In Italy, 500,000 cases of varicella are estimated each year, most of them occurring in children aged between 0 and 14 years.

Pediculosis can elicit considerable emotional distress in the infected and their carers, but the role of attitude in head lice reinfection has not been explored. Failure of head lice control is often attributed to insecticide resistance because human aspects of reinfestation are unknown. This study collected data from 128 teenagers with a history of pediculosis to retrospectively explore attitudes towards head lice. One third of female and two thirds of male teenagers were unconcerned about having head lice. One fifth of parents did nothing about their child's head lice infections, while a few male students did not inform their parents when they had pediculosis. This is the first study on the prevalence of human lice carriers who are a primary cause of head lice reinfection. Medical and public health professions need to understand the social reasons for the failure of insecticide-based head lice control.

Pediculosis is a ubiquitous disease common throughout the globe and managed entirely through the application of insecticides and natural therapies with varying success. Resistance and reinfection are known to be responsible for increases in prevalence reported in many countries since the 1900s. This study investigated reinfection, which has been neglected by researchers, by attempting to learn more about the role of reservoir hosts. Open-ended questions were asked from 126 students of Grades 8 and 9 to explore this issue from the perspective of the infected population. A majority of females (60%) and 40% of males had no idea that they had pediculosis until it was discovered by themselves, a friend or a carer. Some female (12.1%) and male (14.5%) students did not tell their parents when they became aware that they had pediculosis. Hair thickness was significantly related to this question with 23.3% of thick-haired students concealing their infections. The results from this study suggest that brown-and short-haired White boys should be a primary target in lice awareness and control programs, because they are much more likely to harbor lice than long-haired girls. Health professionals should be aware of the social reasons for why this pest is so difficult to control.

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Dear Sir,We thank Coenraads and Tang for their interesting comments on our contact point entitled 'Chloracne due to o-dichlorobenzene in a laboratory worker' (1) and offer the following reply.Coenraads and Tang state that chloracne is known to be caused by substances that have a chemical structure, which is different from dichlorobenzene; the causative chemicals are polychlorinated dibenzodioxins (PCDDs) and polychlorinated dibenzofuranes (PCDFs). If we understand the point correctly, they suggest that, in the case we described, such compounds (PCDDs or PCDFs) could have been present in the o-dichlorobenzene, being the real causative agents of chloracne.We initially considered the hypothesis that chloracne could have been caused by TCDD (or like) compounds, but, even after a careful investigation, we were unable to find any source of such compounds in the laboratory. Could TCDD have been present in the o-dichlorobenzene used in the laboratory? We have no reason to believe it, because the o-dichlorobenzene used in the laboratory was a pure compound (analytical grade, more than 98%) and the production technology used for laboratory reagents confirms the absence of significant contamination. For this reason, we did not analyse the o-dichlorobenzene searching for TCDD (or like) compounds. For the sake of conciseness, we did not fully describe in the case report all the work performed to assess occupational exposure of the worker in the laboratory.A further point is the issue of o-dichlorobenzene as a causative agent for chloracne. The literature reports at least another study (2) in which o-dichlorobenzene has been described as a causative agent for chloracne, but at higher exposure levels and involving dichlorobenzene in an industrial process.Finally, Coenraads and Tang suggest the DR-CALUX bioassay to give proof of the chloracne causing capability of o-dichlorobenzene. The DR-CALUX is used for detecting dioxin and dioxin-like compounds in a wide variety of matrices. We, therefore, think that it would give the same information, which can be obtained using a chemical analysis.A case report can only suggest hypotheses that need further study to be confirmed. This is what we implicitly suggest at the end of our report.