Prevention And Control

the current arsenal of techniques. Chemicals used to kill lice are called pediculicides.

Clothes of persons with body lice should be changed frequently, preferably daily, and washed in very hot, soapy water to kill lice and nits. Washing associated bed linen in this manner is also advisable. Infested people should also receive a concurrent whole-body treatment with a pedi-culicide. Overcrowded and unsanitary conditions should be avoided whenever possible during outbreaks of human body lice and louse-borne diseases because it is under these situations that both can thrive.

Crab lice can often be avoided by refraining from multiple sexual partners and changing or laundering bed linen slept on by infested persons. Pediculicides should be applied to the pubic area and to any other infested body regions.

To reduce the spread of head lice, the sharing of combs, hats, earphones, and blankets, especially by children, should be discouraged. Often, parents of children with head lice are notified to keep youngsters away from school or other gatherings until the infestation has been eliminated. If the parents are also infested, this can further involve ridding the entire family of lice to prevent reinfestations. Various pediculicidal shampoos, lotions, and gels are widely available for controlling head lice. These treatments typically kill all nymphal and adult lice, but only a small proportion of viable louse eggs. Therefore, treatments should be repeated at weekly intervals for 2—4 weeks in order to kill any recently hatched lice. Hatched or dead nits which remain glued to hair may be unsightly or embarrassing, and these can be removed with a fine-toothed louse comb. Louse combs have been used, in various forms, since antiquity to remove head lice (Mumcuoglu 1996). A wide range of pediculicides is commercially available. Although its use is now banned in many developed countries, the organochlorine DDT is widely used, especially in less developed countries, for controlling human and animal lice. Several alternative pediculicides, such as lindane, chlorpyrifos, diazinon, malathion, permethrin, or pyrethrins, are currently used throughout the world. Pediculicides can be used in powders, fogs, or sprays to treat furniture or premises for lice. Several general parasiticides show promise as pediculicides. Avermectins such as abamectin, doramectin, and ivermectin can kill human body lice and livestock lice. Prescribed doses of these compounds can be administered orally, by injection, or as topical applications of powders, dusts, and pour-ons. However, many of these compounds have not yet been approved for use on humans. The development of novel control agents for lice is a constant process because resistance to various pediculicides has developed in lice in many parts of the world (Burgess 1995, Mumcuoglu 1996).

Lice of livestock can be controlled by both husbandry practices and chemical intervention. Providing a high-energy diet, especially to cattle, can be an effective louse control strategy. If possible, it is important to keep animals in uncrowded conditions and to spot-treat or quarantine any infested individuals until they have been successfully deloused. Various formulations and applications of pediculicides are typically used to control lice on livestock. Insecticidal dusts, powders, sprays, dips, ear tags, tail tags, resin strips, gut boluses, collars, pour-ons, lotions, and injections are widely used products. Infested animals should be treated twice weekly for 2—4 weeks. Insecticidal dust bags or back rubbers can be used as self-dosing rubbing stations for cattle and other livestock. Because louse populations on livestock are typically greater during the winter months, pediculicides are usually best applied to them in the late fall. Fall systemic treatments of cattle for both lice and bots are often administered. Shearing wool from sheep removes up to 80% of the lice present on infested animals.

Pets, laboratory animals, and poultry can be treated for lice in several ways. Pets such as dogs and cats can be dipped or bathed with a pediculicidal lotion or shampoo. Various oral or topically applied insecticides used for controlling fleas on pets also are efficacious against lice. Similarly, flea combs also remove lice from pets. Poultry and laboratory animals can be treated with pediculicidal dusts or sprays. Although host treatment is most efficacious, bedding materials and cages can also be treated. Insecticidal feed additives are also available. Insecticide-impregnated resin strips can be added to cages of poultry or laboratory animals to control lice. The bacterium Bacillus thuringiensis and the nematodes Steinernema carpocapsae and S. glaseri, which are effective biological control agents against numerous arthropods, can also be used to kill livestock lice. Some juvenile hormone analogs and insect growth regulators such as diflubenzuron have similarly shown promise as pediculicides.

With respect to louse-borne diseases, vaccines have been developed only against epidemic typhus, and none is completely safe or currently approved for widespread use. The live attenuated E-strain vaccine has been administered to humans, particularly in certain African nations, in attempts to quell epidemic typhus outbreaks. However, this vaccine actually caused disease in some patients and did not always prevent subsequent infection.

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