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Genotyping of Human Lice Suggests Multiple Emergences of Body Lice from Local Head Louse Populations Wenjun Li1¤, Gabriel Ortiz1, Pierre-Edouard Fournier1, Gregory Gimenez1, David L. Reed2, Barry

Pittendrigh3, Didier Raoult1*

1 URMITE, UMR CNRS 6236, IRD 198, Université de la Méditerranée, Faculté de Médecine, Marseille, France, 2 Florida Museum of Natural History, Dickinson Hall, University

of Florida, Gainesville, Florida, United States of America, 3 Department of Entomology, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States of

America

Abstract

Background: Genetic analyses of human lice have shown that the current taxonomic classification of head lice (Pediculus humanus capitis) and body lice (Pediculus humanus humanus) does not reflect their phylogenetic organization. Three phylotypes of head lice A, B and C exist but body lice have been observed only in phylotype A. Head and body lice have different behaviours and only the latter have been involved in outbreaks of infectious diseases including epidemic typhus, trench fever and louse borne recurrent fever. Recent studies suggest that body lice arose several times from head louse populations.

Methods and Findings: By introducing a new genotyping technique, sequencing variable intergenic spacers which were selected from louse genomic sequence, we were able to evaluate the genotypic distribution of 207 human lice. Sequence variation of two intergenic spacers, S2 and S5, discriminated the 207 lice into 148 genotypes and sequence variation of another two intergenic spacers, PM1 and PM2, discriminated 174 lice into 77 genotypes. Concatenation of the four intergenic spacers discriminated a panel of 97 lice into 96 genotypes. These intergenic spacer sequence types were relatively specific geographically, and enabled us to identify two clusters in France, one cluster in Central Africa (where a large body louse outbreak has been observed) and one cluster in Russia. Interestingly, head and body lice were not genetically differentiated.

Conclusions: We propose a hypothesis for the emergence of body lice, and suggest that humans with both low hygiene and head louse infestations provide an opportunity for head louse variants, able to ingest a larger blood meal (a required characteristic of body lice), to colonize clothing. If this hypothesis is ultimately supported, it would help to explain why poor human hygiene often coincides with outbreaks of body lice. Additionally, if head lice act as a reservoir for body lice, and that any social degradation in human populations may allow the formation of new populations of body lice, then head louse populations are potentially a greater threat to humans than previously assumed.

Citation: Li W, Ortiz G, Fournier P-E, Gimenez G, Reed DL, et al. (2010) Genotyping of Human Lice Suggests Multiple Emergences of Body Lice from Local Head Louse Populations. PLoS Negl Trop Dis 4(3): e641. doi:10.1371/journal.pntd.0000641

Editor: Genevieve Milon, Institut Pasteur, France

Received September 4, 2009; Accepted February 8, 2010; Published March 23, 2010

Copyright: � 2010 Li et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors received no specific funding for this paper.

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: [email protected]

¤ Current address: Department of Molecular Genetics and Microbiology, Duke University Medical Center, Research Drive, Durham, NC, 27710, USA.

Introduction

Lice are extremely well-adapted ectoparasites that are usually

host-specific [1]. Three recognized taxa of lice feed on humans:

head lice (Pediculus humanus capitis), body lice (Pediculus humanus

humanus), and pubic lice (Pthirius pubis), feed on humans. As one

of the most intimate parasites of humans, lice have been widely

used as a genetic model to infer host evolutionary history by

providing genetic date independent of host data [1,2]. Several

nuclear and mitochondrial DNA sequences have previously

been used in population genetic studies of human lice. Of these,

the nuclear DNA sequences, EF-1a and 18S rDNA, discrimi- nated lice into two subgroups, lice from Sub-Saharan Africa and

lice worldwide[3]. In each subgroup, the head lice were

genetically different from the body lice [3]. However, Leo

et al. suggested that 18S rDNA phylogeny was concordant with

the phylogenies from mitochondrial genes, but the EF-1a phylogeny was concordant neither with the mitochondrial

phylogenies nor with the 18S rRNA phylogeny [4]. Further-

more, the mitochondrial DNA markers, partial COI and cytB

classified the lice into three deeply divergent clades (Clades A,

B, and C), and each having unique geographical distribution.

Clade A includes both head and body lice and is worldwide in

distribution. Clade B consists only of head lice from America,

Australia and Europe, and Clade C consists only of lice from

Ethiopia and Nepal [5].

