HEAD LICE

YUCK!!!!!!!!!!!!!!!!!!!! This is the general reaction by most people when the topic of lice is raised. In reality, while lice is not something that we want to have to deal with, the biggest issue is that it is difficult to effectively treat and eradicate it without vigilance and patience.

Head Lice Facts

Head lice are small insects that can live on the scalp and neck of a human host. They do not live on animals. They need the human host to survive and will not live for any length of time off of the scalp.

They hatch from small eggs (nits) that are attached with a cement-like substance to the shaft of individual hairs.

They must have the warmth of the human body and blood on the scalp to survive.

They are NOT a health hazard, a sign of uncleanliness nor do they spread disease.

They do not fly or jump. They want to STAY on the hair near the scalp.

They need very close head-to-head contact to spread from one person to another. Homes and camps are the most common mode of transmission.

Indirect transmission is uncommon but may occur via shared combs, brushes, hats and hair accessories that have been in contact with lice. RARELY are they spread through shared helmets or headsets.

Itching occurs when they inject a bit of saliva into the scalp, but itching can persist even after treatment and is not a reliable sign of lice.

Due to the life cycle of the louse, when lice are discovered, they have usually been there about a month. Checking the scalp within a few days of exposure will more than likely NOT result in finding any evidence of lice.

An infected individual may complain of itching as well as a tickling sensation of something moving in the hair.

Diagnosis and Treatment

The gold standard of diagnosis for head lice is the presence of a live bug. Finding a live louse can be difficult as they crawl very rapidly and are generally very tiny. Nits attached to the hair shaft are much easier to identify. Nits are the egg casings of the lice eggs and are generally about 1 mm long and shaped like a teardrop. Nits are often confused with such things as hair casts, residue from hair products, or dandruff. Classically, nits are cemented to the hair shaft and are difficult to remove as opposed to the other substances. Scientific evidence has shown that nits that are further than approximately 6 mm from the scalp are probably not viable. Nits can be examined under a microscope for definitive determination of viability, but this is most often unreasonable and not done. According to experts, if the nit is further from the scalp and there is no evidence of live bugs, the nits may be left from a previous infestation. Nits may remain on the hair well after the infestation and vigilant rechecking of the head may be warranted to determine that there is not a viable case of lice.

The Issues and the Evidence

Previously school policies and best practices have been based on misinformation, myths and stigmas regarding lice. In recent years research has been released from organizations such as Harvard School of Public Medicine, The American Academy of Pediatrics, The Center for Disease Control, and the National Association of School Nurses that address the issues of treatment of lice, school absences, and embarrassment and confidentiality issues that have in the past created undue anxiety on the part of parents and school staff. School nurses are available to provide accurate information and work with parents and school staff to minimize the uproar that can occur when a child is identified as having lice. Your school nurse can instruct you on how to check your child’s head and are available to answer any questions or give advice in the event that your child has lice.

If your child has lice there are many treatment options. You may wish to discuss your choices with your pediatrician. No treatment is 100% effective; however, using a pediculicide is generally more effective than home remedies. Removal of nits can be helpful in decreasing the risk of self-reinfestation (especially the nits close to the scalp), decreasing diagnostic confusion or the possibility of unnecessary re-treatment. No matter what treatment is used, rechecking the child’s head is a necessary step to decrease the possibility of reinfection. Basic vacuuming of your home and car seats and cleaning of your child’s linens and any objects that are in contact with their heads are recommended to avoid reinfection.

The scientific evidence has shown that head lice screening programs have not had a significant effect on the incidence of head lice in the school setting. It is important to remember that a child who is identified with lice has been infected for 3-4 weeks and poses very little risk of transmission to others. It is more important to maintain that child’s privacy and minimize the loss of classroom time than to exclude or separate that child. Research data does not support immediate exclusion upon identification as an effective means of controlling lice infestation.

Lice is not a public health issue – they do not carry disease nor have any negative implications about the child or family who has been infected. Removing the stigma and having an understanding of the issue, and passing this understanding to our children should be the first step in addressing lice. Below are several resources where you can get more accurate and scientific information:

identify.us.com – Identify US –formerly Harvard School of Public Health information on lice

http://www.cdc.gov– The Centers for Disease Control

http://www.aap.org– American Academy of Pediatrics

(Information in this article was obtained from the above websites.)

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