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PubMed2004

Super bugs.

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Animals↗
PubMed2004

Bug busting.

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Animals↗
PubMed2005

The head and body lice of humans are genetically distinct (Insecta: Phthiraptera, Pediculidae): evidence from double infestations.

Little is known about the population genetics of the louse infestations of humans. We used microsatellite DNA to study 11 double infestations, that is, hosts infested with head lice and body lice simultaneously. We tested for population structure on a host, and for population structure among seven hosts that shared sleeping quarters. We also sought evidence of migration among louse populations. Our results showed that: (i) the head and body lice on these individual hosts were two genetically distinct populations; (ii) each host had their own populations of head and body lice that were genetically distinct to those on other hosts; and (iii) lice had migrated from head to head, and from body to body, but not between heads and bodies. Our results indicate that head and body lice are separate species.

Animals↗
PubMed2000

The methodology and operation of a pilot randomized control trial of the effectiveness of the Bug Busting method against a single application insecticide product for head louse treatment.

A Department of Health leaflet suggests two treatment methods for head lice: mechanical removal by wet combing; and insecticide lotion/rinses. However, there are no reports in the literature comparing the effectiveness of these two treatment methods and well controlled clinical trials of insecticide treatments are sparse. A pilot randomized control trial of the effectiveness of a specific method of wet combing, 'Bug Busting', against a single application of a proprietary insecticide product is reported. The difficulties of designing a trial are discussed and modifications that would allow a definitive trial to take place are suggested. The pilot study included enzyme analysis of lice for insecticide resistance status assessment.

Animals↗
PubMed1999

Evidence for double resistance to permethrin and malathion in head lice.

A rising prevalence of head lice among school children and rising sales of insecticides with anecdotal evidence of their treatment failure, led us to examine whether head lice in Bristol and Bath were resistant to the insecticides available for treating head lice. Ten schools in Bristol and Bath were visited to collect field samples of head lice. A comparison was made of the survival rates of fully sensitive laboratory reared body lice and field samples of head lice on insecticide exposure. To confirm the in vitro relevance of these tests we performed supervised treatments of affected subjects with malathion or permethrin. There were significant differences (P < 10-6 Fishers exact test) between head and body lice survival for malathion and permethrin exposure, but not for carbaryl. There was an 87% failure rate for permethrin and a 64% failure rate for malathion with the topical treatment of a selected number of infested school children. We conclude that there is a high resistance to permethrin and malathion, but head lice remain fully sensitive to carbaryl. This is the first report of doubly resistant head lice. As permethrin, phenothrin (a very similar synthetic pyrethroid) or malathion are the active ingredients in all the over-the-counter head lice treatments in the U.K., then it is likely that head lice prevalence will continue to increase. The resistance against permethrin employed by the head louse is probably the kdr (knockdown resistance) mechanism, and an enzyme-mediated malathion-specific esterase is the likely mechanism against malathion.

Animals↗
PubMed2002

Widespread insecticide resistance in head lice to the over-the-counter pediculocides in England, and the emergence of carbaryl resistance.

BACKGROUND: Increasing resistance to insecticides used for the control of head lice infestation has been documented over the last decade. Treatment failure and tolerance to insecticides have been validated in a number of studies undertaken in several U.K. centres. OBJECTIVES: To establish the extent of insecticide resistance in head lice and acetylcholinesterase activity in the presence of carbaryl in head lice. METHODS: Head lice were collected from school children in four centres across England (Exmouth, Loughborough, Leeds and South Shields), and tested in their response to the insecticides permethrin, phenothrin, malathion and carbaryl. Data were compared with information collected in Bristol and Bath in 1998 and with susceptible body lice. The activity of louse acetylcholinesterase was measured with and without carbaryl in head lice collected in Bristol, Leeds, Loughborough and in body lice. The efficacy of a 1% carbaryl lotion was compared in children in Bristol and Leeds. RESULTS: Compared with body lice, head lice from all six centres were significantly different in their response (P < 0.0001) to permethrin, phenothrin and malathion after 2-h exposure tests. There were significant differences in louse acetylcholinesterase activity in body lice, and head lice collected in Loughborough and Bristol in the presence or absence of carbaryl (P < 0.001), indicating enzyme inhibition. However, the difference for lice from Leeds was not significant (P = 0.363) suggesting that the enzyme was resistant to carbaryl. Eighty-nine per cent of children treated in Leeds with carbaryl were cured compared with 100% in Bristol. CONCLUSIONS: The data suggest head lice resistance is present in many parts of England to over-the-counter products containing synthetic insecticides (permethrin, phenothrin and malathion). They further suggest that resistance is starting to develop to carbaryl in head lice in Leeds and that extensive use of this product would lead to significant resistance.