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More variable genetic markers, such as internal transcribed

spacers (ITS) of ribosomal DNA and microsatellite DNA, were also

used to deduce the louse phylogeny. However, the ITS that was

chosen was not useful to study the populations structure of human

lice because some of the lice had more than one copy of ITS2 in

their genome [6]. A subsequent microsatellite DNA-based study

has suggested that human head and body lice are genetically

distinct [7], however recent studies contradict this hypothesis [5,8].

Taken together, the population structure of human lice is complex

and still unclear. The previously used genetic markers were mostly

mitochondrial and nuclear genes that were too conserved to

generate more information of genetic diversity of studied louse

isolates. So far, no genetic marker has been found that can

discriminate among individual human lice.

While being used as a suitable genetic model to study the

evolutionary history of humans, lice have long been associated

with infectious diseases. Of the three types of lice associated with

humans, body lice can be a serious public health problem because

they are known vectors of Rickettsia prowazekii, Bartonella quintana,

and Borrelia recurrentis, which cause epidemic typhus, trench fever

and relapsing fever in humans, respectively [9]. However, medical

interest in louse-borne diseases had waned for more than 30 years

until 1997, when an outbreak of infection of louse-transmissed R.

prowazekii and B. quintana occurred among the displaced population

of Burundi [10,11].

Body lice have long been recognized as human parasites and

although typically prevalent in rural communities in upland areas

of countries close to the equator, high incidence of louse-borne

infections are also increasingly found in the homeless in developed

countries [9,12,13]. In contrast, head lice represent a major

economic and social concern throughout developed nations,

because head louse infestations are often associated with school-

aged children.

Faster evolving molecular markers are needed in order to

epidemiologically survey the vectors of these bacterial infections and

to address more recent population-level questions, [8,14]. Among

these fast-evolving genetic markers, intergenic spacers are promising

for individual discrimination of lice because they are under less

evolutionary pressure, and are more variable than coding genes.

These factors make intergenic spacers useful for understanding the

population genetics of lice. Highly variable intergenic spacers are

useful for strain-typing many bacteria, including louse-transmitted

R. prowazekii and B. quintana [15,16] as well as other pathogenic

bacteria [17]. Additionally, intergenic spacer sequences for

individual discrimination of lice, are now publicly available [14].

In this study, we used four highly variable intergenic spacers that

were selected from the genomic sequence to study the genotypic

distribution of a large collection of lice of worldwide origins.

Methods

Louse collection and DNA preparation Two hundred and eighty-four human lice collected from Russia,

France, Portugal, Mexico, USA, UK, Morocco, Algeria, Peru,

Thailand, Australia, Rwanda, and Burundi were included in this

study. Lice were collected by experienced entomologists from

patients who had only one type of infestation (head or body) and

classified according to the site where they were found. Among

them, only 97 lice were tested with four nuclear intergenic spacers,

other 110 and 77 lice were tested with two intergenic spacers,

respectively, due to limited DNA quantity. The strain information,

including origin, the body part where they were removed (body or

head), and the year when it was collected are given in Figure 1 and

Figures S1 and S3. In addition, to estimate the utility of multi-

spacer typing (MST) of louse populations, we also studied two

body lice from our laboratory colony (Culpeper strain) per year,

collected in 1998, 1999, 2000, 2003, 2004 and 2009. From 1998 to

2009, our louse colony went through 132 generations.

All lice were stored at 220uC until processed further. Before DNA isolation, each louse was rinsed twice in sterile water for 15

minutes and cut lengthwise in half. Then, total genomic DNA of

each half louse was extracted using the QIAamp Tissue kit

(QIAGEN, Hilden, Germany) as described by the manufacturer.

The extracted genomic DNA was stored at 220uC until PCR amplification.

Selection of nuclear intergenic spacers as typing markers and primer design

The nuclear intergenic spacers were randomly selected from the

genomic sequence of Pediculus humanus humanus UDSA strain

(http://phumanus.vectorbase.org/index.php) and were identified

with flanking genes which exhibited .40% sequence identity with

homologous genes in the Vectorbase [14,18]. Primers used for

amplification and sequencing of these intergenic spacers were

chosen from the flanking genes using the Primer 3.0 software

(http://frodo.wi.mit.edu/cgi-bin/primer3/primer3_www.cgi) and

are listed in Table 1. All Primers used in this project were obtained

from Eurogentec (Seraing, Belgium).

As the testing of all intergenic spacers on all louse samples was

labor intensive, a panel of 16 lice from a wide range of origins was

first used to test for the validity and the presence of polymorphisms

for each of the intergenic spacers. Subsequently, the intergenic

spacers with successful amplification and sequencing from the 16

tested louse samples, were finally used as markers in order to

genotype the remaining strains.

