1. Margaret Jahn, MS, MPH Freehold Health Dept.
PEDICULOSIS HEAD LICE
Margaret Jahn, MS, MPH
Freehold Health Dept.

2. GOALS Learn about head lice Biology Treatment Diagnosis
WHO, WHAT, WHEN, WHERE & HOW
Biology
Treatment
Diagnosis
Prevention & control

3. HEAD LICE Infestation of Pediculus capitis Parasitic insect
Hair, eyebrows & eyelashes
Excessive itching & scratching
Universal susceptibility
Unrelated to hygiene

4. HEAD LICE VERY common Affects children 3-11yrs
Est million infestations annually
Spread from head-to-head contact
Feed on blood from scalp
DO NOT SPREAD DISEASE!
Nuisance!

5. BIOLOGY 101
Life cycle – 3 stages
Egg, nymph and adult

6. EGGS Called “Nits” Laid by adult female
Cemented to base of hair (6 mm from scalp)
Hard to see
Resemble dandruff
~ 1 week to hatch

7. EGGS

8. NYMPHS Hatch from eggs Look like adult louse Mature after 3 molts
~ 1 week

9. ADULTS Size of sesame seed 6 legs with claws Females larger
Lay up to 8 nits per day
30 day life span
2-3 meals of blood/day
Die 1-2 days off scalp

10. ADULTS

11. RISK FACTORS Not related to cleanliness!!
Common transmission head-to-head
Home
School
Elsewhere (camp, sports, playground etc.)

12. RISK FACTORS Uncommon transmission Sharing clothing, hair ribbons
Using infested combs, brushes, towels
Lying on a bed, couch etc. recently in contact with infested person

13. DIAGNOSIS Misdiagnosis – VERY common Look for live insects
Nits not always reliable
Easily confused with dandruff, hair spray etc.
Nits >1/4 inch from scalp – old

14. TREATMENT ONLY FOR ACTIVE INFESTATION!
Check household members & contacts
Treat all at same time
Supplemental measures

15. TREATMENT Over-the-counter medication FDA approved
Pyrethrins or permethrins
READ LABEL
Do not re-wash hair for 1-2 days
Check 8-12 hrs after tx
Slower moving, comb dead
No dead – call healthcare provider

16. SUPPLEMENTAL Bedding, towels & clothing
With in 2 day period
Launder in hot water & dry
Place in plastic bag for 2 weeks
Vacuum furniture and floors of infested hair

17. CDC RECOMENDATIONS Students remain in school if Dx during day
Children return to school after treatment
Nits still present?
O.K. as long as no crawling/ live insects
Burdensome absenteeism
Nits not easily transferred
Misdiagnosis common if not by health provider

18. Freehold Township School Policy

19. REMEMBER! WE ARE HERE TO HELP
Freehold Health Department

20. QUESTIONS