Head Lice Information

Nevada R-5 School Health Services Program

PROCEDURE FOR PEDICULOSIS MANAGEMENT

IN THE SCHOOL SETTING

Pediculosis refers to the information of head lice. Head lice are not linked to disease transmission. Head lice crawl and are primarily transmitted through direct head-to-head contact. They can also be transmitted indirectly through the sharing of personal items such as combs, brushes, hats, etc. The most common symptom of head lice is itching of the scalp. This is the result of an allergic reaction to saliva that is injected by the louse when it feeds on the blood of its human host. It may take 4 to 6 weeks for this reaction to occur in a first-time infestation. (Frankowski, Bocchini and THE COUNCIL ON SCHOOL HEALTH AND COMMITTEE ON INFECTIOUS DISEASE)

The following procedure will be followed by the Nevada R-5 Health Services staff in regard to the management of head lice in the school setting.

1. Screening for head lice will take place as the need arises. Staff members may request a student(s) be checked if they notice signs of head lice (i.e.: excessive itching) or if the student confides in them they have head lice. A student may also request their hair be checked at their own discretion. Steps will be taken to ensure strict confidentiality in the identity of students found to be infested.

2. If the school nurse discovers a student to have live head lice or viable nits, the parent/guardian of the student will be notified. Viable nits are defined as those nits found on the hair shaft within ¼ inch of the scalp. The determination to send a student home will be decided on a case-by-case basis and will be at the discretion of the school nurse, with involvement of the building administrator, if necessary. Students who reside with the infested student, and who attend the Nevada R-5 school district, may also be checked upon notification of that student’s school nurse.

3. Proper treatment of head lice must be followed at home before the student returns to school. The school nurse will discuss with the parent/guardian the various pediculicides and other treatment products available for purchase to assist in eliminating head lice and/or nits. Information will also be given regarding steps necessary to ensure the elimination of head lice in the home.

4. Following treatment for live head lice, the student must be checked by the school nurse before they may return to the classroom. The parent/guardian will be required to bring the student to school, at which time they will be questioned regarding the method of treatment and the steps taken to treat the home. The student will be allowed to return to the classroom based on the recommendation of the school nurse. A student may periodically be re-examined by the school nurse, dependent on the nurse’s findings.

INSTRUCTIONS FOR TREATING HEAD LICE

The MO Department of Health recommends treatment only for individuals found to have live lice or viable nits (eggs within ¼ inch of the scalp). If nits are found further than ¼” from the head, they are probably hatched and no longer viable.

Available Products for Treatment

The following products are available in our community and have been recommended for the treatment of live head lice: Permethrin 1% (NIX) is recommended by the American Academy of Pediatrics because of lower toxicity and fewer allergic reactions in individuals with plan allergies; Pyrethrins, (RID, Pronto, Clear Lice System), have a low toxicity but may cause allergic reaction to people who are sensitive to ragweed. Malathion (Ovide) is available only by prescription but is useful in cases where resistance to other products has occurred.

Alternative Treatments – Suffocating Agents – Although there has been no data to support the effectiveness of this method, some success has been reported with suffocating agents such as olive oil that is left on the hair for at least 3-4 hours. This treatment is not supported by the American Academy of Pediatrics.

Heat – The hot dry air produced by standard hand-held hair dryers may help to kill lice and their eggs on a person’s hair, however, great care must be used, as the heated air from these devices may result in burning/scalding the scalp. Items that cannot be washed, such as pillows/stuffed animals, can be dried in a hot clothes dryer for 20 minutes or placed in a closed plastic bag for 2 weeks.

Manual Removal of Nits

The Licemeister comb has been recommended by the National Pediculosis Association for it’s effectiveness in removing both live lice and their eggs. (Community Pharmacy keeps these in stock)

1. Begin by treating your student’s hair with product of choice or with a non-conditioning shampoo.

2. Brush or comb your student’s hair to remove tangles.

3. Work under good light, such as the natural sunlight by a window, witting outdoors or with a lamp that has the shade removed.

4. Divide and fasten hair in 1-inch sections, working each section individually.

5. Work (through each section of hair) from scalp to the end of the hair shaft, pulling out nits with the Licemeister comb. (This has been found to be very effective when used in conjunction with the treatment of the home and family. If a comb is not available, manual removal using finger and thumbnail is advised. This process is more time-consuming as nits can be very difficult to see and it allows only 1 hair shaft to be treated at a time. (Nits are “cemented” to the hair shaft by the adult louse with a substance similar to glue.) Even under the best of circumstances, few lice or nits may be missed. Check hair daily until all lice and nits are removed. If additional nits (3-5 per day) are covered, this may signal that live lice may still be on your student’s head.

Steps in Treating the Home

1. Machine wash all washable clothing, coats, bed linens, etc. in hot water and detergent, allowing to dry in a hot clothes dryer for at least 20 minutes. A hot pressing iron may help to kill lice or their eggs on pillowcases, sheets, nightclothes, towels and similar items your student has been in contact with during the previous three days. (Lice and their eggs do not live more than one to three days off the human body.)

2. Check all family members regularly and treat any that have live head lice; remove nits.

3. Disinfect combs, brushes and similar items by soaking in the lice treatment product for 10 minutes or cleaning with hot, soapy or boiling water for 5 minutes.

4. Vacuum your car and home; all carpets, floors and furniture thoroughly. (Lice sprays are not recommended for treatment of home due to their ineffectiveness. These also pose a risk as they contain pesticidal ingredients and can cause allergic reactions in humans.)

Source: Missouri Department of Health and Senior Services www.health.mo.gov/living/families/schoolhealth