Amplification and sequencing of intergenic spacers PCR amplification of each intergenic spacer was carried out in a

PTC-200 automated thermal cycler (MJ Research, Waltham, MA,

USA). 1 ml of each DNA preparation was amplified in a 20 ml reaction mixture containing 10 pM of each primer, 2 mM of each nucleotide

Author Summary

While being phenotypically and physiologically different, human head and body lice are indistinguishable based on mitochondrial and nuclear genes. As protein-coding genes are too conserved to provide significant genetic diversity, we performed strain-typing of a large collection of human head and body lice using variable intergenic spacer sequences. Ninety-seven human lice were classified into ninety-six genotypes based on four intergenic spacer sequences. Genotypic and phylogenetic analyses using these sequences suggested that human head and body lice are still indistinguishable. We hypothesized that the phenotypic and physiological differences between human head and body lice are controlled by very limited mutations. Under conditions of poor hygiene, head lice can propagate very quickly. Some of them will colonize clothing, producing a body louse variant (genetic or phenetic), which can lead to an epidemic. Lice collected in Rwanda and Burundi, where outbreaks of louse-borne diseases have been recently reported, are grouped tightly into a cluster and those collected from homeless people in France were also grouped into a cluster with lice collected in French non-homeless people. Our strain-typing ap- proach based on highly variable intergenic spacers may be helpful to elucidate louse evolution and to survey louse- borne diseases.

Head and Body Lice

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(dATP, dCTP, dGTP and dTTP), 4 ml of Phusion HF buffer, 0.2 ml of Phusion polymerase enzyme (Finnzymes, Espoo, Finland) and 12.4 ml of distilled water. The following conditions were used for the

amplification: an initial 5 min of denaturation at 95uC, followed by 35 cycles of denaturation for 1 min at 94uC, an annealing time of 30 sec at 56uC, and an extension cycle for 1 min at 72uC. The amplification was completed by an extension period of 5 min at 72uC.

PCR products were purified, using the MultiScreen PCR filter

plate (Millipore, Saint-Quentin en Yvelines, France), as recom-

mended by the manufacturer. PCR products were then sequenced

in both directions, with the same primers used for PCR

amplification, using BigDye Terminator version 1.1 cycle

sequencing ready reaction mix (Applied Biosystems, Foster City,

CA). Sequencing products were resolved using an ABI 3100

automated sequencer (Applied Biosystems). Sterile water was used

as a negative control in each assay.

Amplification and sequencing of partial cytB gene In order to compare the discriminatory power of intergenic

spacers with genes, as well as to compare their phylogenetic

organizations, the mitochondrial gene, cytB (cytochrome b) was

amplified and sequenced from those louse samples when there was

DNA to perform the PCR experiments. The primers used for this

experiment were CytbF1 (59-GAGCGACTGTAATTACTAATC-

39) and CytbR1 (59-CAA CAA AAT TAT CCG GGT CC-39) [19].

Sequence analysis and phylogenetic analysis Nucleotide sequences were obtained using Sequencher 4.8 (Gene

codes Corp, Ann Arbor, MI, USA). The primers used to amplify

intergenic spacers were selected based on flanking gene sequences.

The sequences from the coding sequence fragments were not used

in the analyses. For each intergenic spacer, and cytB, a genotype was

defined as a sequence exhibiting a unique mutation. Each genotype

was confirmed to be unique by BLASTn search in all the obtained

sequences [20]. Multiple sequence alignments were carried out

using the Clustal W software [21]. Phylogenetic analysis of the lice

that were studied was obtained using the neighbor-joining and

maximum parsimony methods within the MEGA 3.1 software with

complete deletion [22] and using the maximum likelihood method

in PhyML 3.0 with SH-like approximate likelihood-ratio test and

HKY85 substitution model [23,24]. For this purpose, sequences of

the selected intergenic spacers were concatenated.

Comparison of discriminatory power intergenic spacers with cytB

The discriminatory power (D) of each intergenic spacer, and

cytB, was calculated with the Hunter and Gaston’s formula [25].

D~1{ 1

N N{1ð Þ Xs

j~1

xj xj {1 � �

Accession numbers DNA sequences obtained from the S2 and S5 spacers, the PM1

and PM2 spacers and the cytB gene were deposited in GenBank

under accession numbers EU928781-EU928862, EU913096-

EU913223, and GU323324-GU323334respectively.

