Yersinia pestis can infect the Pawlowsky glands of human body lice and be transmitted by louse bite.

Yersinia pestis, the causative agent of plague, is a highly lethal vector-borne pathogen responsible for killing large portions of Europe's population during the Black Death of the Middle Ages. In the wild, Y. pestis cycles between fleas and rodents; occasionally spilling over into humans bitten by infectious fleas. For this reason, fleas and the rats harboring them have been considered the main epidemiological drivers of previous plague pandemics. Human ectoparasites, such as the body louse (Pediculus humanus humanus), have largely been discounted due to their reputation as inefficient vectors of plague bacilli. Using a membrane-feeder adapted strain of body lice, we show that the digestive tract of some body lice become chronically infected with Y. pestis at bacteremia as low as 1 × 105 CFU/ml, and these lice routinely defecate Y. pestis. At higher bacteremia (≥1 × 107 CFU/ml), a subset of the lice develop an infection within the Pawlowsky glands (PGs), a pair of putative accessory salivary glands in the louse head. Lice that developed PG infection transmitted Y. pestis more consistently than those with bacteria only in the digestive tract. These glands are thought to secrete lubricant onto the mouthparts, and we hypothesize that when infected, their secretions contaminate the mouthparts prior to feeding, resulting in bite-based transmission of Y. pestis. The body louse's high level of susceptibility to infection by gram-negative bacteria and their potential to transmit plague bacilli by multiple mechanisms supports the hypothesis that they may have played a role in previous human plague pandemics and local outbreaks.

Effectiveness and chemical insights: Exploring interactions between nanomicelles and monoterpenoids for head lice treatment.

This study evaluates the pediculicidal activity of nanoformulations containing different binary essential oil component mixtures (eugenol:linalool, 1,8 -cineole:linalool, and eugenol:thymol) using immersion bioassays. These have allowed us to evaluate the knockdown time affecting 50% of the individuals (KT50). In addition, the type of interaction between the components in each mixture was established in terms of the combination index (IC). The KT50 values were 6.07; 8.83; 7.17 and 27.23 h for linalool, 1,8 -cineole, eugenol, and thymol, respectively. For the eugenol:linalool mixtures, the efficacy was lower or equal to that obtained for the nanoformulations of the pure compounds, with values of KT50 about 13.33, 8.16 and 6.71 h for mixtures with ratios 3:1, 1:1 and 1:3, respectively. These mixtures present IC > 1, evidencing antagonistic interaction, which is enhanced with eugenol content. In the case of the binary mixtures of 1,8 -cineole: linalool, KT50 values were similar to those obtained for eugenol:linalool mixtures with similar ratios. In this case, IC assumes values close to unity, suggesting additive interactions independently of the mixture composition. On the other side, mixtures of eugenol:thymol with 1:1 and 1:3 ratios showed values of 9.40 and 32.93 h, while the mixture with a 3:1 ratio showed the greatest effectiveness (KT50 of 4.42 h). Eugenol:thymol mixtures show synergistic interaction (IC < 1) for combinations 3:1 and 1:1, while no interaction was observed for 1:3 combination. This indicates that eugenol enhances thymol activity. These results must be considered an important step forward to the development of effective pediculicidal nanoformulations based on botanical compounds.

Investigation of Head Lice and Intestinal Parasites in Primary and Secondary School in Sivas.

Objective: The purpose of this study was to investigate the prevalence of intestinal parasites and head lice in primary school-aged children and to determine a possible relationship between the co-occurrence of ecto-endoparasites. Methods: The study were conducted in three schools in the center of Sivas: Sivas Karsiyaka Primary School, Kilavuz IMKB Primary School, and Karsiyaka 27 June Middle School. The presence of head lice and intestinal parasites was investigated in a total of 563 children aged 6 to 17, with 294 girls and 269 boys. Classroom teachers and students were provided with information about intestinal parasites, head lice, and methods of transmission and prevention, and a questionnaire was administered. During the head lice examination, students were inspected with a comb, and samples with nits were examined under a microscope in the laboratory. Cellophane tape and stool samples obtained from the participants were examined on the same day using the native-lugol, flotation, and trichrome staining methods under a light microscope (x10, x40, x100). Results: Five hundred sixty-three children were evaluated for head lice and 15 (2.6%) were found to be positive. During the examination, only nits were found in 11 students (1.9%), and both adult lice and nymphs were seen in 4 students (0.7%). Head lice were found positive in 2 out of 269 boys (0.7%), while 13 out of 294 girls (4.2%) positive (p<0.05). As a result of stool examination in children, Entamoeba coli was found in 11 (1.95%), Giardia intestinalis in 4 (0.71%), Blastocystis sp. in 14 (2.48%), Enterobius vermicularis in 8 (1.42%) and Taenia spp. in 2 (0.35%). Head lice infestation and Taenia spp. were found to coexist in 2 (0.35%) children. Conclusion: In conclusion, although there has been a noticeable decrease in head lice and intestinal parasites among primary school-aged children in Sivas province, these conditions are still present, as evidenced by previous studies conducted in our region.

