Head Lice: What You Should Know Virginia O’Malley

Head Lice/Pediculosis Are tiny parasitic insects about the size of a sesame seed. Have six claws that are used to “cling” to hair shaft. Are tan, brown or grey in color. Can only live on a human head and feed on human blood Can move very fast and are hard to see. Are wingless and do not jump or fly – they crawl. Are not a health hazard, do not cause diseases Are not a sign of poor hygiene. (Frankowski, 2010) (CDC, 2013)

Lice Facts Who gets lice? How does a person get lice? In the U.S. it is estimated 6-12 million infestations of head lice occur each year in children ages 3-11yrs. Almost anyone can get head lice. Preschool or elementary school aged children, and persons who live with them, are the most commonly affected. How does a person get lice? Spread by direct head-to-head contact with an already infested person. They do not live off the head for long, so it is uncommon to spread head lice by contact with clothing or other personal items. Your pets cannot get or transmit lice. (CDC, 2013)

Stages of Head Lice *You may see all stages present at the same time Nits Lice eggs laid by adult female Teardrop/oval shaped Attached to the hair shaft, with a glue like substance Yellowish or white Often confused with dandruff Cannot be brushed off Nymph Are baby/immature louse Grows to adult size in 9-12 days Found on the scalp or in the hair Adult louse Size of a sesame seed Lives about 30 days on a persons head Lay about 6 eggs a day. Commonly behind the ears and near the neckline *You may see all stages present at the same time (CDC, 2013)

Life Cycle

Symptoms of Possible Head Lice Tickling feeling on the scalp or hair, like something is moving Itching (allergic response from the louse’s bite) may start after 4 to 6 weeks after initial infestation Since lice are more active in the dark, may experience irritability and difficulty sleeping Sores on the head from scratching Seeing a live nymph or louse is the best way to confirm having head lice! (CDC, 2013) (Frankowski, 2010)

What Do You See?

Treatment Considerations Only treat persons with evidence of live infestation. Everyone in the household should be regularly checked for live lice. Consult your physician for pediculicide recommendation and follow instructions per label or box. Do make sure to consult your physician for retreatment if needed. Continue to check the hair every 2-3 days for 2-3 weeks Do not over-treat. Resistance to some over-the-counter medications has been reported. (CDC, 2013) (Frankowski, 2010)

Environmental Care Full grown/adult head lice survive less than 1-2 days, and nits usually die within a week once they fall off a person and cannot feed Do not use insecticide fumigants or fogs; they are not necessary and may be toxic if inhaled or absorbed through the skin Machine wash in hot water any bed linens and recently used clothes, hats and towels. Disinfect combs, brushes and hair clips in very hot water or sealed in a plastic bag for two weeks (CDC, 2013)

Challenges and Issues with Head Lice Misdiagnosis results in unnecessary treatments “No Nit” policies keep children out of classroom Improper use of treatment, whether overuse or underuse, can lead to resistance Indirect cost – childcare expense, lost wages Direct cost – pediculicides, office visits, laundry Caregiver strain (Sciscione, 2007)

School Procedure Moved away from No-Nit Policy Students with live lice will be dismissed. Parent/guardian will be notified via telephone and a note sent home with student. Treatment is required before returning to school Upon returning to school, student must be escorted by an adult and the school nurse will check for continued presence of live lice. Classrooms are not routinely screened Notices are not routinely sent home Confidentiality must be and will be maintained (Sciscione, 2007)

Head Lice are Here to Stay But can be managed

References Centers for Disease Control and Prevention. (2013). Biology. Retrieved from http://www.cdc.gov/parasites/lice/head/biology.html Centers for Disease Control and Prevention. (2013). Epidemiology & risk factors. Retrieved from http://www.cdc.gov/parasites/lice/head/epi.html Centers for Disease Control and Prevention. (2013). Head lice information for schools. Retrieved from http://www.cdc.gov/parasites/lice/head/schools.html Centers for Disease Control and Prevention. (2013). Prevention & control. Retrieved from http://www.cdc.gov/parasites/lice/head/prevent.html Centers for Disease Control and Prevention. (2013). Treatment. Retrieved from http://www.cdc.gov/parasites/lice/head/treatment.html Frankowski, B., & Bocchini, J.r. (2010). Head lice. Pediatric, 126(2), 392-403. doi:10.1542/peds.2010-1308 Sciscione, P., & Krause-Parello, C.A. (2007). No-Nit policies in schools: Time for change. The Journal of School Nursing, 23(1), 13-20. doi:10.1177/10598405070230010301