Drug Resistant Head Lice May Soon be Creeping into a School Near You!

[tnbutterfly - Mary, BSN]

As kids are starting back to schools across the country, school nurses may be facing a new problem when it comes to dealing with head lice. There's a good chance that widely available treatments that have been effective for years will no longer get rid of the creepy crawling insects.

A recent study shows that at least 25 states host lice populations that are unresponsive to the commonly used over the counter lice treatments. The dreaded insects have developed genetic mutations due to continued exposure to permethrin.

Are you in one of the red states where the mutant lice reside??

The good news is that prescription medications that don't contain permethrin remain effective against lice. These contain powerful agents such as benzyl alcohol, ivermectin, malathion and spinosad. Lindane shampoo is another alternative for difficult-to-treat cases.

According to Jake Deutsch, MD, founder and clinical director of New York's CURE Urgent Care, there are a number of home remedies that are inexpensive, non-toxic, and effective. Those include using essential oils like tea tree, clove oil, and nutmeg oil, as well as vinegar. But if you prefer sticking with a more traditional treatment, Deutsch recommends Sklice, Ovide, and Natroba.

I bet you are just itching to try out these new treatments!

For more about this story go to:

Head Lice Now Resistant to Common Meds in 25 States

[Farawyn]

New York, Newwwwww Yooorrrrrk!

[SnugglePuggle, MSN, RN]

Do not forget Manual Removal! All you need is a spray bottle of conditioner, a good nit comb, paper towels and a lot of patience! You Tube has some good videos demonstrating the technique.

[abc123RN]

Parents and teachers are in a panic now!! My phone has been ringing off the hook! I just love when this gets posted on places like Facebook, said no school nurse ever.

[GmaPearl BSN RN]

Oh Goodie….

[RatherBHiking, BSN, RN]

I see the state I work in is green however we're surrounded by red but for some reason those resistant lice don't cross our state border I guess! I've seen first hand for years some of the treatments just don't work. That's not news to me but I find it hopeful that it's finally being recognized so that better options and research will hopefully come of it. I can see parents who aren't trying very hard to get rid of lice using this as an excuse to give up though which isn't helpful to the students being excluded.

[Spidey's mom, ADN, BSN, RN]

A teacher brought this up in the teacher's lounge. I basically acted in a "ho hum, no big deal" manner.

The impression the teacher gave was these monstrous new kind of lice had landed from planet Mars and were going to take over the school.

Lice are lice. The treatments might be changed due to the lice becoming more resistant to the medications (typical with some illnesses as well - think MRSA). But there are still treatments the doctor can prescribe.

OTC stuff and homemade naturopathy cures don't really work and never have.

And the school nurse doesn't do the nit combing. Don't ever walk down that path. We are too busy.

[Spidey's mom, ADN, BSN, RN]

Whenever the subject of lice comes up, I add links. Wish we could have them as stickies in the School Nurse Forum.

Pediculosis

It is the position of the National Association of School Nurses that the management of pediculosis (infestation by head lice) should not disrupt the educational process. No disease is associated with head lice, and in-school transmission is considered to be rare. When transmission occurs, it is generally found among younger-age children with increased head-to-head contact (Frankowski & Bocchini, 2010).

Children found with live head lice should remain in class, but be discouraged from close direct head contact with others. The school nurse should contact the parents to discuss treating the child at the conclusion of the school day (Frankowski & Bocchini, 2010). Students with nits only should not be excluded from school (American School Health Association, 2005, Frankowski & Bocchini, 2010, Pollack, Kiszewski & Spielman, 2000), although further monitoring for signs of re-infestation is appropriate. It may be appropriate to screen other children who have had close head-to-head contact with a student with an active infestation, such as household family members, but classroom-wide or school-wide screening is not merited (Andresen & McCarthy, 2009). In cases that involve head lice, as in all school health issues, it is vital that the school nurse prevent stigmatizing and maintain the student's privacy as well as the family's right to confidentiality (Gordon, 2007).

The school nurse, as a student advocate and nursing expert, should be included in school district-community planning, implementation, and evaluation of vector control programs for the school setting. School nurses are also in a pivotal position to dispel myths and stigmas regarding pediculosis by providing education on the life cycle of the louse, methods of transmission, treatment options and care of the environment to the student's family, school and community at large.

https://identify.us.com/idmybug/head-lice/head-lice-FAQS/index.html

Regardless of whether lice are becoming resistant to usual treatments, we should not panic or buy into the myths perpetuated by scared teachers or parents.

[OldDude]

Regardless of whether lice are becoming resistant to usual treatments we should not panic or buy into the myths perpetuated by scared teachers or parents.[/quote']

EXACTLY!!!! I constantly remind our staff that head lice are not introduced to the classroom by our school and it is not our school's responsibility to treat. We can assist in identification and education but the buck stops there. And.....considering the life span of a louse without a host......every Monday the students enter a lice free school.

[coughdrop.2.go, BSN, RN]

I try stressing to my parents that the shampoo does nothing if you do not work to remove the nits! We all know the resistance is proabably due to parents constantly shampooing the kids hair instead of waiting a week in between treatments and combing everyday. It's time consuming, but nit removal (and environmental clean up) has to be done in order for the whole treatment to be effective.

And I found it interesting that he only found the resistance in a random sample of lice and not those specifically from children that have been difficult to treat or have had reoccuring cases. There's nothing saying those children weren't treated properly and de-loused within a resonable time. Just that the lice showed resistance. (If I'm wrong, please correct me and I'll shuffle my way over to the coffee maker).

[blue bag nurse]

Typical back to school panic article. I was interviewed for a similar article back in 2008, same sort of attention grabbing title. Lice have been resistant for as long as I have been a school nurse, and probably long before! :)

[AlphaM]

Why not just removing all the hair with clippers?? Problem solved