Genomic Diversity in the Endosymbiotic Bacteria of Human Head Lice.

Insects have repeatedly forged symbioses with heritable microbes, gaining novel traits. For the microbe, the transition to symbioses can lead to the degeneration of the symbiont's genome through transmission bottlenecks, isolation, and the loss of DNA repair enzymes. However, some insect-microbial symbioses have persisted for millions of years, suggesting that natural selection slows genetic drift and maintains functional consistency between symbiont populations. By sampling in multiple countries, we examine genomic diversity within a symbiont species, a heritable symbiotic bacterium found only in human head lice. We find that human head louse symbionts contain genetic diversity that appears to have arisen contemporaneously with the appearance of anatomically modern humans within Africa and/or during the colonization of Eurasia by humans. We predict that the observed genetic diversity underlies functional differences in extant symbiont lineages, through the inactivation of genes involved in symbiont membrane construction. Furthermore, we find evidence of additional gene losses prior to the appearance of modern humans, also impacting the symbiont membrane. From this, we conclude that symbiont genome degeneration is proceeding, via gene inactivation and subsequent loss, in human head louse symbionts, while genomic diversity is maintained. Collectively, our results provide a look into the genomic diversity within a single symbiont species and highlight the shared evolutionary history of humans, lice, and bacteria.

Highly Resolved Genomes of Two Closely Related Lineages of the Rodent Louse Polyplax serrata with Different Host Specificities.

Sucking lice of the parvorder Anoplura are permanent ectoparasites with specific lifestyle and highly derived features. Currently, genomic data are only available for a single species, the human louse Pediculus humanus. Here, we present genomes of two distinct lineages, with different host spectra, of a rodent louse Polyplax serrata. Genomes of these ecologically different lineages are closely similar in gene content and display a conserved order of genes, with the exception of a single translocation. Compared with P. humanus, the P. serrata genomes are noticeably larger (139 vs. 111 Mbp) and encode a higher number of genes. Similar to P. humanus, they are reduced in sensory-related categories such as vision and olfaction. Utilizing genome-wide data, we perform phylogenetic reconstruction and evolutionary dating of the P. serrata lineages. Obtained estimates reveal their relatively deep divergence (∼6.5 Mya), comparable with the split between the human and chimpanzee lice P. humanus and Pediculus schaeffi. This supports the view that the P. serrata lineages are likely to represent two cryptic species with different host spectra. Historical demographies show glaciation-related population size (Ne) reduction, but recent restoration of Ne was seen only in the less host-specific lineage. Together with the louse genomes, we analyze genomes of their bacterial symbiont Legionella polyplacis and evaluate their potential complementarity in synthesis of amino acids and B vitamins. We show that both systems, Polyplax/Legionella and Pediculus/Riesia, display almost identical patterns, with symbionts involved in synthesis of B vitamins but not amino acids.

Cuticular extracts induce aggregation in head lice.

The human head lice Pediculus humanus capitis (De Geer) (Phthiraptera: Pediculidae) are strict, obligate human ectoparasites that spends their entire life cycle in the host and cause skin irritation and derived infections. Despite the health-related importance, few studies have evaluated the chemical communication among these insects. Here, we evaluate the response of lice of both sexes to cuticular extracts using two solvents of different polarity (hexane and methanol). Cuticular extracts that elicited an attraction response towards head lice were analysed by gas chromatography-mass spectrometry (GC-MS) to determine the cuticular lipid profile. Both lice sexes were attracted to the hexane extracts but not the methanol extracts, suggesting the non-polarity of the compounds present in the cuticle. Chemical analyses of hexane extracts from males and females showed high similarity in major compounds. This study provides the first evidence that lice respond to cuticle extracts, which may be important to understand aggregation behaviour.

Body lice: a vector for re-emerging disease outbreak in a rehabilitation camp in Northwestern Iran.

