8/1/2009

It’s back-to-school time, and while many parents worry about their children contracting the novel H1N1 virus sometimes called swine flu at school or camp, there are plenty of other annoying bugs being shared, such as head lice.

Lice are parasitic insects that survive by feeding on human blood and can be found on people's heads and bodies. Three types of lice live on humans and are associated with different areas of the body:

• Pediculus humanus capitis (head louse)
• Pediculus humanus corporis (body louse, clothes louse)
• Pthirus pubis (“crab” louse, pubic louse)

Head lice are most commonly spread through person-to person contact, but can also be spread by sharing personal items such as combs and brushes. Lice move by crawling -- they cannot hop or fly. Head lice are small, about the size of a strawberry seed, have six legs and are tan to grayish-white in color. A head louse infests a person’s head or neck and attaches their nits (eggs) at the base of the hair shaft (near the scalp). Nits often look like dandruff, but unlike dandruff, lice cannot be easily combed out of hair. Human lice can not be transmitted by pets.

Symptoms
The signs and symptoms of head lice may include: a feeling of something moving in the hair, itching caused by an allergic reaction to the bites, or sores on the head caused by scratching.

Head lice can be detected by closely examining hair and scalp for nits or lice. If you are uncertain if you or your child has head lice, visit your healthcare provider or have your child see the school nurse.

Treatment
The use of over-the-counter products is usually the first option in treating head lice.  You can purchase shampoos containing either pyrethrin (RID®, others) or permethrin (Nix®) to treat the infestation.  These products work best if you follow the directions very carefully.  In some instances, head lice become resistant to the ingredients in the shampoos. If the shampoo is not effective, your doctor can prescribe products with different ingredients. 
Before treating very young children (two years of age or less), consult with your healthcare provider or health department for treatment recommendations based on the child’s age and weight.

Alternative Treatment
If you do not want to use insecticides to treat the infestation, you can use a fine-toothed comb (called a “nit” comb) to remove the lice and nits from the infected person.  The comb will physically remove the lice and nits from the hair.  You should comb wet hair every three to four days for two weeks. This method is highly recommended for children under the age of two.

Prevention and Control
The Centers for Disease Control and Prevention (CDC) recommends the following steps to help prevent and control the spread of head lice:

• Avoid head-to-head (hair-to-hair) contact during school, sports activities, on the playground or at camp.
• Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
• Do not share combs, brushes or towels. You can disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5-10 minutes.
• Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an infested person.
• Machine wash and dry clothing, bed linens, and other items that an 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 weeks.
• Vacuum the floor and furniture, particularly where the infested person sat or lay, to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing. However, spending too much time and money on housecleaning activities is not necessary.
• Do not use fumigant sprays or fogs; they are not necessary to control head lice and can be toxic if inhaled or absorbed through the skin.
• Parents should notify the school nurse or principal so the school can take appropriate measures to prevent further spread.

For More Information
Centers for Disease Control and Prevention
Harvard School of Public Health
Mayo Clinic
September - Head Lice Prevention Month

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