Borrelia recurrentis in Head Lice, Ethiopia

Amina Boutellis, Oleg Mediannikov, Kassahun Desalegn Bilcha, Jemal Ali, Dayana Campelo, Stephen C. Barker, and Didier Raoult

Author affiliations: Marseille UniversitA(c), Marseille, France (A. Boutellis, O. Mediannikov, D. Raoult); Campus Commune UniversitA(c) Cheikh Anta Diop-Institut de Recherche pour le DA(c)veloppment d'Hann, Dakar, SA(c)nA(c)gal (A. Boutellis, O. Mediannikov, D. Raoult); University of Gondar, Gondar, Ethiopia (K.D. Bilcha, J. Ali); University of Queensland, Brisbane, Queensland, Australia (D. Campelo, S.C. Barker)

Abstract

Since the 1800s, the only known vector of Borrelia recurrentis has been the body louse. In 2011, we found B. recurrentis DNA in 23% of head lice from patients with louse-borne relapsing fever in Ethiopia. Whether head lice can transmit these bacteria from one person to another remains to be determined.

Humans are the sole hosts of the pubic louse (Pthirus pubis), the body louse (Pediculus humanus humanus), and the head louse (Pediculus humanus capitis) (1). The body louse can transmit the following life-threatening forms of bacteria to humans: Rickettsia prowazekii, which causes epidemic typhus; Bartonella quintana, which causes trench fever; and Borrelia recurrentis, which causes louse-borne relapsing fever (2). Recently, DNA from B. quintana has been found in head lice from Nepal (3), the United States (4), France (5), Senegal (6), and the highlands of Ethiopia (Gibarku and Tikemit Eshet) (7). Louse-borne relapsing fever is among the top 10 causes of hospital admissions in Ethiopia and is associated with substantial illness and death (8). Infection of head lice with B. recurrentis or R. prowazekii has not been reported. Our aim was to assess the presence of Borrelia, Rickettsia, and Bartonella spp. in head lice and body lice from persons in the highlands of Ethiopia, where an outbreak of relapsing fever is ongoing.