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Head Lice

Head Lice. James R. Ginder, MS, WEMT,PI, CHES Health Education Specialist Hamilton County Health Department www.hamiltoncounty.in.gov. The student will be able to. identify the various stages of head lice recall the signs and symptoms of head lice describe how head lice are transmitted

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Head Lice

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  1. Head Lice James R. Ginder, MS, WEMT,PI, CHES Health Education Specialist Hamilton County Health Department www.hamiltoncounty.in.gov

  2. The student will be able to.. • identify the various stages of head lice • recall the signs and symptoms of head lice • describe how head lice are transmitted • list various treatment opportunities

  3. Health Problem Lice are not a Public Health Problem Source: Harvard School of Public Health

  4. What are head lice ? • Head lice (Pediculus capitis) are small insects that can live on the scalp and neck hair of a human host • Approximately 6 to 12 million children are infected with Head Lice per year (AAP) • Head lice are not a health hazard or a sign of uncleanliness and are NOT responsible for the spread of ANY diseases • All groups of people can develop Head lice

  5. Preschool and elementary age children (age 3-11) and their families are infested most often (CDC) • African Americans have fewer cases of head lice due to oval-shaped hair shafts which are harder for lice to grasp • Lice seem to prefer red or brown hair over blonde or black hair (Vessey) • Lice development has no connection with the length of hair or the frequency of brushing or shampooing

  6. Lice need blood to feed each day • They cannot survive for more than a day or so at room temperature without access to a persons blood (Pollack) • Lice CAN NOT jump or fly, BUT they can crawl from head to head • Transmission of lice is by direct contact with a person’s hair • Indirect transmission can occur. (combs, brushes, hats)

  7. Nits • Tiny eggs that are attached to the hair shaft by a glue- like substance made by the louse • They incubate by body heat and hatch 10-14 days • Nits are camouflaged with the pigment of the hair.

  8. Life Cycle • Adult Louse • 2 to 3 mm long • Color can vary • Female can live up to 3-4 weeks and deposit more than 100 eggs at a rate of six eggs each day • Feeds by injecting a small amount of saliva and taking a tiny amount of blood from the scalp every few hours. This saliva may create the itchy irritation

  9. Nymphs • Nymphs leave the shell casing which can be seen easily at the posterior hairline • They grow for about 9-12 days, mate, and the female lays eggs • If not treated, this process will repeat every three weeks Nymph Adult

  10. Signs and Symptoms • Tickling feeling or something moving in the hair • Itching, caused by an allergic reaction to the bite • Irritability • Sores on the head caused by scratching

  11. Diagnosis • Diagnosing lice is done by finding a live louse on the head • Eggs, or nits, may be easier to spot at the nap of the neck or behind the ears, within 1 cm of the scalp • If nits are seen farther than 6 mm from the scalp and no nymphs or adult lice are seen, the infestation is a past infestation and DOES NOT require treatment (Hansen) • It is important not to confuse live nits with dead or empty egg cases

  12. DO not confuse nits with: *dandruff *hair casts *hair debris Egg Cases

  13. Treatment • Various treatments for lice include: ● Insecticides ● Mechanical Removal ● Enzyme Treatments ● Antibiotics ● Suffocating Agents ● Heat/Cold ● Haircuts BeforeANY treatment contact a pharmacist or your healthcare provider

  14. At Home • Washing and drying (with heat) pillowcases, sheets, nightclothes, towels and stuffed animals to prevent reinfestation • Combs, brushes, hats and other hair accessories that are in contact with an infected person should be washed in Hot water EACH day to dislodge any lice and nits • Furniture and carpeting that have been in contact with the head of an infected person within 24 to 48 hours before treatment should be considered for cleaning. Lice can not live off the scalp longer than 48 hours

  15. Pets can NOT transmit lice and SHOULD NOT be treated • If items cannot be washed, place them in a plastic bag for two weeks, by which time any nits that may have survived would have hatched, and nymphs would die without a source to feed on • ALL household members should be checked for live lice • Check household contacts for lice and nits every two-three days. TREAT only if crawling lice or nits within a ¼ inch of the scalp are found (CDC)

  16. Prevention • AVOID head-to-head contact during play at school and at home • DO NOT share clothing, such as hats, scarves, coats, sports uniforms and hair ribbons • DO NOT share infested combs, brushes or towels • DO NOT lie on beds, couches, pillows, carpets or stuffed animals that have been in contact with an infected person • Talk with your child about not sharing clothing with anyone

  17. It is the position of the National Association of School Nurses that the management of pediculosis should not disrupt the education process.

  18. Schools & Lice • No-nit policies developed by school systems were established in response to the stigma and unclear transmission of lice • Attendance records indicate that 12-24 million school days are lost annually in the U.S. due to students with nits (Scott) • The National Association of School Nurses (NASN) states that children who have been treated for lice SHOULD NOT be excluded from school because of the existence of residual nits (NASN) • According to the American Academy of Pediatrics, no-nit policies in schools are a detrimental cause of lost time in the classroom.

  19. Children with an active head lice infestation are likely to have had the infestation for at lease a month by the time it is discovered (Frankowski) • A child with active head lice have NO immediate risk to others and SHOULDbe allowed to remain in school for the day. • Lice transmission in school is low, due to close head-to-head contact which is low and generally does not happen in the school setting

  20. Screening entire classrooms is an unjustified response (Plooack) • Parents of students found to have LIVE lice should be contacted by the school nurse and advised of treatment options • Children SHOULD NOT be sent home for head lice • Students CAN RETURN to school if they have DOCUMENTATIONof at least ONE treatment • Teachers SHOULD reinforce not sharing hats or other objects that comes in contact with hair

  21. If younger children nap on carpet area, these areas should be vacuumed daily • NO, notification needs to be sent home to classmates parents • Insecticides in the school are not warranted and provide unnecessary chemical exposure • Call your school nurse and see what head lice policies the school district has in place

  22. Care Plans

  23. Cost • Parents must take off work to care for children who are excluded from school due to no-nit policies • Cost associated with treatment, including the cost of doctors visits, medication and nit-removal utensils • Parents must arrange alternate child care to prevent lost days at work

  24. More Information on Lice • HeadLice.orghttp://www.headlice.org • CDChttp://www.cdc.gov • Harvard School of Public Healthhttp://hsp.harvard.edu • Medline Plushttp://www.nlm.nih.gov/medlineplus/headlice.html • Hamilton County Health Departmentwww.hamiltoncounty.in.gov/health

  25. References • Centers for Disease Control and Prevention • Frankowski, B.L. (2004) . American Academy of Pediatrics Guidelines for the Prevention and Treatment of Head Lice infestation. American Journal of Managed Care 10 S269-S272 • Hansen, R.C. (20004). Overview: The State of Head Lice Management and Control. The American Journal of Managed Care, 10, S260-S263 • Pollaxk, R.J. (2000). Head Lice Information. February 2007, form The Harvard School of Public Health Website: http://hsph.harvard.edu/headlice.html

  26. References • Sciscione,.,Krause-Parello, C. (2007) No-Nit Policies in Schools: Time for Change. The Journal of School Nursing 23, 13-20 • Vessey, J.A. (2000). Current Concepts in Pediculosis Management. Scarborough, Me:NASN

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