Acetylcholinesterase↗
PubMed2001

Towards the eradication of head lice: literature review and research agenda.

Head lice infestation is a public health issue. In the effort to compile an evidence-base about the physiology, detection, treatment, effects and management strategies of head lice infestations we reviewed current literature. This literature signalled significant evidence gaps and these gaps provide incentives for further research. Our conclusions from the literature are that parents of children are responsible for head lice detection and treatment but have varying access to advice about how best to treat this condition. Concern is exacerbated by misconceptions surrounding the circumstances of infestation. Head lice are a low priority for health professionals in Australia, whereas parents and teachers believe the problem necessitates greater attention. It is important to provide a unified evidence-based approach to good information. It is timely for health care professionals to re-examine and prioritize this public health issue. They should research and work collaboratively towards the eradication of head lice.

Animals↗
PubMed2001

Head lice infestation: bug busting vs. traditional treatment.

The two main methods of managing head lice infestation in the UK are head lice lotions and bug busting; there is no conclusive evidence as to which of these methods is most effective. The aim of this study was to compare the effectiveness of the bug busting method with lotion. A pilot study in the form of a randomized controlled trial involving two semi-rural general practices was used. Thirty children aged 4-16 years were randomly assigned to two intervention groups. After initial dry combing to detect the presence of head lice, one group was treated with phenothrin lotion. The bug busting group received combing using special combs provided in the bug busting pack and hair conditioner. The main outcome measure was the number of adult live lice and nymphs at day 14. On day 14 in the bug busting group, total eradication of head lice had occurred in eight children; in the lotion group, total eradication had occurred in two children (P=0.052); number needed to treat 2.5 (95% CI: 2.19-2.81). These results suggest that bug busting performed by nurses in a controlled situation is an effective method of managing head lice infestation.

Adolescent↗
PubMed1999

Head lice in pupils of a primary school in Australia and implications for control.

BACKGROUND: Anecdotal reports suggest that head lice infestations are a common problem in school-aged children in Australia; however, only a few data are available. The present study aimed to determine the prevalence of infestation with head lice in children in an urban Australian school. METHODS: All 735 pupils from grades preschool to five of a government run primary school were invited to participate in the cross-sectional survey. Overall, 212 boys (46.5%) and 244 girls from 29 classes were examined. The main outcome measures were: (1) the detection of lice or eggs by visual examination of the child's head, and classification into 'not infested' and 'infested;' infested cases were further classified into 'active infestation' (lice or viable eggs found) or 'inactive infestation' (only unhatched eggs found); (2) for each child, a parent or guardian was asked to complete a standardized questionnaire. RESULTS: Of the 456 children examined, 33.7% (95% confidence interval = 95%-CI = [26.9%, 40.4%]) had evidence of infestation with head lice, 21.0% (95%-CI = [15.2%, 26.8%]) with active infestation. The prevalence of infestation (active plus inactive) varied greatly between classes, ranging from zero to 72.2% (p < 0.001). Head lice were more prevalent in girls than boys (p < 0.001). Analysis of questionnaires showed that 47.7% (95%-CI = [43.0%, 52.4%]) of the children had been infested with head lice in the previous 6 months. For children with active pediculosis capitis on examination, 14.0% (95%-CI = [7.9%, 22.4%]) of parents or guardians had not noticed the infestation. CONCLUSIONS: In an urban primary school in Australia, head lice infestation was present at a hyperendemic level. Clustering by class indicated the classroom as a main source of infestation. Control strategies implemented in schools and including the education of teachers and parents need to be evaluated.

Animals↗