Bartonella quintana in Head Lice from Se´ne´gal Amina Boutellis, 1 Aure´ lie Veracx, 1 Emmanouil Angelakis, 1 Georges Diatta, 2 Oleg Mediannikov, 2 Jean-Franc¸ ois Trape, 2 and Didier Raoult 1 Abstract Head and body lice are strict, obligate human ectoparasites with three mitochondrial clades (A, B, and C). Body lice have been implicated as vectors of human diseases, and as the principal vectors of epidemic typhus, relapsing fever, and Bartonella quintata-associated diseases (trench fever, bacillary angiomatosis, endocarditis, chronic bacteremia, and chronic lymphadenopathy). Using molecular methods (real-time and traditional PCR), we assessed the presence of Bartonella quintana DNA in black head lice collected from three locations in Se´ne´gal. DNA from B. quintana was identified in 19 lice (6.93%) collected from 7 patients (7%) in Dakar. B. quintana- positive lice collected from three subjects were identified as clades C and A. Key Words: Bartonella quintana—Head louse—Pediculus humanus capitis—Se´ne´gal—Trench fever. Introduction H ead and body lice (Pediculus humanus capitis de Geer and Pediculus humanus humanus Linnaeus, respectively) are strict, obligate human ectoparasites that differ mainly in their habitat on the host, and have been parasites of humans for thousands of years (Light et al. 2008). The type A mtDNA phylotype is the most common among both head and body lice and is distributed worldwide (Ingman et al. 2000; Reed et al. 2004). The second mtDNA group (type B) occurs only in head lice, and has been found in the New World, Europe, and Australia. The third group (type C) has been found only among head lice from Nepal and Ethiopia (Kittler et al. 2003; Reed et al. 2004; Raoult et al. 2008). Traditionally, only body lice have been implicated as vectors of human diseases and as the principal vectors of epidemic typhus (Rickettsia prowazekii); louse-borne relapsing fever (Borrelia recurrentis); and trench fever, bacillary angiomatosis, endocarditis, chronic bacter- emia, and chronic lymphadenopathy (Bartonella Quintana; Brouqui 2011). Body lice usually feed five times per day; proteins in their saliva provoke an allergic reaction and lead to pruritus and scratching that facilitates the fecal transmission of these agents (Foucault et al. 2006). Recently, DNA from B. quintana has been found in head lice collected from home- less individuals in Nepal (Sasaki et al. 2006), the U.S. (Bonilla et al. 2009), France (Angelakis et al. 2011a), and Ethiopia (Angelakis et al. 2011b). Cases of endocarditis due to B. quintana have been reported in a patient in Se´ne´gal (Thiam et al. 2002), and in Se´ne´galese travelers to France (Monticrol et al. 2009) and to Switzerland (Barbe et al. 2000). The objec- tive of our study was to use molecular methods to assess the presence of B. quintana DNA in head lice collected from Se´ne´gal, where epidemiological and clinical studies of zoo- noses are scarce, and to identify which phylotyping clade they belong to. Materials and Methods The study was conducted during October and December 2010 and January 2011. After ethical approval for the search for pathogens responsible for non-malarial fever, and after informed consent was obtained from parents for minors, we collected head lice from different locations in Se´ne´gal: Kaolack City (14°14’N,16°08’W), Dakar City (14°34’N,17°29’W) and its suburbs, and two villages in the Fatick region, Dielmo and Ndiop (14°20’N,16°25’W). All lice were preserved dry in sterile conditions, except two that were kept in ethanol at room temperature and then sent to our reference center in Marseille in January 2011. Pictures of the ventral and dorsal sides of each louse were taken in the laboratory (Fig. 1). Before DNA isolation, each louse was rinsed twice in sterile water for 15 min. Then total genomic DNA was extracted from each louse using a QIAamp Tissue kit (Qiagen, Hilden, Germany) per the manufacturer’s instructions. The extracted genomic DNA was stored at -20°C under sterile conditions to avoid cross-contamination until the PCR assays were performed. DNA was used as a template in a previous study that utilized an RT-PCR assay targeting a portion of the Bartonella 16S-23S 1 Universite´ de la Me´diterrane´e, Faculte´ de Me´decine, Marseille, France. 2 Institut de Recherche pour le De´veloppement (IRD), Campus Commun UCAD-IRD of Hann, Dakar, Se´ne´gal. VECTOR-BORNE AND ZOONOTIC DISEASES Volume 12, Number 7, 2012 ª Mary Ann Liebert, Inc. DOI: 10.1089/vbz.2011.0845 564