1. Healthy Start in Child Care
Presented By:
Janet Blair
Perry County Health Department

2. Head Lice
What do we need to know??
(Or, more than we care to know?)

3. This is a close-up of a louse.

4. 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

5. What is there to know?
There are three types of human lice. The one schools deal with most often are head lice.

6. 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.

7. 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.

8. What is there to know?
Head louse infestation is more common among children than all other childhood communicable diseases combined.

9. The head louse found on humans is specific to people
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.

10. Does only “Dirty” people get Lice?
(NO)
Actually lice prefer clean heads. Head lice should not be equated with poor personal hygiene.

11. SEEK ANY HUMAN HOST
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”
Seek food, warmth & shelter
Settle for 1st opportunity that comes along
Can survive temps between 59 F degrees & F

12. LICE “CANNOT” CANNOT jump like fleas CANNOT fly or hop CANNOT swim
CANNOT live on dogs, cats or other animals
Cannot transmit disease

13. 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.

14. The Facts On Head Lice
Head Lice are NOT known to transmit pathogens (germs). They are a nuisance but NOT a health hazard.

15. 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.

16. 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.

17. The Facts on Head Lice….
It is nearly impossible to tell visually which nits are still incubating eggs and which are hatched.

18. SIGNS & SYMPTOMS May or May not have itchy scalp
A secondary bacterial infection may result from scratching
May have tingling feeling of something moving in the hair

19. 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

20. 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

21. 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

22. How is lice transmitted from one person to another???

23. Lousy ways they’re spread PERSON TO PERSON/HEAD TO HEAD

24. 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.

25. 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.

26. Transmission of Head Lice
Only LIVING LICE can transfer from one person to another
Nits cannot be passed onto someone else

27. 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.

28. 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

29. The Facts on Head Lice
A female louse will lay about 6 eggs/day. Only those deposited by an inseminated female can hatch.
(about in life span)

30. 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.

31. 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.

32. 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!!!!!

33. Lice move very fast, flee from light and hide behind hair
SCREENING
Use magnifying glass & natural light
Lice 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)

34. 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 pesticides and overuse can be dangerous.

35. What medications are available to treat head lice?
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.

36. 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.

37. 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.

38. 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.

39. Most sprays are also pesticides
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.

40. 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.

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

42. Why NOT a no-nit policy??
Such a policy has not been supported by research and is not recommended by experts.
Misdiagnosis of nits is common.

43. Why NOT a no-nit policy?
Encourages use of potentially dangerous pesticides for no reason.
Causes children to miss school needlessly.

44. Why Not a “No-nit” Policy?
It doesn’t prevent “chronically” infested children from being re-infested.

45. 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.

46. Children can (and do) get head lice from school
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.

47. 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.

48. 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.

49. 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.

50. School Exclusion That’s a lot of activity for a 7-hour school day!!!
If she isn’t inseminated, she has to find a mate.
That’s a lot of activity for a 7-hour school day!!!

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

52. THANKS FOR LISTENING TO OUR
INTERNET RESOURCES
headlice.org
THANKS FOR LISTENING TO OUR
“LOUSY PRESENTATION”