Ectoparasites favour dirty dark places, whether they are searching for a suitable habitat on a person or a vantage place in the house from which to mount an attack. Fleas and lice are not removed by washing, but the continued use of warm water and soap considerably deters them. If this is combined with washing of clothes, then fleas can rapidly be controlled. Where possible, clothes and bedding should be boiled or at least subjected to very hot water as fleas are not affected by cold water. Some communities practice head shaving to control lice, while short hair makes them easier to control.
Fleas and lice favour overcrowded conditions, such as those occuring during wars, famines or refugee camps. Efforts should be instituted to reduce overcrowding, but where this is impossible, washing and laundry facilities should at least be provided. Wearing of other people's clothes or sharing combs are common methods of transferring ectoparasites in tropical areas.
Repellents have been used successfully in areas where infection is likely. Impregnated socks and trousers can be effective when passing through micro-habitats of scrub typhus or wild rodent plague. Ticks, bedbugs and reduviids are repulsed by repellents.
Bedbugs, ticks and reduviid bugs live in cracks in the walls of poorly constructed houses, coming out at night to attack sleeping persons. Improving house construction or applying a layer of unbroken plaster to a wall discourages these arthropods permanently. Bed nets can protect the individual from being bitten.
Insecticides are especially useful in epidemic conditions. Dusting clothing, using a puffer to supply the insecticide up trouser legs and skirts and down collars and sleeves, can quickly reduce the number of ectoparasites in concentrations of people. Insecticide solutions can be applied to the hair to kill off head lice or to clothing if repellents are not available. Rat burrows and runs should be dusted with insecticides to kill off plague-carrying fleas before rat catching. Benzyl benzoate or BHC is effective against scabies mites.
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