Healthy Start in Child Care

Presented By:

Janet Blair

Perry County Health Department

Head Lice

What do we need to know??

(Or, more than we care to know?)

WHERE DID THEY COME FROM?

•Plagued humankind since recorded time-5000 years•Lice & eggs mummified with ancient Egyptian nobility upon whom they dwelled•Also recovered from 2000 year-old delousing combs excavated from the Judean Desert

What is there to know?

There are three types of human lice. The one schools deal with most often are head lice.

What is there to know? Lice have been around

for centuries. Archeologists have excavated mummies with lice, ancient combs with nits and other records related to head lice.

What is there to know?

Examination of ancient lice show they are identical to those we deal with today.

An estimated 6-12 million people get head lice each year.

These are equal opportunity parasites: they don’t respect socio-economic class distinctions.

What is there to know?

Head louse infestation is more common among children than all other childhood communicable diseases combined.

The head louse found on humans is specific to people. It can’t be contracted from the family dog, cat or any other animal. Mammals and birds can have lice but they are species specific.

Does only “Dirty” people get Lice?

(NO)Actually lice prefer

clean heads. Head lice should not be equated

with poor personal hygiene.

SEEK ANY HUMAN HOST

Seek food, warmth & shelter

Settle for 1st opportunity that comes along

Can survive temps between 59 F degrees & 100.4 F

Adult lice feed on human blood by stabbing an opening through the skin

Pour in saliva to prevent clotting Feed for 45 seconds-8 to 12 x per day or every 3 t0 4 hours if not disturbed Bloodsucking & saliva injection cause the most common symptom “itching”

LICE “CANNOT”

CANNOT jump like fleas CANNOT fly or hop CANNOT swim CANNOT live on dogs,

cats or other animals Cannot transmit disease

The Facts on Head lice

These are insects that CANNOT jump or fly.

Their method of movement relies on 6 legs, each of which ends in a claw which can grasp human hair.

The Facts On Head Lice Head Lice are

NOT known to transmit pathogens (germs). They are a nuisance but NOT a health hazard.

The Facts on head lice…. Lice eggs are called nits. They are

oval shaped and usually yellow to white. The female louse lays these close to the scalp at the base of the hair. The eggs are attached to the hair with a quick hardening glue that the female louse extracts from her body.

The Facts on Head Lice….

The young lice hatch 6-10 days later and leave the egg shell behind.

Dead eggs and egg shells may remain attached to the hair for 6 months or more.

The Facts on Head Lice….

It is nearly impossible to tell visually which nits are still incubating eggs and which are hatched.

SIGNS & SYMPTOMSMay or May not have itchy

scalp

A secondary bacterial infection may result from scratching

May have tingling feeling of something moving in the hair

LIFE SPAN

Adult head lice-about one month Attach egg firmly with a cement like

substance at an angle on the hair shaft next to the scalp

Yellowish or grayish white oval eggs (nits) hatch in 5 to 12 days and the young resemble adults except they are smaller-young (nymphs) mature in about 8-9 days

Empty egg cases can remain stuck on the hair shaft for long periods of time because of the cement-like substance. They get farther from the scalp as the hair grows

Lice survive 6-26 hours rarely longer than 36 hours without a human host

Nits, off the host, can survive 10 days under the right conditions of heat and humidity

WHERE NITS ARE FOUND

Typically adhere within ¼ inch from scalp especially found at nape of neck or behind ears

In warmer climates and during summer viable nits can be found further down the hair shaft-up to 6 inches

In cooler climates nits are more than ½ inch from scalp and usually have hatched

How is lice transmitted from one person to

another???

LOUSYLOUSY ways they’re spreadPERSON TO PERSON/HEAD TO

HEAD

Transmission of Head Lice

Host-to-host (direct contact from someone who is infested)

By wearing infested clothing (hats, scarves, coats, hair ribbons etc.)

By using infested combs, or brushes By lying on a bed, couch or carpet

that has recently been in contact with an infested person.

Can you catch head lice in a pool, pond or lake?

Risk of transmission is no higher than any other activity. When in water lice go into a state of suspended animation but remain firmly on the hair….they “hang on for dear life”. They survive washing, rain, swimming pools & seawater. Transmission risk occurs with sharing & piling of towels, clothes stored in close proximity & head to head contact.

Transmission of Head Lice Only LIVING

LICE can transfer from one person to another

Nits cannot be passed onto someone else

The Facts on Head Lice Nymphs: The egg hatches to

release a nymph. The nymph looks like an adult head louse but is about the size of a pinhead. Nymphs become adults 7-12 days after hatching.

Nymphs cannot fertilize or lay eggs until they become adults.

