@article {221,
	title = {Antibody and antibiotic action on Rickettsia prowazeki in body lice across the host-vector interface, with observations on strain virulence and retrieval mechanisms},
	journal = {American Journal of Epidemiology},
	volume = {98},
	year = {1973},
	note = {1209},
	month = {1973},
	pages = {262 - 282},
	abstract = {Using a membrane feeding technique to administer known quantities of rickettsiae,antibodies and antibiotics, the influence of a series of variables in the host-vector-agent interaction on the replication of Rickettsia prowcizeki
in the human body louse was examined. Rickettsial replication
and louse death patterns were indistinguishable whether the lice were
infected with the virulent Breini or the attenuated E strain. Ingestion
of blood containing clinically attainable levels of doxycycline or ritampin
inhibited rickettsial growth in lice and delayed their death from infection.
However, 4 days of "treatment" with either antibiotic failed to
eradicate the rickettsiae from the lice and, after a delay, peak rickettsial
populations equalled those of untreated controls. Antibodies in
serum from a person solidly immune to typhus had no influence at any
stage on the rickettsial infection in the louse. The rickettsiae excreted
by such lice had detectable amounts of immunoglobulins on their surface.
Regardless of strain virulence for man, or the presence or absence
of antirickettsial antibodies or of prior exposure to antibiotics, the rickettsiae
attained a peak population of 1-2 X 108 organisms per louse.
Some of the conclusions drawn from these studies and bearing on the
epidemiology and control of typhus are as follows: 1) Body lice do not
appear to discriminate between rickettsial strains of high and low
virulence for {\textquoteright}man and, in nature, might be capable of transmitting
strains of low virulence it available in the blood. 2) Effective antibiotic
therapy does not eradicate the rickettsiae from infected lice feeding
upon treated patients. The prolonged survival of "treated" infected lice increases the opportunity for typhus transmission and enhances the possibility for the selection of antibiotic resistant rickettsiae. The importance, therefore, of effective louse control measures concurrent with antibiotic therapy is emphasized. 3) If rickettsiae are present in sufficient numbers in the blood of immune or partially immune individuals,
lice should be able to (a) retrieve them, (b) provide a favorable environment
for their massive replication and (c) reintroduce them into the transmission sequence.},
	keywords = {antibiotics, antibody, body lice, doxycyline, immunity, Pediculus humanus humanus, Rickettsia prowazeki, rifampin, typhus},
	url = {http://www.phthiraptera.info/Publications/40298.pdf},
	author = {Boese,J. L. and Wisseman,Charles L., Jr. and Walsch,W. T. and Fiset,P.}
}