Figure 1. Phylogenetic organization of 97 human lice based on concatenation of four nuclear intergenic spacers, PM1, PM2, S2, and S5, using the neighbor-joining method. doi:10.1371/journal.pntd.0000641.g001

Head and Body Lice

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Results

Four nuclear intergenic spacers, S2, S5, PM1, and PM2, were selected as typing markers

Twenty-two nuclear intergenic spacers were initially selected

from the genomic sequences and preliminary tested on 16 louse

samples (Table 1). However, due to non-specific amplification, or

low sequencing quality, 18 intergenic spacers were removed from

this study. Finally, four intergenic spacers, hereafter termed S2, S5,

PM1, and PM2, were used as typing markers in this study (Table 1).

Through amplification and sequencing, 165–185 bp of S2 and

156–189 bp of S5 were obtained from 207 louse samples and133–

155 bp of PM1 and 323–328 bp of PM2 were obtained from 174

louse samples. Sequences from the different genotypes of the four

intergenic spacers have been deposited in the EMBL/GenBank

database with access numbers: EU928781-EU928862 for S2 and

S5 and EU913096-EU913223 for PM1 and PM2.

Genotypic distribution of studied lice based on intergenic spacers

Two hundred and seven lice were differentiated into 84 and 49

genotypes based on intergenic spacers S2 and S5, respectively.

Concatenation of S2 and S5 sequences differentiated the 207 lice

into 148 genotypes.

One hundred and seventy-four lice were differentiated into 25

and 62 genotypes based on intergenic spacers PM1 and PM2,

respectively. Concatenation of PM1 and PM2 sequences differen-

tiated the 174 lice into 77 genotypes.

Further concatenation of S2, S5, PM1, and PM2, discriminated

a panel of 97 lice into 96 MST genotypes. Except for two lice

collected from French homeless people which shared the MST

genotype 89, the other 90 lice exhibited unique MST genotypes

based on the concatenation of four intergenic spacers.

Sequences from each of the four intergenic spacers S2, S5,

PM1, and PM2 were identical among the 12 body lice from our

laboratory colony collected over 12 years. The genotypes obtained

were: 8, 6, 18, and 39 for S2, S5, PM1 and PM2, respectively.

Genotypic distribution of lice based on the mitochondrial gene cytB

A partial cytB gene sequence was amplified and sequenced from

170 lice. A 316 bp fragment was obtained from each louse after

sequence correction and assembling. The cytB sequences were used

to classify the 170 lice into 11 genotypes. The body lice sampled

from our laboratory colony over 132 generations exhibited

identical cytB sequences (genotype 4).

Discriminatory power of each marker The discriminatory power (D) of the intergenic spacers, PM1,

PM2, S2, and S5 was respectively 0.6988, 0.8406, 0.9677, and

0.8913. The D value of cytB was 0.6445. The D value of

concatenation of intergenic spacers varied from 0.9123 for

concatenation of PM1 and PM2 to 0.9945 for concatenation of

S2 and S5. A D value of 0.9998 was reached by combined use of

the four intergenic spacers.

Phylogenetic organization of lice based on intergenic spacers and partial cytB

The dendrograms of studied lice inferred by the methods of

neighbor-joining, maximum parsimony, and maximum likelihood

Table 1. The name, position on supercontig, size, and primers used for amplification of 22 intergenic spacers.

Name Start End Foward primer (59-39) Reverse primer (59-39) Size (bp)

