Lice

 The Life Cycle of Head Lice

The life cycle of the head louse has three stages: egg, nymph, and adult.

Eggs: Nits are head lice eggs. They are hard to see and are often confused for dandruff or hair spray droplets. Nits are laid by the adult female and are cemented at the base of the hair shaft nearest the scalp . They are 0.8 mm by 0.3 mm, oval and usually yellow to white. Nits take about 1 week to hatch (range 6 to 9 days). Viable eggs are usually located within 6 mm of the scalp.

Nymphs: The egg hatches to release a nymph . The nit shell then becomes a more visible dull yellow and remains attached to the hair shaft. The nymph looks like an adult head louse, but is about the size of a pinhead. Nymphs mature after three molts (, ) and become adults about 7 days after hatching.

Adults: The adult louse is about the size of a sesame seed, has 6 legs (each with claws), and is tan to grayish-white . In persons with dark hair, the adult louse will appear darker. Females are usually larger than males and can lay up to 8 nits per day. Adult lice can live up to 30 days on a person’s head. To live, adult lice need to feed on blood several times daily. Without blood meals, the louse will die within 1 to 2 days off the host.                                                                   http://www.cdc.gov/parasites/lice/head/biology.html

Lice-Removal Tips: Secrets of a Nitpicker

So your child has head lice.

That's not too surprising, according to the Centers for Disease Control and Prevention (CDC). Each year an estimated 6 million to 12 million children -- mostly 3- to 12-year-olds -- get head lice. These parasitic wingless insects live only on the human head and are extremely contagious. Chances are, your kid will have a head-lice scare at least once during your parenting career.

Kids get lice when their heads come into close contact -- hugging, crouching around a video game, doing each other's hair. Personal hygiene has nothing to do with it. Head lice do not spread disease, according to the National Institutes of Health (NIH).

Signs of lice may include a tickling feeling in the hair, sores from scratching, and difficulty sleeping, as head lice are most active in the dark. The itchiness mostly comes from human allergy to louse saliva as they feed on the blood of the head. (Some kids aren't allergic, so you'll probably just spot the bugs.)

A louse is a tan to grayish-white bug that's about the size of a sesame seed; nits are grayish eggs the size of a grain of salt, and they're attached to hair shafts a few millimeters from the scalp.

Lice "hot spots" are the top of the head, behind the ears, and the nape of the neck.

If your kid has lice, other family members might also have it. You'll need to treat those who do, as well as parts of your house.

That's where things can get tricky, says Sally Kelly, R.N., a school nurse who makes lice-removal house calls in and around Chatham, New Jersey.

You can go to the pharmacy and buy over-the-counter lice- removal shampoos, but the pesticides in these shampoos aren't 100 percent effective. Kelly uses a more natural method that, when closely followed, works for her every time. "Not only is it more effective, but you also don't apply chemicals to your child's head," she says.

Step One: First Comb-Out
In this stage, focus on getting the nits out.

Purchase a nit and lice-removal comb, usually metal and with teeth that are very close together. (Kelly likes LiceMeister, available online.)

If your child has thin hair, pour baking soda (an abrasive agent) into one bowl and cheap, thick hair conditioner into another bowl. Dip the comb first into the conditioner and then into the baking soda. (If your child's hair is coarse, you can skip the baking soda.)

Separate out very small sections of hair, and comb them through. Wipe the comb after every couple of swipes so you see what you're pulling out. Comb at a 45-degree angle, working each small section up, down, and side-to-side, making sure to run the comb along the scalp.

Step Two: Second Comb-Out
Now, wet your child's hair. Apply the conditioner directly to the hair this time. Wrap it in a towel to absorb the bulk of the water, leaving the conditioner in.

Comb the hair again with the nit comb, this time working through slightly bigger, inch-thick sections. "This is when you'll pull the bugs out," Kelly says. "Do this comb-out fast, and don't worry about parting it. It's easier to capture those bugs when you don't part the hair, because lice are light-sensitive and they're fast."

When you're finished, boil the comb for a few minutes, disinfect it with a 20-minute soak in ammonia, or run it through a cycle in the dishwasher (put it on the top rack). Repeat this step every day for five days. Change your child's pillowcase and bath towel on each of these days.