OBJECTIVE: The report of the outbreak of body louse in northwestern Iran after three decades reminds us again of the danger of the re-emerging of previous epidemics. RESULTS: The results of the study that nearly 70% of the patients in a rehabilitation Centre were infected with body louse. In this study, scientific measures were taken to prevent the spread of body lice to healthy people, including isolation of the patients, washing the clothes of those infected at high temperatures, and spraying the rest area, beddings, and blankets. This is a more recent report on an outbreak of body louse in Iran in 2023.

Pediculicide regulations and usage trends in Türkiye in 2015-2022.

BACKGROUND: Over the years, the increasing prevalence of head lice infestation has led to an increase in treatment-related costs and the development of resistance to pediculicides. This study aimed to evaluate pediculicide sales over an 8-year period (2015-2022), including the COVID-19 pandemic. METHODS: Data on products registered in the Turkish Pharmaceutical Index Dataview, Intercontinental Medical Statistics (IMS) database, sold on prescription and approved by the Ministry of Health in Türkiye were formally requested from the research organization IQVIA for pharmacologically active pediculicides (PAP) such as permethrin, pyrethrin, and sumithrin. Data for physically active products containing dimethicone (DMT) were obtained from the relevant pharmaceutical companies. Sale revenues were determined based on sale prices in the aforementioned year. RESULTS: Total sales of pediculicides decreased from 2,452,846 units in 2015 to 2,028,840 units in 2022. While PAP consumption decreased over the years, from 1,832,006 to 518,460 units, DMT consumption increased from 620,840 to 1,510,380 units, from 2015 to 2022. The total price of pediculicides for the consumer increased more than threefold in Turkish currency. In terms of USD, an almost similar amount of money was spent over the years, with the exception of 2022 when the expenditure almost halved mainly due to the high inflation rate in the country. CONCLUSION: The decrease in PAP and the increase in DMT indicate that local lice have developed resistance to the former. Further studies are needed to determine the possible development of resistance in the country.

The effect of educational intervention on efficacy of 1% permethrin shampoo and 4% dimeticone lotion to treat head lice infestation using propensity score matching (PSM).

BACKGROUND: Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. METHODS: This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. RESULTS: The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. CONCLUSION: Participants who received the training intervention (OR = 3.29; CI 95%: 2.21-4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

Molecular detection of Bartonella quintana, Acinetobacter baumannii and Acinetobacter haemolyticus in Pediculus humanus lice in Nigeria, West Africa.

The human lice Pediculus humanus is distributed worldwide but, it thrives and flourishes under conflict situations where people are forced to live in crowded unhygienic conditions. Molecular methods were used to identify and screen human lice for the DNA of pathogens of public health importance in an area that has been under insurgency related to religious and political conflicts with tens of thousands of internally displaced people (IDP). DNA of Bartonella quintana, Acinetobacter baumannii and Acinetobacter haemolyticus was detected in 18.3%, 40.0% and 1.7%, respectively, of human lice collected from children in Maiduguri, Nigeria. More body lice than head lice were positive for pathogen's DNA (64.3% vs. 44.4%; χ2 = 1.3, p = 0.33), but the difference was not significant. Two lice samples were found to harbour mixed DNA of B. quintana and A. baumannii. Phylogenetic analysis of the cytochrome b (cytb) gene sequences of the positive lice specimens placed them into clades A and E. This is the first report on the molecular identification of human lice and the detection of the DNA of pathogens of public health importance in lice in Nigeria, West Africa. The findings of this study will assist policy makers and medical practitioners in formulating a holistic healthcare delivery to IDPs.

Pediculosis capitis risk factors in schoolchildren: hair thickness and hair length.

The human head lice is a cosmopolitan ectoparasite that causes pediculosis. The main way of spreading lice is through direct head-to-head contact. It is popular knowledge that some individuals are more susceptible to contracting head lice than others. Reports of individuals who have never been affected by the disease are common, even living in the same environment and under the same conditions as people who regularly have lice infestations. Previous research has been carried out on the risk of this infection associated with different human factors like gender or age. However, studies on the influence of the individual hair characteristics are scarce. The objective of the study was to analyze the pediculosis risk using geographical location, gender, age and individual hair characteristics as variables. Pediculosis was diagnosed through the detection of living lice in the hair. This cross-sectional school-based epidemiological study was conducted in 310 schoolchildren aged 1 to 13 years of schools in 4 municipalities situated in the State of Paraná, Brazil. The prevalence of head louse infection in primary school students was 49.35 %. The Odds Ratio of presence of pediculosis (OR) was estimated using multivariate logistic regression analysis. The results obtained indicate that hair length and thickness increase the risk of infection. Furthermore, the inclusion of hair color, hair shape, kind of hair-scale as covariates increases the risk of pediculosis, indicating that these variables partly explain this susceptibility and that pediculosis is independent of gender. A smaller hair diameter may favor insect fixation to the hair in the nymphal phases. These results may explain why girls are a greater risk as they let their hair grow for cultural reasons, i.e., being of female gender is an agglutinating variable. The conclusions drawn may explain the discrepancies obtained in previous analyses.

