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!
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
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
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