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Background Louse-borne trench fever caused by Bartonella quintana is a neglected public health concern, known to be transmitted from body louse feces via scratching. No viable B. quintana have ever been isolated from head lice before; therefore, their role as a vector is still poorly understood. Methods In Senegal, the implementation of a permanent local surveillance system in a point-of-care laboratory (POC) allows the monitoring of emerging diseases. Here we used culture as well as molecular and genomic approaches to document an outbreak of trench fever associated with head lice in the village of Ndiop. Head lice and blood samples were collected from febrile patients between November 2010 and April 2015. Genomes of 2 isolated strains of B. quintana were sequenced and analyzed. Results A total of 2289 blood samples were collected in the 2010–2015 period. From 2010–2013, B. quintana DNA was detected by polymerase chain reaction (PCR) in 0.25% (4/1580). In 2014, 228 blood samples were collected, along with 161 head lice from 5 individuals. B. quintana DNA was detected in 4.4% (10/228) of blood samples, and in lice specimens collected from febrile patients (61.7%, 50/81) and non-febrile patients (61.4%, 43/70). Two B. quintana strains were isolated from blood and head lice from 2 different patients. Genomic sequence analysis showed 99.98% overall similarity between both strains. Conclusions The presence of live B. quintana in head lice, and the genetic identity of strains from patients' blood and head lice during a localized outbreak in Senegal, supports the evidence of head lice vectorial capacity. [ABSTRACT FROM AUTHOR]

Q fever and tick-borne borreliosis are two zoonotic diseases rarely diagnosed in Senegalese health facilities, particularly in rural areas. Our study aims to better understand the circulation of Coxiella burnetii and Borrelia spp. DNA on human skin and the domestic environment in rural areas. Cutaneous swabs were taken from febrile patients being treated for borreliosis and/or Q fever, the members of patients' households and control households in the Niakhar area. Dust samples were also collected from 90 households where 54 cases of borreliosis and Q fever were reported as well as from the households of members of control populations in Dielmo, Ndiop, and Niakhar. C. burnetii and Borrelia spp. DNA were detected by quantitative PCR in cutaneous swabs and dust samples targeting spacers IS 1111 _IS 30A and Bor 16S gene. Of 1365 persons tested, 76 were shown to carry C. burnetii , 13 Borrelia spp., and 6 were identified as carrying both C. burnetii and Borrelia spp. The prevalence of Borrelia spp. DNA in households was 16.7% in Dielmo, 6.7% in Ndiop, and 23.3% in all other villages in the Niakhar area, and the presence of C. burnetii in the same localities was 10%, 13.3% and 66.7%, respectively. Furthermore, C. burnetii genotyping identified the presence of Multispacer Sequence Typing group 6. These results revealed for the first time the carriage on the skin of C. burnetii and Borrelia spp. DNA in humans and its wide distribution across households. Our findings suggest that many populations are exposed to these diseases, with frequent contaminating cases of infectious origin arising from the domestic environment.

Pediculus humanus capitis , the head louse, is an obligate blood-sucking ectoparasite that occurs in six divergent mitochondrial clades (A, D, B, F, C and E). Several studies reported the presence of different pathogenic agents in head lice specimens collected worldwide. These findings suggest that head louse could be a dangerous vector and a serious public health problem. Herein, we aimed to study the mitochondrial genetic diversity, the PHUM540560 gene polymorphisms profile of head lice collected in Guinea, as well as to screen for their associated pathogens. In 2018, a total of 155 head lice were collected from 49 individuals at the Medicals Centers of rural (Maférinyah village) and urban (Kindia city) areas, in Guinea. Specimens were subjected to a genetic analysis and pathogens screening using molecular tools. Results showed that all head lice belonged to eight haplotypes in the E haplogroup, with six newly identified for the first time. The study of the PHUM540560 gene polymorphisms of our clade E-head lice revealed that 82.5% exhibited the same polymorphism profile as the previously reported clade A-body lice. Screening for targeted pathogens revealed the presence of Acinetobacter spp., while sequencing highlighted the presence of several species, including Acinetobacter baumannii , Acinetobacter nosocomialis, Acinetobacter variabilis, Acinetobacter towneri and for the first time Acinetobacter haemolyticus . Our study is the first to report the existence of the Guinean haplogroup E, the PHUM540560 gene polymorphism profile as well as the presence of Acinetobacter species in head lice collected from Guinea.