S1 27999 28435 GACCAACCAACCAGCCAATA TTCCAGAAGCCTTGTTACCG 437

S2 665433 665920 ATGATGTGCATTGCGAGTGT AAACTTAACCCGGGCCCTAT 488

S3 44210 44721 GAAAGTGACGACGATGACGA TCCCAATTTTTGTTTCCCTG 512

S4 76618 77129 ACCCGATAAACCGACAGATG TTTGCCCATACAGCAATTCA 512

S5 69159 69650 TCCAAATGAAACCCACACTTT TGGCAGACACTGCTTCCTTA 492

S6 63422 63928 AACAAAACAATTTGACCCGC GCATCTTTAAATCCGACAATTTT 507

S7 188992 189457 ATGATTGCATCACTCCGTCA CGTTGAGGAATCTGGCATTT 466

S8 64865 65355 GGATTTGCAAAAAGCGGATA ATTTGCCGGGTAGGGTACTT 491

S9 292090 292560 AAGTTTTGTGCTCAAAGCG AATTCGCAGACGTAAAGCGT 471

S10 86299 86794 TCTTTAGCAAAACTTGGTGATGAG TGCCTGAAGAGCTTCACATT 496

S11 22923 23408 AGGAATTGGATGAATTGCTCA ATGACTGTGACTTCCAGCCC 486

S12 20812 21327 CCGCTGAACGAATCTTTCTC TCATCCCTTGTTTTTCCACC 516

S13 155485 155887 TGGTTGTTTTTCACCCATTG AAACCCGAGCGAATGTTTT 403

S14 228690 229166 TAATACGGAAAAATGCGTCG CGATCGGAATTGTGAGGTTT 477

S15 279599 280127 CCTGAACAACTTGAAAGAATTGC GGCAAGCCAAAACACCTAAA 529

S16 41948 42461 GGGGAAATAAAACAAGAGGAGG CAACCGGGTGACCACATTAT 514

S17 248360 248834 TGATTTAGGTGGATTTCACGG TTTCCAACGAATTTCGAACC 475

S18 321921 322390 ATCTCTGTTTTCAGTGGCGG TCTGGTTTACAGGTGTCGAAAA 470

S19 204723 205216 AAAACAAACAGACGTAGAAAGCG GGGGGTAAACAAAATGGGTAA 494

S20 603 1045 GGATTTTCTGTTTTGCGTTTT TTGGTTCTGCATGAAATACGTT 443

PM1 538639 538857 GAAATAATATCCAACCTCGTTCA CATTCTTCCTCATCAAGCTGC 217

PM2 115253 115810 CCGAAGGAGCTGATTCTTTT CCACAACGAGTGATGTGAGC 437

doi:10.1371/journal.pntd.0000641.t001

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exhibited similar phylogenetic organizations (Figures 1 – 3, Figures

S1 – S6).

The 148 genotypes of intergenic spacers S2 and S5, were

grouped into 3 clusters, C1, C2, and C3 (Figure S1). Each

cluster included both head and body lice. In addition, genotypes

96 and 101 consisted of two body lice and two head lice,

respectively (Figure S1). A subcluster (Burundi and Rwanda

subcluster) in cluster C3 was comprised of 29 lice from Burundi

and Rwanda and one louse from Russia. The other 24 lice

collected in Rwanda and Burundi were grouped into cluster C2.

The majority of French lice, including those collected from

homeless people, were grouped into a sub-clade within cluster

C1 (Figure S1).

The 77 nuclear intergenic spacer-genotypes, for PM1 and PM2,

were grouped into 2 distinct clusters (Figure S3). Cluster C1

included 148 lice collected from Russia, Mexico, France, UK,

USA, and Portugal as well as one louse from Rwanda (Figure S3).

A subcluster in cluster C1 contained 31 lice from France and 2 lice

from Portugal, which is hereafter referred to as the ‘‘French

subcluster’’. The 19 lice collected from French homeless

individuals were tightly grouped with French lice in cluster C1

(Figure S3). Cluster C2 was comprised of 25 lice collected from

Figure 2. Phylogenetic organization of 97 human lice based on concatenation of four nuclear intergenic spacers, PM1, PM2, S2, and S5, using the maximum likelihood method. doi:10.1371/journal.pntd.0000641.g002

Figure 3. Phylogenetic organization of 170 human lice based on partial cytB gene using using the neighbor-joining method. doi:10.1371/journal.pntd.0000641.g003

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Rwanda and Burundi. Genotypes 6, 29, and 32, were observed in

both head and body lice.

Based on the concatenation of the four intergenic spacers PM1,

PM2, S2, and S5, the 97 lice were discriminated into 96 MST

genotypes and grouped into two clusters (Figures 1 and 2). Cluster

C1 included 75 lice from Russia, France, Mexico, and Portugal,

and Cluster C2, the Burundi and Rwanda cluster, contained 22

lice from Burundi and Rwanda (Figure 1). Lice collected from the

French homeless individuals were tightly grouped with French lice

into two subclusters within C1 (Figure 1).

The 11 genotypes of cytB from 170 lice were grouped into 2

clusters (Figure 3). Cluster C1 included 111 lice from France,

Russia, UK, USA, Mexico, Portugal, Burundi, and Rwanda

(Figure 3), and corresponded to Type A in a study by Light et al

[5]. Cluster C2 included 59 lice from the UK, USA, and Mexico,

and corresponded to the Type B reported by Light et al. [5].

Genotypes 4 and 6 comprised both head and body lice.

Discussion

In this study, MST based on four highly variable intergenic

spacers selected from the genomic sequence of a body louse,

classified 97 lice into 96 MST genotypes. To date, MST appears to

be the most sensitive discriminatory genotyping system of human

lice, allowing for discrimination of individuals. In addition, MST

helped us to address several important debates associated with

human lice. One of the ongoing debates is whether head and body

lice are separate species or two subspecies within Pediculus humanus

[3,4,7,8,26]. To address this issue, most of the previous studies

have used mitochrondrial or nuclear genes to evaluate and

compare the genetic variability of human head and body lice.

