus Chrysanthemum, revealed pediculicidal activity but did not produce satisfactory results in antiprotozoal activity.

Studies of Ancient Lice Reveal Unsuspected Past Migrations of Vectors.

Lice are among the oldest parasites of humans representing an excellent marker of the evolution and migration of our species over time. Here, we analyzed by real-time polymerase chain reaction (RT-PCR) developed in this study the mitochondrial DNA of seven ancient head louse eggs found on hair remains recovered from two sites in Israel: 1) five nits dating from Chalcolithic period (4,000 bc) were found in the Cave of the Treasure located at Nahal Mishmar, in the Judean Desert and 2) two nits dating from Early Islamic Period (ad 650-810) were found in Nahal Omer in the Arava Valley (between Dead Sea and Red Sea). Our results suggest that these eggs belonged to people originating from west Africa based on identification of the louse mitochondrial sub-clade specific to that region.

PREHISTORICAL Pediculus humanus capitis INFESTATION: QUANTITATIVE DATA AND LOW VACUUM SCANNING MICROSCOPY / Infestação pré-histórica por Pediculus humanus capitis: análise quantitativa e por microscopia de varredura de baixo vácuo

A pre-Columbian Peruvian scalp was examined decades ago by a researcher from the Oswaldo Cruz Foundation. Professor Olympio da Fonseca Filho described nits and adult lice attached to hair shafts and commented about the origin of head lice infestations on mankind. This same scalp was sent to our laboratory and is the subject of the present paper. Analysis showed a massive infestation with nine eggs/cm2 and an impressive number of very well preserved adult lice. The infestation age was roughly estimated as nine months before death based on the distance of nits from the hair root and the medium rate of hair growth. A small traditional textile was associated with the scalp, possibly part of the funerary belongings. Other morphological aspects visualized by low-vacuum scanning electron microscopy are also presented here for adults and nits.

Há décadas um escalpo peruano, datado do período pré-colombiano, foi examinado por um pesquisador da Fundação Oswaldo Cruz. O Professor Olympio da Fonseca Filho descreveu lêndeas e adultos fixos a fios de cabelos e fez comentários sobre a origem da infecção por piolhos na espécie humana. Este mesmo escalpo foi enviado ao nosso laboratório e é objeto deste artigo. Sua análise mostrou maciça infestação, com nove lêndeas/cm2 em impressionante número de adultos muito bem preservados. O tempo de infestação foi estimado em cerca de nove meses antes da morte, baseado na maior distância entre lêndeas e o couro cabeludo, levando em consideração taxa média de crescimento capilar de 1 cm por mês. Um pequeno pedaço de tecido tradicional peruano foi encontrado associado ao escalpo, provavelmente pertencente ao conjunto de peças usado no ritual funerário. Aqui, apresentamos alguns aspectos morfológicos de adultos e lêndeas vizualizados por microscopia eletrônica de varredura de baixo vácuo.

Prehistorical Pediculus humanus capitis infestation: quantitative data and low vacuum scanning microscopy.

A pre-Columbian Peruvian scalp was examined decades ago by a researcher from the Oswaldo Cruz Foundation. Professor Olympio da Fonseca Filho described nits and adult lice attached to hair shafts and commented about the origin of head lice infestations on mankind. This same scalp was sent to our laboratory and is the subject of the present paper. Analysis showed a massive infestation with nine eggs/cm2 and an impressive number of very well preserved adult lice. The infestation age was roughly estimated as nine months before death based on the distance of nits from the hair root and the medium rate of hair growth. A small traditional textile was associated with the scalp, possibly part of the funerary belongings. Other morphological aspects visualized by low-vacuum scanning electron microscopy are also presented here for adults and nits.

Severe head lice infestation in an Andean mummy of Arica, Chile.

Pediculus humanus capitis is an ancient human parasite, probably inherited from pre-hominid times. Infestation appears as a recurrent health problem throughout history, including in pre-Columbian populations. Here, we describe and discuss the occurrence of pre-Columbian pediculosis in the Andean region of the Atacama Desert. Using a light microscope and scanning electron microscopy, we studied a highly infested Maitas Chiribaya mummy from Arica in northern Chile dating to 670-990 calibrated years A.D. The scalp and hair of the mummy were almost completely covered by nits and adult head lice. Low- and high-vacuum scanning electron microscopy revealed a well-preserved morphology of the eggs. In addition, the excellent preservation of the nearly 1,000-yr-old adult head lice allowed us to observe and characterize the head, antennae, thorax, abdomen, and legs. Leg segmentation, abdominal spiracles, and sexual dimorphism also were clearly observed. The preservation of the ectoparasites allowed us to examine the micromorphology using scanning electron microscopy; the opercula, aeropyles, and spiracles were clearly visible. This case study provides strong evidence that head lice were a common nuisance for Andean farmers and herders. Head lice are transmitted by direct head-to-head contact; thus, this ancient farmer and herder was potentially infesting other people. The present study contributes to the body of research focusing on lice in ancient populations.

The use of mercury against pediculosis in the Renaissance: the case of Ferdinand II of Aragon, King of Naples, 1467-96.

