pediculosis head lice

HEAD LICE

PEDICULOSISHEAD LICEMargaret Jahn, MS, MPHFreehold Health Dept.

GOALSLearn about head liceWHO, WHAT, WHEN, WHERE & HOWBiologyTreatmentDiagnosisPrevention & control

HEAD LICEInfestation of Pediculus capitisParasitic insectHair, eyebrows & eyelashesExcessive itching & scratchingUniversal susceptibilityUnrelated to hygiene

HEAD LICEVERY commonAffects children 3-11yrsEst. 6-12 million infestations annuallySpread from head-to-head contactFeed on blood from scalpDO NOT SPREAD DISEASE!Nuisance!

BIOLOGY 101Life cycle 3 stagesEgg, nymph and adult

EGGSCalled NitsLaid by adult femaleCemented to base of hair (6 mm from scalp)Hard to seeResemble dandruff~ 1 week to hatch

EGGS

NYMPHSHatch from eggsLook like adult louseMature after 3 molts~ 1 week

ADULTSSize of sesame seed6 legs with clawsFemales largerLay up to 8 nits per day30 day life span2-3 meals of blood/dayDie 1-2 days off scalp

ADULTS

RISK FACTORSNot related to cleanliness!!Common transmission head-to-headHomeSchool Elsewhere (camp, sports, playground etc.)

RISK FACTORSUncommon transmissionSharing clothing, hair ribbonsUsing infested combs, brushes, towelsLying on a bed, couch etc. recently in contact with infested person

DIAGNOSISMisdiagnosis VERY commonLook for live insects Nits not always reliableEasily confused with dandruff, hair spray etc.Nits >1/4 inch from scalp old

TREATMENTONLY FOR ACTIVE INFESTATION!Check household members & contactsTreat all at same timeSupplemental measures

TREATMENTOver-the-counter medicationFDA approvedPyrethrins or permethrinsREAD LABELDo not re-wash hair for 1-2 daysCheck 8-12 hrs after txSlower moving, comb dead No dead call healthcare provider

Bedding, towels & clothingWith in 2 day periodLaunder in hot water & dryPlace in plastic bag for 2 weeksVacuum furniture and floors of infested hairSUPPLEMENTAL

CDC RECOMENDATIONSStudents remain in school if Dx during dayChildren return to school after treatmentNits still present? O.K. as long as no crawling/ live insectsBurdensome absenteeismNits not easily transferred Misdiagnosis common if not by health provider

Freehold Township School Policy

REMEMBER!WE ARE HERE TO HELPFreehold Health Department732-294-2060

QUESTIONS