Arthropod-borne diseases associated with political and social disorder.

The living conditions and the crowded situations of the homeless, war refugees, or victims of a natural disaster provide ideal conditions for the spread of lice, fleas, ticks, flies and mites. The consequence of arthropod infestation in these situations is underestimated. Along with louse-borne infections such as typhus, trench fever, and relapsing fever, the relationship between Acinetobacter spp.-infected lice and bacteremia in the homeless is not clear. Murine typhus, tungiasis, and myiasis are likely underestimated, and there has been a reemergence of bed bugs. Attempted eradication of the body louse, despite specific measures, has been disappointing, and infections with Bartonella quintana continue to be reported. The efficacy of ivermectin in eradicating the human body louse, although the effect is not sustained, might provide new therapeutic approaches. Arthropod-borne diseases continue to emerge within the deprived population. Public health programs should be engaged rapidly to control these pests and reduce the incidence of these transmissible diseases.