POPULATION STRUCTURE AND BARTONELLA QUINTANA IN HEAD AND BODY LICE IN POKHARA, NEPAL (ANOPLURA: PEDICULIDAE).

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.

Nuclear genetic diversity of head lice sheds light on human dispersal around the world.

The human louse, Pediculus humanus, is an obligate blood-sucking ectoparasite that has coevolved with humans for millennia. Given the intimate relationship between this parasite and the human host, the study of human lice has the potential to shed light on aspects of human evolution that are difficult to interpret using other biological evidence. In this study, we analyzed the genetic variation in 274 human lice from 25 geographic sites around the world by using nuclear microsatellite loci and female-inherited mitochondrial DNA sequences. Nuclear genetic diversity analysis revealed the presence of two distinct genetic clusters I and II, which are subdivided into subclusters: Ia-Ib and IIa-IIb, respectively. Among these samples, we observed the presence of the two most common louse mitochondrial haplogroups: A and B that were found in both nuclear Clusters I and II. Evidence of nuclear admixture was uncommon (12%) and was predominate in the New World potentially mirroring the history of colonization in the Americas. These findings were supported by novel DIYABC simulations that were built using both host and parasite data to define parameters and models suggesting that admixture between cI and cII was very recent. This pattern could also be the result of a reproductive barrier between these two nuclear genetic clusters. In addition to providing new evolutionary knowledge about this human parasite, our study could guide the development of new analyses in other host-parasite systems.

Phylogenetic and network analysis of Pediculus humanus in Nigeria reveal the presences of clade E body lice and novel haplotypes.

An investigation was conducted for the first time to determine the prevalence and genetic diversity of human lice, for the first time in Nigeria, using conventional PCR and sequencing methods. Three mitochondrial genes, cytochrome oxidase subunit 1 (cox1), cytochrome b (cytb), and 12S rRNA of Nigerian human lice, were amplified, sequenced, and analyzed. Overall, high prevalence (72.5%; 103/142) of lice infestation was recorded among the examined volunteers. Head lice infestation was more common 63 (61.2%) than body lice infestation 34 (33.0%). Co-infestation with both head and body lice was recorded in six humans (5.8%). The Nigerian human lice specimens were placed mostly into clade A with few in clade E, including body lice for the first time. Six, three, and eight haplotypes of Nigerian human lice were obtained for the cytb, cox1, and 12S rRNA genes, respectively. Additionally, one (E51), three (A31, A32, and E5), and six (A20, A21, A23, A24, A30, and E1) novel haplotypes were recorded for cox1, cytb, and 12S rRNA, respectively, from the Nigerian specimens which were corroborated by the ML phylogenetic trees and MJ network analyses. Genetic diversity indices indicate minimal variation in the parameters analyzed among the clades of the three genes. However, a statistically significant Snn test, negative Tajima's D test for clade A (cox1 and 12S rRNA genes), and negative Fu and Li's D test in clade A for cox1 gene indicate a geographical structure and the signature of population expansion of the Nigerian human lice. The findings from this study provide additional data on the human lice structure in Africa.

Prevalence of permethrin-resistant kdr mutation in head lice (Pediculus humanus capitis) from elementary school students in Jeddah, Saudi Arabia.

Head lice (Pediculus humanus capitis) are a major global concern, and there is growing evidence of an increase in head lice prevalence among Saudi schoolchildren. The purpose of this study is to investigate the prevalence of an insecticidal resistance mutation in head lice collected from schoolchildren. A polymerase chain reaction (PCR) was used to amplify a segment of the voltage-gated sodium channel gene subunit to assess the prevalence and distribution of the kdr T917I mutation in head lice. Subsequently, the restriction fragment length polymorphism (RFLP) patterns revealed two genotypic forms: homozygous-susceptible (SS) and homozygous-resistant (RR). The results showed that 17 (37.80%) of the 45 samples were SS, whereas 28 (62.2%) were RR and T917I and L920F point mutations were found in the nucleotide and amino acid sequences of RR. Compared to other nations, the frequency of permethrin resistance mutation in the head louse population in Saudi Arabia was low. This study provides the first evidence of permethrin resistance mutation in human head lice in Saudi Arabia. The findings of this study will highlight the rising incidence of the kdr mutation in head lice in Saudi Arabia.