Prevention of louse-borne relapsing fever and typhus

Let us now focus on the common prevention aspects of relapsing fever and typhus. As we said earlier, these diseases are associated with overcrowding and insanitary conditions – in other words, they are associated with poverty. They are best prevented by addressing the underlying socioeconomic circumstances that promote louse infestation: overcrowding, poverty, homelessness and population displacement. However, you should also educate people in your community to take the following preventive actions:

• Maintain good hygienic practices, such as washing the body, clothes and bedding regularly, and drying clothes and bedding in direct sunlight, which damages the lice and their eggs to some extent
• Change clothes and bedding at frequent intervals to reduce the number of body lice
• Treat louse-infested clothes and bedding with chemicals to kill the lice and their eggs (this is called delousing). In infested situations like those in refugee camps, clothes and bedding should be deloused by trained personnel with appropriate insecticides, such as 0.5% permethrin dust or DDT. You are not expected to apply these chemicals. Treating clothing with liquid permethrin can provide long-term protection against louse infestation.

Note that close contact with patients should be avoided and delousing of the patient's clothes and bedding should be done immediately, to prevent transmission of infected body lice from the patient to healthy people – including the health professionals who are caring for them.

If there is an outbreak of relapsing fever or typhus, the spread of infection can be controlled by active case finding and effective treatment of infected persons and their close contacts with the correct antibiotics. These drugs have to be prescribed and monitored by doctors – you are not expected to give any drugs to patients with RF or typhus. Early treatment controls the spread of infection by reducing the reservoir of bacteria in the local population.