Τόμος 23 (2009) – Τεύχος 2 – Άρθρο 8 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Διεθνής Έκδοση – Volume 23 (2009) – Issue 2 – Article 8 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-International Edition

Title Homeless: a high risk group for ectoparasites infestation and arthropod-borne diseases
Authors Fotoula Babatsikouand Assimina Zavitsanou2

1. Department of Nursing and 2. Laboratory of Medical Entomology-Zoology, Department of Public Hygiene, Technological Educational Instituteion (TEI) of Athens, Hellas

Citation Babatsikou, F., Zavitsanou, A.: Homeless: a high risk group for ectoparasites infestation and arthropod-borne diseases, Epitheorese Klin. Farmakol. Farmakokinet. 23(2): 93-98 (2009)
Publication Date Accepted for publication (Final Version): July 1, 2009
Full Text Language English
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Keywords Arthropod borne diseases, ectoparasites, homeless.
Other Terms review article
Summary Introduction: Homeless people are at great risk for certain infectious diseases, as a result of their lifestyle and of other social factors. These diseases include several arthropod borne diseases, and it is well established that homeless people are particularly exposed to ectoparasites. The living conditions of this particular group, along with their limited access to health care services facilitate the spread of lice, fleas, ticks and mites. Methods: The medical literature was reviewed in order to present in detail the various ectoparasites that homeless people are exposed; moreover, the related arthropod-borne diseases that affect this specific risk group are being discussed. Results: Three species of louse have been shown to affect humans including Pediculus humanus capitis (head lice), Pediculus humanus humanus (body lice), and Phthirus pubis (public or crab louse). Among the above species, the body louse is the major concern for homeless people and the louse-borne diseases that this population is exposed are trench fever, relapsing fever and epidemic typhus. Several seroepidemiological studies conducted on the homeless report high prevalence rates of Bartonella quintana, the etiologic agent of trench fever. In addition, although no outbreaks of epidemic typhus have been reported so far in the homeless, there is evidence that the disease may occur. Although very few data are available in the international literature concerning the occurrence of relapsing fever in these populations, a small disease outbreak has been reported among homeless in France in 2002. Another ectoparasite affecting this high risk group is Sarcoptes scabiei var humanus, a mite that causes scabies. Scabies is more prevalent in the homeless than in the general population and are not potential vectors for infectious agents. Additionally, several studies show serological evidence of Bartonella henselae among homeless populations, a bacterium transmitted through the cat fleas. On the other hand, very few data are available on either tick borne diseases or tick infestation among homeless. Conclusions-Discussion: The major arthropod borne disease among homeless is trench fever, although there is evidence of transmission of other arthropod borne diseases. Implementation of public health interventions among homeless populations is a crucial step for diminishing the risk of arthropod borne diseases either in this high risk group or in the community.
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