Studies based on the mitochondrial gene COI [26], the

mitochondrial genes cytB and ND4 and nuclear genes EF-1a and RPII [27], the mitochondrial genes cytB and COI [28], or the

nuclear gene 18S rDNA [4], supported the hypothesis that human

head and body lice are conspecific. Using previously published

sequence data, by reticulated networks, gene flow, population

genetics, and phylogeny analysis, Light et al. [8] also observed that

human head and body lice are conspecific.

However, a recent study performed by Leo et al. [7], in which

microsatellites were used as genetic markers, concluded that

human head and body lice are two distinct species. These studies

made opposite conclusions by using different genetic markers. The

low discriminatory power of previously used markers limited their

ability to provide convincing evidence whether head and body lice

are subspecies of one species or two distinct species.

Our genotypic and phylogenetic analyses using MST did not

support the hypothesis that human head and body lice are

separate species. For instance, genotype 32, which was a

concatenation of the intergenic spacers PM1 and PM2, was

comprised of 44 head lice from the USA and the UK as well as

one body louse from Europe (Figure S3). Genotypes 6 and 29 were

comprised of both head and body lice collected in France (Figure

S3). Genotypes 96 and 101, a concatenation of the intergenic

spacers S2 and S5, also were comprised of both head and body lice

(Figure S1).

Phylogenetic organizations of head and body lice based on each

of the four intergenic spacers, and on concatenation of both,

support the hypothesis that head lice were grouped with body lice

in the same clusters or subclusters (Figure 1, Figures S1 and S2).

The changing tree topography observed among spacers may be

related to differences in selection pressure that their flanking genes

undergo. The genotypic distribution of 170 lice based on partial

cytB gene sequences, and the phylogenetic organization of 11 cytB

genotypes, also demonstrated that head and body lice shared the

same cytB genotypes and were grouped in the same cluster

(Figure 2), which further confirmed the hypothesis that human

head and body lice are conspecific [3,27,28].

In our study, although only two clusters were observed based on

partial cytB gene sequences, cluster C1 contained both head and

body lice from worldwide origins, and cluster C2 included only

head lice from America and Europe (Figure 3). This result did not

contradict the previous observation [19] of three deeply divergent

clades of human lice, as our study did not include lice from either

Ethiopia or Nepal. However, the phylogenetic organization of cytB

sequences was significantly simpler than those based on intergenic

spacers. Three and two clusters were respectively obtained from

the concatenations of the intergenic spacers S2 and S5 (Figure S1),

and the intergenic spacers PM1 and PM2 (Figure S3). Addition-

ally, two clusters were generated from the concatenation of the

four intergenic spacers PM1, PM2, S2 and S5 (Figure 1, Figures

S1 and S2). Each cluster was comprised of several subclusters, such

as the French subcluster, including the majority of French lice, and

the Rwanda/Burundi cluster, which also consisted of lice collected

from sub-Saharan Africa (Figure 1, Figures S1 and S2). This

discrepancy of phylogenetic organizations obtained from interge-

nic spacers and cytB sequences resulted, at least partially, from the

high variability of intergenic spacers, which enabled individual

discrimination of human lice. In addition, these differences may

also be explained by the fact that the louse samples incorporated in

each phylogenetic analysis were different due to limited DNA

available for such experiments. Furthermore, louse genomic DNA

may be highly recombined, which would in turn result in distinct

phylogenetic organization from different markers [8]. Thus,

collecting more louse samples with wide origins, especially lice

from Ethiopia and Nepal, and subjecting them to MST analysis,

would help to further clarify the relationship between head and

body lice.

Human head and body lice are strict obligate human

ectoparasites that differ in several aspects of their morphology,

physiology and life histories. Head lice are mostly found on the

head and attach their eggs to the base of hair shafts, whereas body

lice reside in clothing and attach their eggs to clothing fiber, a life

history strategy that probably arose when humans first began

wearing clothes [27]. By comparison with body lice, head lice have

been described as having shorter and broader antennae, shorter

legs, more marked indentations between successive abdominal

plates, and as being larger and more deeply pigmented [29,30].

However, such morphological differences have been determined

on a small number of lice and may not hold at the species level

[29]. Body lice also take a larger blood meal, lay higher numbers

of eggs and develop faster than head lice [29,31,32]. In addition,

body lice are more resistant to environmental conditions, can stay

alive for longer period of time outside the host, are able of

transmitting infectious diseases, and are mostly found in adults

whereas head lice are essentially found in children [29]. Despite

various genetic differences [1–8], detailed above, head and body

lice have been shown to be able to interbreed [30].

