PEDICULOSISHEAD LICE

Margaret Jahn, MS, MPHFreehold Health Dept.

GOALS

• Learn about head lice– WHO, WHAT, WHEN, WHERE & HOW

• Biology• Treatment• Diagnosis• Prevention & control

HEAD LICE

• Infestation of Pediculus capitis• Parasitic insect• Hair, eyebrows & eyelashes• Excessive itching & scratching• Universal susceptibility• Unrelated to hygiene

HEAD LICE

• VERY common• Affects children 3-11yrs• Est. 6-12 million infestations annually• Spread from head-to-head contact• Feed on blood from scalp• DO NOT SPREAD DISEASE!• Nuisance!

BIOLOGY 101

• Life cycle – 3 stages– Egg, nymph and adult

EGGS

• Called “Nits”• Laid by adult female• Cemented to base of hair (6 mm from scalp)• Hard to see• Resemble dandruff• ~ 1 week to hatch

EGGS

NYMPHS

• Hatch from eggs• Look like adult louse• Mature after 3 molts• ~ 1 week

ADULTS

• Size of sesame seed• 6 legs with claws• Females larger• Lay up to 8 nits per day• 30 day life span• 2-3 meals of blood/day• Die 1-2 days off scalp

ADULTS

RISK FACTORS

• Not related to cleanliness!!• Common transmission head-to-head– Home– School – Elsewhere (camp, sports, playground etc.)

RISK FACTORS

• Uncommon transmission– Sharing clothing, hair ribbons– Using infested combs, brushes, towels– Lying on a bed, couch etc. recently in contact with

infested person

DIAGNOSIS

• Misdiagnosis – VERY common• Look for live insects • Nits not always reliable– Easily confused with dandruff, hair spray etc.

• Nits >1/4 inch from scalp – old

TREATMENT

• ONLY FOR ACTIVE INFESTATION!• Check household members & contacts• Treat all at same time• Supplemental measures

TREATMENT

• Over-the-counter medication• FDA approved• Pyrethrins or permethrins• READ LABEL• Do not re-wash hair for 1-2 days• Check 8-12 hrs after tx– Slower moving, comb dead – No dead – call healthcare provider

• Bedding, towels & clothing– With in 2 day period– Launder in hot water & dry– Place in plastic bag for 2 weeks

• Vacuum furniture and floors of infested hair

SUPPLEMENTAL

CDC RECOMENDATIONS

• Students remain in school if Dx during day• Children return to school after treatment• Nits still present? – O.K. as long as no crawling/ live insects– Burdensome absenteeism– Nits not easily transferred – Misdiagnosis common if not by health

provider

Freehold Township School Policy

REMEMBER!WE ARE HERE TO HELP

Freehold Health Department732-294-2060

QUESTIONS