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Head Lice


identify the various stages of head lice. recall the signs and symptoms of head lice ... Tickling feeling or something moving in the hair ... – PowerPoint PPT presentation

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Title: Head Lice

Head Lice
  • James R. Ginder, MS, WEMT,PI, CHES
  • Health Education Specialist
  • Hamilton County Health Department
  • www.co.hamilton.in.us

The student will be able to..
  • identify the various stages of head lice
  • recall the signs and symptoms of head lice
  • describe how head lice are transmitted
  • list various treatment opportunities

Health Problem
  • Lice are not a Public Health Problem
  • Source Harvard School of Public Health

What are head lice ?
  • Head lice (Pediculus capitis) are small insects
    that can live on
  • the scalp and neck hair of a human host
  • Approximately 6 to 12 million children are
    infected with Head Lice per year (AAP)
  • Head lice are not a health hazard or a sign of
    uncleanliness and are NOT responsible for the
    spread of ANY diseases
  • All groups of people can develop Head lice

  • Preschool and elementary age children (age 3-11)
    and their families are infested most often (CDC)
  • African Americans have fewer cases of head lice
    due to oval-shaped hair shafts which are harder
    for lice to grasp
  • Lice seem to prefer red or brown hair over blonde
    or black hair (Vessey)
  • Lice development has no connection with the
    length of hair or the frequency of brushing or

  • Lice need blood to feed each day
  • They cannot survive for more than a day or so at
    room temperature without access to a persons
    blood (Pollack)
  • Lice CAN NOT jump or fly, BUT they can crawl from
    head to head
  • Transmission of lice is by direct contact with a
    persons hair
  • Indirect transmission can occur. (combs, brushes,

  • Nits
  • Tiny eggs that are attached
  • to the hair shaft by a glue- like
  • substance made by the louse
  • They incubate by body heat
  • and hatch 10-14 days
  • Nits are camouflaged with the
  • pigment of the hair.

Life Cycle
  • Adult Louse
  • 2 to 3 mm long
  • Color can vary
  • Female can live up to
  • 3-4 weeks and deposit
  • more than 100 eggs at a
  • rate of six eggs each day
  • Feeds by injecting a small amount of saliva
  • and taking a tiny amount of blood from
  • scalp every few hours. This saliva may
  • the itchy irritation

  • Nymphs
  • Nymphs leave the shell casing
  • which can be seen easily at the
  • posterior hairline
  • They grow for about 9-12 days,
  • mate, and the female lays eggs
  • If not treated, this process will
  • repeat every three weeks

Signs and Symptoms
  • Tickling feeling or something moving in the hair
  • Itching, caused by an allergic reaction to the
  • Irritability
  • Sores on the head caused by scratching

  • Diagnosing lice is done by finding a live louse
    on the head
  • Eggs, or nits, may be easier to spot at the nap
    of the neck or behind the ears, within 1 cm of
    the scalp
  • If nits are seen farther than 6 mm from the scalp
    and no nymphs or adult lice are seen, the
    infestation is a past infestation and DOES NOT
    require treatment (Hansen)
  • It is important not to confuse live nits with
    dead or empty egg cases

  • DO not confuse nits with
  • dandruff
  • hair casts
  • hair debris

Egg Cases
  • Various treatments for lice include
  • ? Insecticides
  • ? Mechanical Removal
  • ? Enzyme Treatments
  • ? Antibiotics
  • ? Suffocating Agents
  • ? Heat/Cold
  • ? Haircuts
  • Before ANY treatment contact a pharmacist or
    your healthcare provider

At Home
  • Washing and drying (with heat) pillowcases,
    sheets, nightclothes,
  • towels and stuffed animals to prevent
  • Combs, brushes, hats and other hair accessories
    that are in contact with an infected person
    should be washed in Hot water EACH day to
    dislodge any lice and nits
  • Furniture and carpeting that have been in contact
    with the head of an infected person within 24 to
    48 hours before treatment should be considered
    for cleaning. Lice can not live off the scalp
    longer than 48 hours

