1. Head Lice

2. The Life of a Louse
The life cycle of the head louse has three stages: egg, nymph, and adult.

3. The Nit
Eggs: Nits are head lice eggs. They are hard to see and are often confused for dandruff or hair spray droplets. Nits are laid by the adult female and are cemented at the base of the hair shaft nearest the scalp . They are 0.8 mm by 0.3 mm, oval and usually yellow to white. Nits take about 1 week to hatch (range 6 to 9 days). Viable eggs are usually located within 6 mm (1/4 inch) of the scalp. (cdc.org)

4. Important Note~
Nits are laid close to the scalp as body heat is needed to incubate the eggs. Egg production occurs at a temperature that is warmer than room air…therefore nits found greater than ½ inch from the scalp no longer contain viable eggs.

5. Nymphs
The egg hatches to release a nymph. The nit shell then becomes a more visible dull yellow and remains attached to the hair shaft. The nymph looks like an adult head louse, but is about the size of a pinhead. Nymphs mature after three molts and become adults about 7 days after hatching. (cdc.org)

6. Adult Louse
The adult louse is about the size of a sesame seed, has 6 legs (each with claws), and is tan to grayish-white . In persons with dark hair, the adult louse will appear darker. Females are usually larger than males and can lay up to 8 nits per day. Adult lice can live up to 30 days on a person’s head. To live, adult lice need to feed on blood several times daily. Without blood meals, the louse will die within 1 to 2 days off the host. (cdc.org)

7. American Academy of Pediatrics
“The child with active head lice should remain in class, but be discouraged from close head contact with others. The parent should be contacted and educated on how to deal with (treat) the lice at home.” (Frankowski et al., 2002, pg 641)

8. The Centers for Disease Control
“Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun.”

9. Who’s At Risk?
While everyone is susceptible to infestations, some groups are at greater risk than others. Those include:
Children between 3-10 yrs. of age and their families.(CDC, 2001) Females have more head lice than males, in a 2:1 ratio.
Whites have a greater likelihood than African Americans by almost 99%. This lower prevalence is attributable to the North American species of lice as it cannot grip to the oval-shaped hair shaft characteristic of African Americans. (Meinking, 1999)

10. Epidemiology & Risk Factors
Reliable data on how many people get head lice each year in the United States are not available; however, an estimated 6 million to 12 million infestations occur each year in the United States among children 3 to 11 years of age.(CDC)

11. The Role of the School Nurse School Nursing: A Comprehensive Text
Identify if pediculosis exists.
Document the problem.
Contact, educate, and support the family.
Facilitate the students return to school, or if your school does not have a no nit policy, to ensure that the student remains in school.
Maintain the students confidentiality.
Currently Watauga County Schools maintains a No-Nit Policy

12. Are There Alternatives?
School Nursing; A Comprehensive Text Scott, Gilmer, and Johnannessen (2004) recommend that a nit rating scale be used. (School Nursing; A Comprehensive Text)

13. According to the Rating Scale, if lice are identified, the family will be notified, educated, and the student can receive treatment at home.
If nits are identified, but no live lice are present, the student will remain at school. The nits will be “scored” or measured daily to ensure that no new nits are being discovered and that the previous nits continue to grow with the hair. This scoring system prevents unnecessary absence's of a student who is not a threat to the school population.

14. References: CDC (Centers for Disease Control)
American Academy of Pediatrics
School Nursing, A Comprehensive Text
National Association of School Nurses
Watauga County Schools