Body lice are not just an annoyance; they also pose a health risk. One of the diseases that lice can spread is bartonellosis (also called trench fever), and it can lead to life-threatening complications.
Homeless people are especially at risk for lice (and thus bartonellosis) because of poor clothing hygiene, lack of resources, exposure to cold weather, and environments that promote transmission of lice (such as crowding). The extent of this risk was more precisely defined by a recent study in San Francisco. Among homeless people who reported itching, 30% had lice; and of lice tested, 16% carried the bartonellosis organism. Risk factors for lice infestation were being male, being African American and sleeping outdoors.
Directing prevention information to these populations might help decrease transmission of lice. For example, those who sleep outside might benefit from learning about the importance of clean bedding and how to clean their bedding.
Bartonellosis is often mild but in serious cases it can affect the whole body. Early signs are fever, fatigue, headache, poor appetite, and an unusual, streaked rash. Swollen glands are typical, especially around the head, neck and arms.Also gastritis, lower abdominal pain, sore soles, and tender subcutaneous nodules along the extremities. Lymph nodes may be enlarged and the throat can be sore.