1. King Chavez Neighborhood of School Presentation

2.  What are head lice?  Misconceptions and stigmas  Treatment  Prevention  School Management

3.  Lice: live bugs that live on the human head and feed off of tiny drops of blood  Louse: the singular form for lice  Nits: lice eggs that are attached to individual strands of hair  Pediculicide: treatment that is applied to the hair that is specifically made for killing the lice

4. Head lice are small, flat, wingless insects with short antennae and 3 pair of legs. Each louse is brown/gray and only about the size of a sesame seed, 1/8 inch in length. Lice eat only the blood of humans and use their claws to hold on to hair. Lice cannot burrow into the skin and do not transmit any diseases. Did you know lice shells have been found on me, Egyptian mummies ?

5.  After a louse grabs onto the hair it will start to lay nits. Nits are attached to strands of hair, close to the scalp.  Nits on the hair look like tiny oval objects about the size of a grain of sand. Lice and nits are usually found where the hair is thickest—behind the ears and around the nape of the neck.

6.  Myth 1: Only dirty individuals get head lice. Fact: Anyone can get it. Lice love everyone!  Myth 2: Head lice jump and fly from person to person. Fact: They simply crawl from place to place, they do not have wings.

7.  Myth 3: You have to cut off all your hair to get rid of them. Fact: The best method to get rid head lice is to use a pediculicide then manually remove lice and nits with a delousing comb and/or by hand.

8.  Myth 4: Head Lice are extremely contagious and individuals with head lice should be isolated until all nits are gone. Fact: Head lice are most frequently spread through head-to-head contact or when people live or sleep together. Lice pass from head to head on objects such as combs, hats, or clothing, as well as bedding and pillows.

9.  Myth 6: Head lice carry diseases. Fact: Head lice while a significant social problem, do not transmit any disease- causing organisms to humans.

10. Treat the infested person(s): Requires using an over-the-counter (OTC) or prescription medication. Follow these treatment steps: 1. Apply lice medicine, according to the instructions contained in the box or printed on the label. If the infested person has very long hair (longer than shoulder length), it may be necessary to use a second bottle. Pay special attention to instructions on the label or in the box regarding how long the medication should be left on the hair and how it should be washed out. 2a. Remove dead, any remaining live lice, and nits out of the hair using a *fine-toothed nit comb or hand picking them from hair. *reusable combs can be purchased in the health office for a small fee WARNING: Do not use a combination shampoo/conditioner, or conditioner before using lice medicine. Do not re-wash the hair for 1-2 days after the lice medicine is removed. Information taken from CDC If you need help deciding what medicine to use please consult with your health care provider.

11. Steps: 1. Detangle the hair. 2. Section the hair into small sections. 3. Starting at the hairline work your way down to the back of the neck, combing each section multiple times. 4. Comb hair from root to tip, stripping the nits off the hair strands. 5. To prevent re-infestation, it is essential to comb the hair every day for one to two weeks.

12. 3. If, after 8-12 hours of treatment, no dead lice are found and lice seem as active as before, the medicine may not be working. Do not retreat until speaking with your health care provider; a different lice medicine (pediculicide) may be necessary. If your health care provider recommends a different pediculicide, carefully follow the treatment instructions contained in the box or printed on the label. 4. Nit combs, often found in lice medicine packages, should be used to comb nits and lice from the hair shaft. After each treatment, checking the hair and combing with a nit comb to remove nits and lice every 2-3 days may decrease the chance of self-re-infestation. Continue to check for 1-2 weeks to be sure all lice and nits are gone. 5. Retreatment generally is recommended for most prescription and non-prescription (over-the-counter) drugs on 7- 9 day in order to kill any surviving hatched lice before they produce new nits. 6. Inspect all family members and treat if live lice are found. Children under two years of age and pregnant mothers should not be treated without consulting with a doctor.

13. Follow these steps to help avoid re-infestation by lice that have recently fallen off the hair or crawled onto clothing or furniture. 1. Machine wash and dry clothing, bed linens, and other items that the infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned OR sealed in a plastic bag and stored for 2 or more days. 2. Soak combs and brushes in hot water (at least 130°F) for 5-10 minutes. 3. Vacuum the floor and furniture, particularly where the infested person sat or lay. However, the risk of getting infested by a louse that has fallen onto a rug or carpet or furniture is very small. Head lice survive less than 1-2 days if they fall off a person and cannot feed; nits cannot hatch and usually die within a week if they are not kept at the same temperature as that found close to the human scalp. Spending much time and money on housecleaning activities is not necessary to avoid re-infestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing. 4. Do not use fumigant sprays; they can be toxic if inhaled or absorbed through the skin. For more information visit the CDC Website

14. It’s not always easy to prevent head lice 100% of the time since it is a common infestation. However, there are some things you can do to minimize the chance of getting lice: 1. Avoid putting your head together and sharing hair items that could contain lice. Such as hats, combs, brushes, hair accessories, bedding etc. 2. Use you own bedding or sleeping bag when sleeping away from home. 3. When in public/group setting such as school and camp keep your hair tied up in a pony tail. 4. Routinely check the heads of every family member periodically for lice and nits.

15.  Mass screenings (school-wide or whole classrooms) is not evidence based practice and not recommended by national pediatrician and school health professional organizations.  If a student is suspected of having lice, he or she should be examined by a medical professional (such as a school nurse or health office staff), not by a teacher, secretary, or parent volunteer.  Parents are encouraged to check their children’s head for lice regularly and if the child is symptomatic. School screenings do not take the place of these more careful parental checks.  National Association of School Nurses recommend no healthy child be excluded from or miss school because of head lice. Head lice cause no medical harm and can be effectively treated.  Provide education to families and school staff to dispel myths and stigmas on the relatively benign consequences of head lice infestation.  Maintain student privacy.

16.  If a child is found to have head lice, confidentiality must be maintained and referred for treatment at the end of the school day. Common sense should prevail when deciding how “contagious” an individual child may be. Until the end of the school day, avoid activity that includes head-to-head contact with other children or sharing of any headgear.  Return to school after the child has received treatment recommended by the child’s health professional. A trained staff member rechecks the student before returning to class.

17.  San Diego Unified School District  Centers for Disease Control and Prevention  National Association of School Nurses  The American Academy of Pediatrics  County of San Diego Community Epidemiology  Lice Advice: The Shepherd Method of Strand by Strand Nit Removal