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Most of us have learned valuable but painful lessons from the two-legged louse. Today, we consider the six-legged louse and a story that gets more interesting with the rapid accumulation of genomic data1. My first exposure to the louse was in Zinsser's remarkable book2), which I came across as a nerdy youngster in Brooklyn. The book weaves a complex tale of medicine, history, and biology, in which the body louse gets significant respect as the vector for epidemic typhus, relapsing fever, and trench fever; it is prevalent in the crowded environments produced by refugee camps, homelessness, and wartime. Our methods of treatment seem almost as primitive as the organism we are trying to kill.
The louse cannot live alone. It …