Lice are extremely well adapted ectoparasites, which are usually

host-specific by co-speciation with their host [2,28,33]. Thus, lice

have become a good genetic model for studying specific aspects of

human evolution, including addressing when our human ancestors

began to wear clothing. Very recently, a study based on sequence

analysis of COI and cytB from human head and body lice suggested

direct contact between modern and archaic humans [28]. More

recently, Light et al. [34] verified this hypothesis by using both

nuclear and mitochondrial genes [34]. However, these studies

were based on conserved mitochondrial or nuclear genes, which

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provided limited genetic variability of studied lice. In our study, we

also tested the use of highly variable intergenic spacers for strain-

typing of human lice to explore human evolutionary history.

Concatenation of these highly variable intergenic spacer sequences

classified some lice from Rwanda and Burundi into a basal cluster

or subcluster and grouped other lice collected in Rwanda and

Burundi with lice from North Africa, Europe, USA, and Asia,

which supports the hypothesis that human beings originated in

Africa (Figure 1, Figures S1 and S2). Thus, highly variable

intergenic spacer sequences could be used to study the evolution

history of human lice and its host. It might be argued that, due to

fast evolution and high polymorphism, intergenic spacers may not

be able to fully reflect long-term dynamic changes of populations.

However, we observed that MST was a valuable tool for tracing

distinct louse populations, and was not biased by mutations that

might arise within a single population over time, for at least 132

generations. Nevertheless, we recommend using a combination of

coding genes and intergenic spacers because coding genes are

conserved enough to highlight evolutionary relationships, and the

intergenic spacers are variable enough to identify fine-scale genetic

variability.

While lice may present a valuable model to study its host

evolution, human head and body lice cause serious health and

social problems. Head lice are common worldwide, infesting

millions of school children every year and the resistance of Pediculus

humanus capitis to insecticides is spreading [35]. Body lice are less

prevalent parasites, associated mainly with those living in poor

conditions, but are potentially more harmful because they are

known vectors of at least three bacterial pathogens in humans: R.

prowazekii, B. quintana, and B. recurrentis. There have been several

outbreaks of louse-borne R. prowazekii infections in Burundi and

Rwanda jails in 1997 and 2001, and sporadic R. prowazekii

infections were also recently reported [9]. Epidemiological surveys

of these louse-borne diseases are also very important for us to

understand and potentially combat these diseases. In addition,

recent evidence has been brought that head lice are potential

vectors of B. quintana [36,37], and their role in the epidemiology of

epidemic typhus has been questioned [38]. Other studies have

identified two endosymbiotic bacteria that have co-evolved in head

and body lice [39–41]. However, whether these symbionts have

any influence on louse behavior, development and/or competence

as disease vectors is as yet mostly unknown.

Based on phylogenetic analysis of the four intergenic spacers,

S2, S5, PM1, and PM2 as well as a concatenation of them, the

head and body lice collected from Rwanda and Burundi tightly

grouped together to form clusters as well as subclusters (Figure 1,

Figures S1 and S2). In addition, the lice collected from homeless

people in France grouped tightly with those collected in non-

homeless French people, which suggested louse populations

migrate between homeless people and non-homeless people in

France and homeless people are known to be at high risk for louse-

borne diseases [9,11,12].

MST may ultimately be a good tool for performing surveys

associated with louse transmission and louse-borne diseases. In

addition, our MST analysis demonstrated that head and body lice

collected in Rwanda and Burundi in 1997, 2001, 2003, and 2008,

were closely grouped (Figure 1, Figures S1 and S2). Thus, the

outbreak of louse-borne R. prowazekii infection that happened in

1997 and 2001 opens up the possibility that lice in this region may

still pose a risk for the transmission of R. prowazekii to humans.

However, clear separation of African lice (collected from Rwanda

and Burundi) from other lice was not recovered by intergenic

spacers S2 and S5, likely due to recent recombination of nuclear

DNA [8].

As mentioned above, head lice are different from body lice

morphologically and physiologically. It is possible that these

phenotypic differences are controlled by a single mutation or

potentially a regulatory gene (or genes) governing, for example, the

volume of ingested blood. This is the simplest explanation to

understand the genetic data showing that lice have exactly the

same origin. Under certain conditions of low hygiene, a head louse

infestation can transform into a massive infestation (Figure 4).

