Head Lice

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Head Lice

• What do we need to know??
• (Or, more than we care to know?)
• Eva Stone, RN Lincoln County Board of Education

Madison County School Health Program (Adapted
with permission)
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What is there to know?

• There are three types of human lice. The one
  schools deal with most often are head lice.

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What is there to know?

• Lice have been around for centuries.
  Archeologists have excavated mummies with lice,
  ancient combs with nits and other records related
  to head lice.

4
What is there to know?

• Examination of ancient lice show they are
  identical to those we deal with today.
• An estimated 6-12 million people get head lice
  each year.
• These are equal opportunity parasites all humans
  are able to get them.

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What is there to know?

• Head louse infestation is more common among
  children than all other childhood communicable
  diseases combined.

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• The head louse found on humans is specific to
  people. It cant be contracted from the family
  dog, cat or any other animal. Mammals and birds
  can have lice but they are species specific.

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The Facts on Head lice

• These are insects that CANNOT jump or fly.
• Their method of movement relies on 6 legs, each
  of which ends in a claw which can grasp human
  hair.

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The Facts On Head Lice

• Head Lice are NOT known to transmit pathogens
  (germs). They are a nuisance but NOT a health
  hazard.

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The Facts on head lice

• Lice eggs are called nits. They are oval shaped
  and usually yellow to white. The female louse
  lays these close to the scalp at the base of the
  hair. The eggs are attached to the hair with a
  quick hardening glue that the female louse
  extracts from her body.

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The Facts on Head Lice

• The young lice hatch 6-10 days later and leave
  the egg shell behind.
• Dead eggs and egg shells may remain attached to
  the hair for 6 months or more if not removed.

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The Facts on Head Lice

• It is nearly impossible to tell visually which
  nits are still incubating eggs and which are
  hatched.

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• The NationalCenter for Disease Control (CDC)
  published a study in May of 2001 which showed
  only 9 of 50 children with nits alone (18)
  converted to live lice. Color of nits was not
  the biggest risk factor, the number of nits was.
  And even that wasnt a definite indicator that
  the infestation would be active.

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The Facts on Head Lice

• Nymphs The egg hatches to release a nymph.
  The nymph looks like an adult head louse but is
  about the size of a pinhead. Nymphs become adults
  7-12 days after hatching.
• Nymphs cannot fertilize or lay eggs until they
  become adults.

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The Facts on Head Lice

• Adults Adult lice are about the size of a
  sesame seed.
• They survive by blood-feeding 1 time or more a
  day. They cannot survive for more than 24 hours
  or so at room temperature without human blood.
• The entire life span of a louse is about 30 days

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The Facts on Head Lice

• A female louse will lay about 6 eggs/day. Only
  those deposited by an inseminated female can
  hatch.

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Facts about Head Lice
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How is lice transmitted from one person to
another???
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Transmission of Head Lice

• Host-to-host (direct contact from someone who is
  infested)
• By wearing infested clothing (hats, scarves,
  coats, hair ribbons etc.)
• By using infested combs, or brushes
• By lying on a bed, couch or carpet that has
  recently been in contact with an infested person.
  

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Transmission of Head Lice

• Only LIVING LICE can transfer from one person to
  another
• Nits cannot be passed onto someone else

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What does that mean for us at school?

• Precautions need to be taken in the classrooms.
• Children shouldnt lay on rugs/floors with their
  heads together.
• They shouldnt share hats.

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• We should do what we can to help children avoid
  direct head to head contact.
• Children will NOT transmit head lice simply by
  standing or sitting by other children.
• Coats/jackets should be hung separately.

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Please Remember

• Lice dont mount expeditions, striking off to
  find new heads. They are obligate human
  parasites, their goal is to stay on the head
  where they presently live!!!!!

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What if a child has head lice?

• It is generally recommended that the first
  treatment for head lice is an over-the-counter
  pediculicide. A prescription can also be obtained
  from the doctor. Both must be used EXACTLY as
  the directions specify.
• Most of these treatments are pesticides and
  overuse can be dangerous

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What Medications are Available to Treat Head Lice?

• Permethrin- Brand name Nix. (OTC)
• Permethrins are similar to natural pyrethrins.
  Permethrins may continue to kill newly hatched
  eggs for several days after treatment. A second
  treatment may be necessary in 7-10 days.
• Treatment failures are common.

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What Medications are Available to Treat Head Lice?

• Malathion (Ovide). This drug has just been
  reapproved for treatment. (Rx)
• Lindane (Kwell). One of the most common drugs
  used in past to treat head lice. Overuse,
  misuse, or swallowing can be toxic to the brain
  and nervous system. It should never be used if
  open sores are on scalp. (Rx)

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What medications are available to treat head lice?

• Pyrethrins ex. Rid, Pronto, A-200, RC, Triple
  X. (OTC)
• These are natural extracts from the chrysanthemum
  flower. A second treatment is recommended in 7-10
  days to kill any newly hatched lice.
• Treatment failures are common.

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What if a child has lice?

• After using the medication, all lice and nits
  should be removed from the scalp and hair. This
  takes time and good light!! A metal nit comb on
  wet hair may be helpful.

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What about lice sprays????

• Most sprays are also pesticides
• and are not recommended by the Center for
  Disease control. They are not effective and may
  be dangerous.

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So, Why not a no nit policy? I thought we were
finally getting somewhere in this lice problem!
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Why NOT a no-nit policy??

• Such a policy has is not recommended by the CDC,
  Academy of Pediatrics or the Harvard School of
  Public Health.
• Misdiagnosis of nits is common.

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Why NOT a no-nit policy?

• Causes children to miss school needlessly.
• Encourages use of potentially dangerous
  pesticides for no reason.

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Why Not a No-nit Policy?

• It doesnt prevent chronically infested
  children from being reinfested.

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No Scientific Support

• Harvards School of Public Health obtained
  samples from health care professionals and the
  public of lice and nits.
• Most samples came from schools.
• Lice or eggs were present in less than two
  thirds.
• Less than half had either a louse or potentially
  viable egg.

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• The researchers found that over-the-counter
  medications were used as much in those with
  active infestations as those without viable lice
  or eggs.
• Misdiagnosis leads to the possibility of overuse
  of pediculocides and inappropriate exclusion
  from school.
• The same researchers have found that the kids
  sitting next to kids with live lice are NOT more
  likely to get it than anyone else.

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• It is transmitted when there is direct
  head-to-head contact where LIVE lice are
  concerned.
• Nits cannot be passed to another person.
• According to the Center For Disease Control (CDC)
  most transmission occurs in the home environment.
  (friends, sleep overs, camps, etc..)

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Think About it

• For transmission to occur from one person to
  another either 2 lice have to crawl from one
  head to another ,OR a female that has been
  inseminated by a male must leave the host and get
  to a new head.

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• Children can (and do) get head lice from school.
  But they also get it from other places.
• If we exclude children from school for nits
  only, we are basing this practice on myth and not
  scientific research.

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School Exclusion

• Nits alone cannot be transmitted from one person
  to another.
• If a nit hatches at school it will take 7-12 days
  to mature.
• Once matured, the female has to be inseminated to
  be able to lay fertile eggs.

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School Exclusion

• If she isnt inseminated, she has to find a mate.
• Thats a lot of activity for a 7-hour school
  day!!!

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In Conclusion

• Remember we need to base practices on scientific
  evidence, not fear and hysteria.