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Tis' the Season... for Head Lice

By Michael D. Shaw, Correspondent at Large - HealthNewsDigest.com

Oct 30, 2006, 07:00

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'TIS THE SEASON...FOR HEAD LICE

(HealthNewsDigest.com).. Along with the glorious colors of the leaves turning in much of the country, and cooler temperatures, the arrival of autumn can often bring unwanted guests. I'm referring to head-scratching among school children, and that doesn't just mean that they might be asked a question by their teacher that seems to be difficult to answer.

The head-scratching may be caused by that common parasite--Pediculus humorifice capitis--also known as the head louse. And, since no human host gets just one, they are better known by their plural form--head lice.

Since head lice can be spread whenever there is direct contact of the head or hair with an infested individual, and via the sharing of personal articles such as hats, towels, brushes, and hair ties, it is not surprising that schools would be a fine place to catch these pests. These creatures do not have hind legs that would allow them to jump like fleas, and they don't have wings to fly, so they cannot of their own volition spread from one host to another.

The good news is that lice are non-discriminatory; they make no distinction between race, class, or religion, despite the false beliefs of some who cling to the idea that any outbreak is solely a phenomenon of the poor or slovenly. The bad news is that, given our abuse of various medicines, lice now have an immunity to traditionally powerful forms of treatment. In fact, scientists believe that 80 percent of these insects can fight most over-the-counter lotions, including the chemicals permathrin and phenothrin. Treatment is only an option when active lice or viable eggs are visible. Itching of the scalp or the perception that something is crawling on the head do not warrant treatment for lice.

Bear in mind that head lice are an annoyance, not a public health crisis. They rarely cause direct harm, and are not known to transmit infectious agents from person-to-person. However, since the head lice is closely related to Pediculus humorifice humorifice, the body louse, which does transmit such diseases as typhus, it is wise not to ignore the pathogenic possibilities of head lice.

Head lice can cause itching or loss of sleep; the louse's saliva and feces may sensitize people to their bites, worsening the irritation and increasing the chance of secondary infection from excessive scratching. Another factor, only recently being publicized, derives from the well-intentioned but misguided use of caustic or toxic substances to eliminate the lice.

Some products are available that are touted as being "natural," even if there is no accepted definition of this term. Of course, a less toxic treatment is preferable, but little data is available establishing efficacy. Indeed, efficacy of treatment will always be clouded by the determination and diligence of the parent, above and beyond the inherent factors of the treatment modality.

The most effective treatment, and the least toxic, is the time-proven method of using a specialized comb to remove the lice, and their eggs (called "nits"). Check the website of the National Pediculosis Association ® for detailed information.

http://www.headlice.org

Thankfully, lice generally lack the potential to cause an epdidemic. According to the Harvard School of Public Health, the basic reproduction number (a measure that defines the number of secondary infections arising from an index case) is far lower for head lice than for infections due to cold or flu viruses. This opens up the topic of the so-called no-nits policies that are in place in many school districts.

On the one hand, if a child is barred from school for having nits, the condition can be easily cleared up within a day or two. On the other hand, some authorities drift toward political correctness by condemning such policies only because they SEEM to hearken back to lice-related ethnic prejudices of the past. Moreover, they claim that such policies are ineffective, conveniently ignoring the extreme difficulty in obtaining meaningful data on human diseases, especially those whereby treatment efficacy is almost completely dependent on parent effort. Clearly, if there are no nits in the school, there will be no cases of head lice!

Finally, I can't help but think that those against no-nits may harbor their own prejudices about putting public health into the hands of the public, and not esteemed authorities such as themselves.

Lice are a nuisance, not a cause for panic, unless toxic remedies are brought to bear. Given enhanced means of communication, and the public's continuing interest in good health, we should be able to vastly reduce the incidence of this parasite.

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Michael D. Shaw

Exec VP

Interscan Corporation

[email protected]

http://www.gasdetection.com

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Specializes in floor to ICU.

this brought back vivid memories. Years ago, I used to be with Immunizations and Communicable Disease in Texas. Lice fell under our Dept. The phone calls, faxes, and emails were endless regarding lice questions/problems. It was like I was the referee between the school nurse and the parents. Our area had a no-nit policy which made matters even worse. Great article.

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Specializes in PCA in Med/Surg.

oh....I am a nursing student with a dear friend...her daughter has had lice since Aug 06 5 times...I can now say I am amazed by the reaction of the school...She has visited the doc every time...YOUR child must have a receipt/script for tx everytime...your child will not be allowed back to school with out one. The school acts as if she has some untreatable disease. She has had her tx all five times by a doc, I have helped strip the house down each time, picked/combed her hair and so on. The poor baby now thinks she has some kind of illness b/c her teacher check's everyday for lice, nits...she then goes to the school nurse which calls and says, "she can not find any lice/nits"-the teacher did see one as always-(the teacher would give a sworn statement to the cops/judge if she could-I am sure she has OCD)the child must be checked out of school....my question is do the teacher not know by now what lice is...just a vent as I just helped once again strip her house down and watched as her long hair was cut 1 inch from her head....funny thing is I do not and have not got lice, nor her parents or brother trust me...I am now as bad as the teacher???? Is that not strange?

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Specializes in OB/peds (after gen surgery for 3 yrs).

I work in a preschool, and last year we had one child who had lice about every six weeks. No one else in class got them, no one else at home got them....it even drove the docs nuts. I wonder if she will just outgrow them? She is now in kindergarten and I don't know how it's going.........

This year we have two girls in one class....if one has it the other doesn't and vice versa.....both sets of parents are very upset and "blaming" the other one....even though we have been strictly confidential, the girls themselves have figured it out....one child's mom is pregnant and I don't want her to keep using the treatment, the other one's father is a big bully, very loud and wants to "keep that OTHER child out of school". Lice are going to be my downfall!!!

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Specializes in School Nursing.

I suppose as long as there are head lice...we'll have jobs ! :lol2:

Head lice are a real pain for everyone involved. There are always going to be parents who want to play the "blame game". There is no way you can point the finger at people and say they "gave" it to you. I just know that over the years I have noticed that you can get rid of head lice. You can ! If you use the shampoo exactly as directed and treat the home environment as well. You can break the cycle. The one's that I see who get them over and over are the ones who don't follow through as they are supposed to do.

I have spoken to many parents who think we "give them out" at school.

Oh my goodness....I can picture that one. :uhoh21: One for you and two for you ....and one for you......ha !

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Specializes in Geriatrics, Pediatrics, Home Health.

We also have a no nits policy! I have been to two different families' homes this week to nit pick! Both families are doing EVERYTHING right. The problem is a parent has the children on the weekends and the friends have head lice...so the kids get it again and AGAIN!!

We are talking about TWO different families!!

My questions are: Is there a secret to seeing the nits? I have trifocals and for me they are very hard to see.

Thanks!!

______________________________________

In His Grace,

Karen

Failure is NOT an option!!

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