Certain head lice could colonize clothing (Figure 5), and produce a

body louse variant by purifying selection or allotropism, which can

in turn generate an epidemic of body lice (Figure 6). Several

previous observational studies had also suggested that head lice

could become body lice when raised in appropriate conditions

[42–44]. If this scenario is true, the body louse reservoir is not

autonomous and actually depends upon head lice. Previous work

has shown that all body lice arose from mitochondrial Type A [5],

which suggests that only that genotype has the ability to evolve

into the body louse niche. This also makes it possible to

understand the difficulties to eradicate body lice in a community,

especially when the patients are surrounded by other individuals

that are infested by head lice. In our clinical work in Marseilles,

France, despite 10 years of attempts to minimize human louse

populations, body lice continually reappear and may be due to the

persistence of head louse populations [45,46]. Recent work

demonstrating the presence of B. quintana in head lice [36,37]

suggested that they might also transmit infectious diseases, which

supports our hypothesis presented in Figure 6, giving them a

greater opportunity to ingest circulating bacteria [29,31], and that

head lice are rarely collected and tested, even when present, in

outbreaks of louse-borne infections, may explain why head lice

have long been considered to be free from human pathogens.

In conclusion, by strain-typing of human head and body lice

using both coding sequences and highly variable intergenic

spacers, our data supports the hypothesis that human head and

body lice belong to the same species. Based on genotypic and

phylogenetic analyses, we also hypothesize that head lice may

Figure 4. Heavily infested hair with Pediculus humanus capitis (arrow). The patient gave informed consent for use of this picture. doi:10.1371/journal.pntd.0000641.g004

Head and Body Lice

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Figure 5. Pediculus humanus capitis eggs attached to tissues (A) in a cap (B). The patient gave informed consent for use of this picture. doi:10.1371/journal.pntd.0000641.g005

Figure 6. Proposed scenario for the evolution of head and body lice. (A) Head lice propagate among humans; (B) in heavily infested patients, head lice might lay eggs in clothes, and resulting lice might develop and subsequently spread among humans as body lice. doi:10.1371/journal.pntd.0000641.g006

Head and Body Lice

www.plosntds.org 8 March 2010 | Volume 4 | Issue 3 | e641

transform into body lice [47] and cause outbreaks of louse-borne

diseases. However, more efforts on the genetic studies of head and

body lice are necessary to link their genetic difference with

morphological and physiological diversity. Whole genome se-

quencing of head lice and comparative genomics between head

and body lice would be useful to address these questions. In

addition, due to its high resolution and reasonable phylogenetic

classification, MST based on highly variable intergenic spacer

sequences may be helpful for the epidemiological survey of louse-

borne diseases.

Supporting Information

Figure S1 Phylogenetic organization of 207 human lice based

on concatenation of two nuclear intergenic spacers, S2 and S5,

using the Neighbor-joining method.

Found at: doi:10.1371/journal.pntd.0000641.s001 (0.02 MB PDF)

Figure S2 Phylogenetic organization of 207 human lice based

on concatenation of two nuclear intergenic spacers, S2 and S5,

using the Maximum parsimony method.

Found at: doi:10.1371/journal.pntd.0000641.s002 (0.02 MB PDF)

Figure S3 Phylogenetic organization of 174 human lice based

on concatenation of two nuclear intergenic spacers, PM1 and

PM2, using the Neighbor-joining method.

Found at: doi:10.1371/journal.pntd.0000641.s003 (0.04 MB PDF)

Figure S4 Phylogenetic organization of 174 human lice based

on concatenation of two nuclear intergenic spacers, using the

Maximum parsimony method.

Found at: doi:10.1371/journal.pntd.0000641.s004 (0.04 MB PDF)

Figure S5 Phylogenetic organization of 97 human lice based on

concatenation of four nuclear intergenic spacers, PM1, PM2, S2,

and S5, using the Maximum parsimony method.

Found at: doi:10.1371/journal.pntd.0000641.s005 (0.05 MB PDF)

Figure S6 Phylogenetic organization of 170 human lice based

on partial sequence of the cytB gene, using the Maximum

parsimony method.

Found at: doi:10.1371/journal.pntd.0000641.s006 (0.02 MB PDF)

Acknowledgments

The authors are thankful to Herve Tissot-Dupont and Aurelie Veracx for

providing pictures of patients, and to one of the reviewers who providing

constructive comments and suggestions to improve the manuscript.

Author Contributions

Conceived and designed the experiments: DR. Performed the experiments:

WL GO GG. Analyzed the data: WL GO PEF GG DLR BP DR. Wrote

the paper: WL PEF DLR BP DR.

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