Step Three: Delouse the House
On that first day, wash your child's bedding. Dry the pillow, stuffed animals, and comforter on high for 20 to 30 minutes. If you're worried you may have missed something, roll a sticky lint brush over the top half of bedding each day for five days. Again, wash all brushes in the top rack of the dishwasher, soak them in ammonia for 20 minutes, or boil them in water for a few minutes.

Now, think about your child's last 48 hours in the house. Vacuum rugs or furniture they've lounged on. "That's mostly for peace of mind," says Kelly, since lice and nits can't survive off the human head. "On the outside chance there's still something there, that'll get it."

In general, focus your efforts on those daily comb-outs. "Get your child's head -- don't get the car detailed," says Kelly.

Step Four: The Follow-Up
Two weeks from your first comb-out, do it one more time. "This is the part people don't do, because they think they've taken care of everything after those first few days," says Kelly. But do not skip this step! "If you left just one nit, the whole process can start over again. And you do not want that."

http://www.parents.com/kids/health/head-lice/lice-removal-tips-secrets-of-a-nitpicker/

Here is a recent article that was in the Times Argus by Dr. Lewis First M.D. on Head Lice in Schools. (9/7/14) Lice don’t have to be a head scratcher by Dr. Lewis First M.D.

Procedures for the Management of Head Lice in the School

The Management and Treatment of Head Lice  

The Lice Program

• Some parents in our school have found the Lice Program helpful. The program focuses on combing and gives a combing schedule based on the life cycle of a louse. This program is not for everyone, but I thought it was worth giving you the information to decide for yourselves.

Pediatricians Say Students With Head Lice Can Stay In School  (4/3/2014)

Read the article and listen to the audio here:

http://digital.vpr.net/post/pediatricians-say-students-head-lice-can-stay-school

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News from the Health Office: December 3, 2013

New Evidence Based Information on Head Lice                                          

Here are some general guidelines and updated evidence based information on lice.

General Guidelines for Staff:

Head Lice:

Remind Students to:

1) Keep heads from touching when lying on the floor or sitting in comfy reading areas (No heads resting on pillows).

2) Do not share hats, combs, hairbrushes, or hair accessories.

General Guidelines for Parents:

Head Lice:

1) Do not share hats, combs, hairbrushes, or hair accessories with friends.

2) Keeping long hair up/back in a braid, pony tail, or pig tails is helpful (not mandatory) while at school and when in close contact with friends; e.g.: summer camps, play dates, overnights, etc....

3) Regular home head checks are recommended.

General Guidelines for Students:

1) Do not share hats, combs, hairbrushes, or hair accessories with friends.

2) Keep heads from touching when lying on the floor or sitting in comfy reading areas (No heads resting on pillows).

3) If your head feels itchy and you have been scratching your head more than usual, have your parents check your head.

Lice are often not found until the lice are well established. This could take from 6-8 weeks or longer. For this reason CESU school nurses strongly recommend regular home checks. Regular home checks will catch lice before they become well established. Evidence based practice says that only close contacts and family members need to be contacted and screened.

Transmission of lice in school is rare; only 1 out of 10 cases are transmitted at school. The most common times for lice to be transmitted are during summer, winter and spring breaks and whenever children are in the community for extended periods of time together. Once the children are back in school, this is the time when we notice the itching because the children are now still enough to take notice of it.

Lice do not jump. They like to stay close to the scalp where it is warm and they can feed. Lice cannot live off the head for more than 24 hours. Eggs will not hatch off the scalp. Eggs need warmth to hatch. Any eggs farther than 1/4 inch from the head are not viable.

Evidence based practice recommends checking close family members and close contacts. It is not recommended to do mass screenings. We need to remember, that lice are in the community at all times. When we hear of a case we tend to panic. None of us want to get lice. By following the general lice guidelines, you should be able to avoid the chances of getting lice.

Please also refer to the CESU website for Management and Procedures for Head Lice within the district.

 http://cesu-nurses-information.cesu.k12.vt.us/modules/locker/files/group_files.phtml?parent=17031042&gid=2296367&sessionid=1446b85c1a3a88e88f9fd892f9cc1c99

Sincerely,

Kristen Taylor, RN