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LICE – IDENTIFICATON & TREATMENT

Learn about head lice and body lice infestations, life cycle, facts, signs, and symptoms. Get tips on identification and treatment methods, including nit removal and insecticides. Follow guidelines for thorough cleaning to prevent reinfestation. 8 Relevant

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LICE – IDENTIFICATON & TREATMENT

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  1. LICE – IDENTIFICATON & TREATMENT

  2. PediculosisCapitis - head lice infection or infestation • PediculosisCorporis - body lice - usually associated with poor socio-economic conditions i.e. – homeless – infrequent change of clothing/poor hygiene

  3. Transmission • Usually head-to-head contact • Can be contracted through the sharing of brushes, hats, scarves, coats, bedding/linens, etc. • Obligate human parasite (a parasite organism that cannot complete its life cycle without dependence on its host)cannot be transferred through pets/animals

  4. Life Cycle • Mature female can lay 3 – 6 eggs/day and live for about 1 month • Eggs hatch within 6 – 10 days, maturity reached after another 10 days • nits may survive up to 3 weeks after removal from the host

  5. MALE FEMALE

  6. Facts • Most commonly affects children 3 – 11 years of age but anyone can be affected • Common to have outbreaks at schools, dormitories, etc • Prevalence - Female > Male • Likely many unreported due to stigma attached to infection • Lice prefer a clean environment

  7. Approx. 1 – 3 mm long • Flat • Wingless • 3 sets of legs - insect

  8. Signs & Symptoms • Most often found on the warmer areas of the head – behind the ears & back of head & neck • Itching common, especially at night • Excessive scratching can cause inflammation and secondary bacterial infection • Lice lay eggs or “nits”, cemented, close to the base of the hair shaft • Eyelashes (rarely) may be involved as well

  9. IDENTIFICATION • Live lice may be detected, but they move very quickly, and shy away from light so detection of live lice may be difficult –advantageous to use 2 people to check the infected person - many of those infected will have < 10 organisms present • Lice appear sluggish away from the warm scalp • Usually 24 hour survival off the host • Some recent data suggest for up to 55 hours

  10. IDENTIFICATION OF NITS • Important to distinguish nits from other possibilities • Dandruff, residues from gels/lacquers can look like nits • Recent, viable “un-hatched” eggs are creamy-yellow and very close to the scalp while older “nit shells” are further away from the scalp and white in colour • Oval in shape, slightly smaller than a sesame seed, never irregular in shape, fuzzy, or encircle the hair

  11. TREATMENT • A NIT REMOVAL COMB IS AN EFFECTIVE SCREENING TOOL • Manual removal may be the most important step, and it is possible to treat head lice with this method alone

  12. TREATMENT • Mainstay of treatment – insecticides

  13. Lice and other arthropods are killed by these medications blocking nerve impulses – causing paralysis and death of the parasite • Products should be applied to clean, dry hair in sufficient quantity to saturate the hair/scalp (especially behind the ears and the nape of the neck) and left on for 10 minutes, then rinsed. • Other treatments, petroleum jelly, kerosene, Tea-tree oil and others are either ineffective or unsafe

  14. Nit or egg removal should follow with a fine-toothed nit comb. • Soaking the hair and wrapping the scalp with a 50/50 solution of vinegar and water for at least 15 minutes • Machine wash (hot) and dry all hats, scarves, coats, bedding, if possible, and dry in dryer on the hot setting • For articles that cannot be cleaned this way, dry clean or seal up in a plastic bag for one week

  15. The nit comb, as well as other combs, brushes, barrettes, etc can be soaked in rubbing alcohol for 1 hour • Clean house room by room by thorough vacuuming (rugs, furniture, floors) • All close contacts should be thoroughly screened and treated only if necessary • After treatment, person should be checked regularly for any evidence of lice or nits • Re-treatment may be necessary and alternate agents may have to be used - resistance

  16. Itching, redness, and inflammation may persist for several days after successful treatment and may not necessarily mean re-application is required • Even the presence of live organisms several hours after treatment does not indicate that the treatment was unsuccessful; often these parasites take several hours to die after exposure to treatment

  17. ALTERNATE TREATMENT • Electric – battery-powered comb “zaps” lice • Some success • Price - $50

  18. REFERENCES • Centers for Disease Control and Prevention. Parasitic disease information: head lice infestation. Division of Parasitic Diseases. http://www.cdc.gov. • Hansen RC, et al. Guidelines for the treatment of resistant pediculosis. Contemporary Pediatrics 2000 Aug:S1-10. • Hipolito RB, Mallorca FG, Zunia-Macaraig ZO, et al. Head lice infestation: single drug versus combination therapy with one percent permethrin and trimethoprim/sulfamethoxazole. Pediatrics 2001;107(3):p.e30. • Burson, SC, Permethrin-Resistant Head Lice Pharmacist's Letter 1999;15(11):151116 • Clinical Pharmacology http://cpip.gsm.com

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