Wednesday, August 29, 2001

Straight talk about head lice

School is back in session, and those pesky head lice have already made their appearance.

Though lice are certainly an unwanted nuisance, parents, please do not panic. In most cases, head lice (Pediculus humanus capitis) are not a health risk and can be successfully killed and removed with careful treatment and attention.

Prolonged, untreated cases of head lice, particularly in those who have a weakened immune system, or scratching which results in skin breaks could possibly become a threat to that person's health. Head lice themselves are not known to transmit disease. However, misuse of pesticides and use of unlabeled treatments (i.e. kerosene) are more likely health risks.

Head lice are transmitted either by close personal contact or by recent contact with infected articles (i.e. clothing, combs, hair ornaments, hats, bedding).

The louse is a bloodsucking parasite that lives close to the scalp and feeds on the blood of its host. Lice feed with piercing and sucking mouthparts, injecting saliva to keep blood from clotting. This feeding process causing itching.

They are usually found on the lower back of the head and behind the ears, but can be found anywhere on the head. A female head louse will live about 30 days on a host. During this period, she will deposit about 90 eggs or "nits" which are cemented to hair shafts near the scalp, and which will hatch in about one week.

Generally speaking, nits found more than 1/4-inch from the scalp are either infertile or hatched.

Signs of infestation include:

Frequent head scratching.

Complaints of itchy scalp/head.

Redness behind the ears or on the back of the neck.

Dispelling myths

Head lice are very common among all classes of people. Having them does not reflect socioeconomic status or personal hygiene. More than 12 million people, mostly children and school personnel, get head lice each year.

Lice cannot hop, jump or fly, but they can crawl rapidly.

Head lice cannot live off a human host for more than 24-48 hours. They cannot live on pets, nor can they reproduce in carpets, furniture or other household furnishings.

Infestations cannot be controlled completely with head lice shampoos alone. Shampoo treatments must be combined with manual (by hand) removal and removal in the environment to be successful.

Pesticide sprays do little or nothing to control lice. Never spray your home, clothing, furniture, bedding, etc. with pesticides (e.g. lice bombs, flea bombs, etc.) in an attempt to control head lice. This would expose you and your family to unnecessary pesticide risk.

How to successfully treat

a head lice infestation

Examine the head under a bright light and remove as many live lice and nits as possible. Use a 'nit comb' (found at most drug stores, and sometimes included with lice shampoos) or very fine-toothed comb and start the process at the neck area.

Take a small section of hair, examine the scalp in that section, and pull the comb through from the scalp to the ends. Make sure to dip the comb in a cup of hot soapy water or use tape to remove nits/lice and other debris before going on to the next section.

The National Pediculosis Association and The University of Georgia Cooperative Extension Service state that "manual removal is the safe alternative and necessary component of any head lice treatment regimen."

If a lice shampoo is used, be certain to follow label directions exactly. Failure to do so could lead to ineffective treatment, and/or dangerous side effects.

There are many of these products (pediculicides) on the market. Some contain the active ingredient permethrin (such as Nix) which kills eggs as well as live lice: and offers 14 days residual protection. Other products use

natural enzyme cleaners to kill lice and eggs. If a person or parent has a desire to avoid chemical treatment entirely, the Health Department can instruct them in a method that uses olive oil. Whichever product/process you choose, you should remove all clothing, apply the pediculicide or treatment as directed, then put on clean clothes.

To prevent reinfestation, check all members of the same household on the same day, and treat all that have head lice on the same day.

The other critical piece of the lice-removal process is the environment. Clothes, bedding, and other items contacted by the infested person within 48 hours should be washed in hot water with a detergent, and dried in a clothes dryer.

Items that cannot be washed may be dry cleaned, or placed in a sealed plastic bag for 10 days, or placed in a freezer. Freezing is lethal to eggs, nymphs (immature louse), and adults; as is a temperature of 125 F for 30 minutes or more.

Carpets, chairs and sofas (including pillows) should be vacuumed. If the infected persons head has or may have come in contact with drapes or curtains within the 48 hours prior to treatment, they should also be washed, dry cleaned, or vacuumed according to fabric type. Car seats and headrests, child car seats and carriers should also be vacuumed.

Although head lice cannot live more than two days off the host; if an infected person who has just been treated returns to the same sofa, bed, or carseat where s/he shed lice that morning, or the night before, then that person will be reinfested.

Many products require re-treatment in 7-10 days to kill any lice that may have hatched since the initial treatment. Regardless of the type of treatment used, the head should be checked daily for the next 10 days: and regularly thereafter.

If 3-5 nits are found, another manual search and removal is recommended. The process for lice removal is tedious at best, but very necessary for successful treatment.

The Fayette County school system has a "no nit" policy. This means that the school cannot accept children into class who have live lice or nits in their hair.

Health Department nurses will examine clients for head lice, and educate them about the various treatment options and their procedures. Once treatment has been completed, the client may then return to the Health Department for re-examination and school clearance.

Since we are aware of, but cannot by State Protocol practice, a "no-nit" policy, we will inform clients when we still see nits in the hair and ask that they be removed prior to returning the child to school. We realize that this is frustrating to parents; think of how much more frustrating to the child who is sometimes socially ostracized and falls behind in school because of missed days.

To insure that you and/or your child are not side-tracked by this 'hair aising' experience:

· Check your children for signs of head lice regularly. Lice are much easier to eliminate if caught early.

· Teach your children not to use the grooming items, hats and other headwear, or headphones of others, and to avoid head-to-head contact.

· If an infestation occurs: follow the guidelines of your physician, or health department personnel carefully. There are no short cuts to successful treatment of head lice.

· Cooperate with the head lice policy of your school and its clinic personnel. These policies are in place to prevent widespread infestation, not to exclude children from school.

For further information, please contact the Fayette County Health Dept. at 770-461-1178, ext. 5416.

Information for this article was obtained from:

University of Maine Cooperative Extension Service

University of Georgia Cooperative Extension Service

http://www.bugwood.org/ipm/factsheets /controlling_head_lice.htm

National Pediculosis Association, Inc.

www.headlice.org