The Facts on Head Lice Adults: Adult lice are about the size

of a sesame seed. They survive by blood-feeding 1 time

or more a day. They cannot survive for more than 24 hours or so at room temperature without human blood.

The entire life span of a louse is about 30 days

The Facts on Head Lice

A female louse will lay about 6 eggs/day. Only those deposited by an inseminated female can hatch.

(about 200-300 in life span)

What does that mean for us at school?

Precautions need to be taken in the classrooms.

Children shouldn’t lay on rugs/floors with their heads together.

They shouldn’t share hats.

We should do what we can to help children avoid direct head to head contact.

Children will NOT transmit head lice simply by standing or sitting by other children.

Coats/jackets should be hung separately.

Please Remember….

Lice don’t mount expeditions, striking off to find new heads. They are parasites that require a human host, their goal is to stay on the head where they presently live!!!!!

SCREENING

Use magnifying glass & natural lightLice move very fast, flee from light and

hide behind hair

“Looking for Lice is like looking for a needle in a haystack, except that lice run and hide” (from The Lice Buster book)

What if a child has head lice? It is generally recommended that

the first treatment for head lice is an over-the-counter lice treatment. A prescription can be obtained from the doctor. It must be used EXACTLY as the directions specify.

Most of these treatments are Most of these treatments are pesticides and overuse can be pesticides and overuse can be dangerous.dangerous.

Pyrethrins: (pie-WREATH-rins) ex. Rid, Pronto, A-200, R&C, Triple X. (OTC)

These are natural extracts from the chrysanthemum flower. A second treatment is recommended in 7-10 days to kill any newly hatched lice.

Treatment failures are common.

What medications are available to treat head

lice?

What Medications are Available to Treat Head

Lice? Permethrin 1%- Brand name Nix. (OTC) Permethrins are similar to natural

pyrethrins. It is safe & effective when used as directed. Permethrins may continue to kill newly hatched eggs for several days after treatment. A second treatment may be necessary in 7-10 days.

Do not use in Children under 2 years old.

Prescription Medications:

Malathion lotion 0.5%-(Ovide). This drug is FDA approved for treatment for 6 yrs & up.

Lindane shampoo 1%-Is not recommended as a first-line therapy. Overuse, misuse, or swallowing can be toxic to the brain & nervous system. It should never be used if open sores are on scalp.

What Other Treatments are Available to Treat Head Lice?

Oil treatments. The thinking is that they smother lice and eggs. There are no published studies on this method. If applied as recommended ,it should be used on days 1,2,5,9,13,17,21.(how many people will do that??)

The proponents of this method do recommend all nits to be combed out of the hair.

What about lice sprays?

Most sprays are also pesticides and are not

recommended by the Center for

Disease control. They are not

effective and may be dangerous.

Eggs by themselves without the

presence of live lice do not indicate an active infestation. Treatment should

ONLY be carried out if live lice are

present.

So, Why not a no nit policy? I thought we were finally getting somewhere in this lice problem!

Why NOT a no-nit policy?? Such a policy has

notnot been supported by research and is not recommended by experts.

Misdiagnosis of nits is common.

Why NOT a no-nit policy?

Encourages use of potentially dangerous pesticides for no reason.

Causes children to miss school needlessly.

Why Not a “No-nit” Policy?

It doesn’t prevent “chronically” infested children from being re-infested.

Think About it:

For transmission to occur from one person to another either 2 lice have to crawl from one head to another ,OR a female that has been inseminated by a male must leave the host and get to a new head.

Children can (and do) get head lice from school. But they also get it from other places.

If we exclude children from school

for “nits” only, we are basing this practice on myth and not scientific research.

Encourages Misuse of Medication

There have been studies done that have documented resistance in lice to medication. The resistant lice are found most commonly in populations that use lice treatments repeatedly.

People apply medication when nits only are noted and there may not be an active infestation.

Misdiagnosis is Common Even the person who is very skilled

at checking children for head lice infestations cannot distinguish living from dead eggs without a microscope.

Other objects in the hair can easily be mistaken for nits.

School Exclusion

Nits alone cannot be transmitted from one person to another.

If a nit hatches at school it will take 7-12 days to mature.

Once matured, the female has to be inseminated to be able to lay fertile eggs.

School Exclusion If she isn’t inseminated, she has to

find a mate.

That’s a lot of activity That’s a lot of activity for a 7-hour school for a 7-hour school day!!! day!!!

In Conclusion

Remember: we need to base practices on scientific evidence, not fear and hysteria.

INTERNET RESOURCES headlice.org http://www.hsph.harvard.edu/headlice.html http://www.publichealth.state.ky.us/head_lice.htm http://www.cdc.com/head_lice

THANKS FOR LISTENING TO OUR “LOUSY PRESENTATION”