The hair samples of Ferdinand II of Aragon (1467-1496), King of Naples, whose mummy is preserved in the Basilica of San Domenico Maggiore in Naples, showed a high content of mercury, with a value of 827ppm. Furthermore, examination using a stereomicroscope and a scanning electron microscope (SEM) of head and pubic hairs of Ferdinand II, revealed a lice infestation. The reasons for the massive presence of the mercury in the king's hair are discussed and contemporary literature regarding the use of this metal in medical therapies and in cosmetic practices is analysed. As a result, the high value of mercury in the hair of Ferdinand II can be attributed to antipediculosis therapy, applied as a topic medicament. This case represents an important finding for the history of medicine, because demonstrates that in the Renaissance mercury was applied locally not only to treat syphilis, as well attested by direct and indirect sources, but also to prevent or eliminate lice infestation.

'Royal' pediculosis in Renaissance Italy: lice in the mummy of the King of Naples Ferdinand II of Aragon (1467-1496).

Pediculosis seems to have afflicted humans since the most ancient times and lice have been found in several ancient human remains. Examination of the head hair and pubic hair of the artificial mummy of Ferdinand II of Aragon (1467-1496), King of Naples, revealed a double infestation with two different species of lice, Pediculus capitis, the head louse, and Pthirus pubis, the pubic louse. The hair samples were also positive for the presence of mercury, probably applied as an anti-pediculosis therapy. This is the first time that these parasites have been found in the hair of a king, demonstrating that even members of the wealthy classes in the Renaissance were subject to louse infestation.

"Royal" pediculosis in Renaissance Italy: lice in the mummy of the King of Naples Ferdinand II of Aragon (1467-1496)

Pediculosis seems to have afflicted humans since the most ancient times and lice have been found in several ancient human remains. Examination of the head hair and pubic hair of the artificial mummy of Ferdinand II of Aragon (1467-1496), King of Naples, revealed a double infestation with two different species of lice, Pediculus capitis, the head louse, and Pthirus pubis, the pubic louse. The hair samples were also positive for the presence of mercury, probably applied as an anti-pediculosis therapy. This is the first time that these parasites have been found in the hair of a king, demonstrating that even members of the wealthy classes in the Renaissance were subject to louse infestation.

[Contribution of palaeopathology to defining the pathocoenosis of infectious diseases (Part two)]. / Apporti della paleopatologia alla definizione della patocenosi delle malattieinfettive (II parte).

In the second part of their review the authors focus on palaeopathological studies, performed in mummified tissues, with reference to infectious diseases. The analysis of samples obtained from both natural and artificial mummies may provide, in some favourable events, a more complete knowledge of these findings in comparison to information obtained from only comprehensive examination of the skeleton. The acquired data enable us to understand not only the diseases which afflicted mankind, but also dietary and hygiene conditions of ancient populations. We report knowledge acquired regarding some palaeopathological conditions, including schistosomiasis, smallpox, cisticercosis, trichinosis, ascaridiasis, echinococcosis, filariasis, hepatitis E virus, condylomatosis, pulmonary tubercolosis, pediculosis, visceral leishmaniasis as well as Diphyllobotrium sp., Dicrocoelium dendriticum and Fasciola hepatica infestations. In addition some interesting findings concerning the relationship between dietary and food intake colonized by streptomyces are described. This review reports the discovery of human remains from different geographic areas: while most of these studies describe findings in two Mediterranean countries (Italy and Egypt), some refer to Britain and German-speaking countries (Austria and Germany) as well as the area in Africa known as Nubia, along the Nile. Both histological and biomolecular diagnosis are useful not only to identify a specific disease in a subject from the remote past, but also to achieve information concerning its frequency and evolution. Such knowledge may thus allow us to understand the intensity of cultural exchanges and links among different populations and the role of these relationships in transmitting and spreading infectious diseases in a certain geographic area.

Evidence for louse-transmitted diseases in soldiers of Napoleon's Grand Army in Vilnius.

BACKGROUND: Many soldiers in Napoleon's Grand Army died of infectious diseases during its retreat from Russia. Because soldiers were commonly infested with body lice, it has been speculated that louse-borne infectious diseases, such as epidemic typhus (caused by Rickettsia prowazekii), were common. METHODS: We investigated this possibility during recent excavations of a mass grave of Napoleon's soldiers in Vilnius, Lithuania. Segments of 5 body lice, identified morphologically and by polymerase chain reaction (PCR) amplification and sequencing, were found in earth from the grave that also contained fragments of soldiers' uniforms. RESULTS: DNA of Bartonella quintana (the agent of trench fever) was identified by PCR and sequencing in 3 of the lice. Similarly, PCR and sequencing of dental pulp from the remains of 35 soldiers revealed DNA of B. quintana in 7 soldiers and DNA of R. prowazekii in 3 other soldiers. CONCLUSIONS: Our results show that louse-borne infectious diseases affected nearly one-third of Napoleon's soldiers buried in Vilnius and indicate that these diseases might have been a major factor in the French retreat from Russia.