1. Presented by Angela Owings, BSN, RN Public Health Nurse Springfield-Greene County Health Department Things That Creep: Bed Bugs, Head Lice, & Scabies

2. Objectives for today: Identify evidence each bug leaves behind. Describe the first steps in eliminating an infestation. Identify proper storage techniques for all personal items that might be infested.

3. Objectives cont… Instruct parents of recommended measures to take once infestation is confirmed. Identify providers to call in the event of certain infestations. Discuss child care center policies for notifying parents and when exclusion of children is necessary.

5. Here we go with Things that Creep !

6. Bed Bugs

8. Don’t mistake them for something else.

9. Where?

10. Hiding spots.

11. Tips. Try to keep luggage off a bed when traveling. Use cubbies and separate kids clothes. Limit clothing brought from home.

12. Leaving a trail. Bed Bugs leave this identifiable pattern of stains on fabric they are regularly inhabiting.

13. Characteristic bite pattern

14. Bed bug bites Bed bug bites usually follow the trail in which they travel.

15. Treatment Use 90% isopropyl (rubbing) alcohol to kill a bed bug found on an everyday item. It is not necessary to send the child home or to exclude children who live in homes where there are bedbugs.

16. At home or in facility.

18. Head Lice Very common in children ages 3 to 12. You too are at risk. All socioeconomic groups are affected.

19. Head lice are worldwide.

20. No-nit policies. Children with nits do not need to be sent home.

21. Stages of life.

22. Nits and lice. Typically head lice are found in the darkened area. They can be found in other areas like the eyebrows.

23. What to look for. Eggs can be seen attached to the hair near the scalp. Itching and scratching caused by the bugs and their bites.

24. Treatment. Conditioners slow down the louse to be combed out. A chemical treatment should be tried with caution. Use chemical treatments for brief periods only, when prescribed.

25. Use caution with OTC drugs to treat head lice. Treatment products not 100% effective in killing lice. Removing nits is essential – must comb hair daily for 2 weeks with nit comb

26. Treat and prevent head lice from spreading.

27. Diagnosis and resources If you would like a resource for more information in eradicating head lice, use the link at www.pediatrics.org

28. Recognition is the best prevention. Be prompt to the symptoms of head lice. Control activities to reduce spread.

29. Scabies “The Human Itch”

30. Signs. Scabies are typically found in areas of skin folds.

31. Symptoms. The only mite that burrows into the human skin… Pimple-like rash, itches especially at night. Tiny burrows may be seen. Takes 2-6 weeks after exposure for symptoms to appear.

33. How are scabies spread? Prolonged skin-to-skin contact with a person who has scabies. Sometimes by indirect sharing of personal items, but this is rare.

34. Treatment Isolation for 24 hours – exclude from child care until treatment is completed. Treat all children in center exposed by direct contact. Treat all personnel who have direct contact. Treat all family members.

35. Treatment. Prevent reoccurrence of Scabies by laundering! 5% Permethrin is a treatment of choice for children. For other treatments, please talk to your doctor or the local Health Department.

36. Treatment cont… Itching may persist for 1-2 weeks after treatment. This should not be regarded as a sign of drug failure or re-infestation.

37. Mange ≠ Scabies.

38. Do you feel itchy yet?! Don’t be afraid. Creepy things can be taken care of quite simply if we keep our eyes open and recognize the signs.

39. Thank you! Any questions?

40. Don’t let the bed bugs bite

41. www.cdc.gov Frankowski, B.L., Bocchini, J.A., & The Council on School Health and Committee on Infectious Diseases. (2010). Clinical report: Head lice. Pediatrics. Doi: 10.1542/peds.2010-1308. E-Magazine Summer Edition. SGCHD. http://kentuckycchc.org/docs/BedBugSchoolDayCare.pdf Resources