Occasionally pubic lice may be spread by close personal contact or contact with articles such as clothing, bed linens, and towels that have been used by an infested person. Pubic lice found on the head or eyelashes of children may be an indication of sexual exposure or abuse. Pubic lice do not transmit disease; however, secondary bacterial infection can occur from scratching of the skin. They are much broader in comparison to head and body lice. Adults are found only on the human host and require human blood to survive. If adults are forced off the host, they will die within 24–48 hours without a blood feeding. Symptoms of crab louse infestation in the pubic area include itching, redness and inflammation. These symptoms cause increased blood circulation to the skin of the pubic region creating a blood-rich environment for the crab louse. Pubic lice infestation can also be diagnosed by identifying the presence of nits or eggs on the pubic hair. When clinicians find the crab louse on one family member they often request to examine other members of the family for similar symptoms of infestation. If a clinician suspects the presence of the louse, they may be able to identify the nits or eggs under magnification.