  • Pets can NOT transmit lice and SHOULD NOT be
  • If items cannot be washed, place them in a
    plastic bag for two weeks, by which time any nits
    that may have survived would have hatched, and
    nymphs would die without a source to feed on
  • ALL household members should be checked for live
  • Check household contacts for lice and nits every
    two-three days. TREAT only if crawling lice or
    nits within a ¼ inch of the scalp are found (CDC)

  • AVOID head-to-head contact during play at school
    and at home
  • DO NOT share clothing, such as hats, scarves,
    coats, sports uniforms and hair ribbons
  • DO NOT share infested combs, brushes or towels
  • DO NOT lie on beds, couches, pillows, carpets or
    stuffed animals that have been in contact with an
    infected person
  • Talk with your child about not sharing clothing
    with anyone

  • It is the position of the National Association of
    School Nurses that the management of pediculosis
    should not disrupt the education process.

Schools Lice
  • No-nit policies developed by school systems were
    established in response to the stigma and unclear
    transmission of lice
  • Attendance records indicate that 12-24 million
    school days are lost annually in the U.S. due to
    students with nits (Scott)
  • The National Association of School Nurses (NASN)
    states that children who have been treated for
    lice SHOULD NOT be excluded from school because
    of the existence of residual nits (NASN)
  • According to the American Academy of Pediatrics,
    no-nit policies in schools are a detrimental
    cause of lost time in the classroom.

  • Children with an active head lice infestation are
    likely to have had the infestation for at lease a
    month by the time it is discovered (Frankowski)
  • A child with active head lice have NO immediate
    risk to others and SHOULD be allowed to remain in
    school for the day.
  • Lice transmission in school is low, due to close
    head-to-head contact which is low and generally
    does not happen in the school setting

  • Screening entire classrooms is an unjustified
    response (Plooack)
  • Parents of students found to have LIVE lice
    should be contacted by the school nurse and
    advised of treatment options
  • Children SHOULD NOT be sent home for head lice
  • Students CAN RETURN to school if they have
    DOCUMENTATION of at least ONE treatment
  • Teachers SHOULD reinforce not sharing hats or
    other objects that comes in contact with hair

  • If younger children nap on carpet area, these
    areas should be vacuumed daily
  • NO, notification needs to be sent home to
    classmates parents
  • Insecticides in the school are not warranted and
    provide unnecessary chemical exposure
  • Call your school nurse and see what head lice
    policies the school district has in place

Care Plans
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  • Parents must take off work to care for children
    who are excluded from school due to no-nit
  • Cost associated with treatment, including the
    cost of doctors visits, medication and
    nit-removal utensils
  • Parents must arrange alternate child care to
    prevent lost days at work

More Information on Lice
  • HeadLice.org http//www.headlice.org
  • CDC http//www.cdc.gov
  • Harvard School of Public Health
  • Medline Plus http//www.nlm.nih.gov/medlineplus/he
  • Hamilton County Health Department

  • Centers for Disease Control and Prevention
  • Frankowski, B.L. (2004) . American Academy of
    Pediatrics Guidelines for the Prevention and
    Treatment of Head Lice infestation. American
    Journal of Managed Care 10 S269-S272
  • Hansen, R.C. (20004). Overview The State of Head
    Lice Management and Control. The American Journal
    of Managed Care, 10, S260-S263
  • Pollaxk, R.J. (2000). Head Lice Information.
    February 2007, form The Harvard School of Public
    Health Website http//hsph.harvard.edu/headlice.h

  • Sciscione,.,Krause-Parello, C. (2007) No-Nit
    Policies in Schools Time for Change. The Journal
    of School Nursing 23, 13-20
  • Vessey, J.A. (2000). Current Concepts in
    Pediculosis Management. Scarborough, MeNASN
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