Epidemiology of tinea capitis

Predominant in children: Tinea capitis is the most frequent fungal infectio n in children under the age of puberty. It occurs only rarely in men but is observed in adult women. Human-to-human, animal-to-human and soil-to-human transmission can be involved. Historical background: The spectrum of fungal species known to cause tinea capitis has steadily grown for more than a century, varying with the local urban or rural environment. Since the beginning of the 20th century and up to the advent of griseofulvin in the sixties, M. audouinii, an anthropophil ic species, caused major epidemics in France, England and the USA In the si xties to eighties, M. canis was the cause of most cases observed throughout the world. Over the last 20 years, anthropophilic species have again becom e the leading cause of tinea capitis epidemics, particularly in large citie s, in relationship with immigration: T. tonsuronsi in the USA and England a nd T. soudanense and M. langeronii in France. Hygiene and education: Despite the benign curable nature of the disease, in terhuman transmission of tinea capitis is nevertheless a considerable publi c health problem due to the increasing number of children affected and the risk of contagion in schools. The considerations resulting from recent stud ies point out the fact that transmission occurs more often in the family th an the school setting, particularly indirectly by common use of grooming in struments. This would explain the high percentage of tinea capitis in large immigrant families where hair combing habits favor transmission. In France , these observations should lead to a revision of the current regulations c oncerning expulsion from school of children affected by tinea capitis. Bett er education would be a more appropriate response to the problem. (C) 2001. Masson. Paris.