HeadLice.Org Hot Spots

There's More To Head Lice
Than Killing The Bug

From School Health Highlights, a publication by the
New York City Dept. of Health; Spring 1998

Our Guest Speaker:
by Deborah Z. Altschuler
President and founder of the National Pediculosis Association (NPA) and Adjunct Assistant Professor of Preventive Medicine at the Uniformed Services Medical University in Bethesda

Since it's grass-roots beginnings in 1982, the National Pediculosis Association, lnc.(NPA) the only non-profit health agency dedicated to protecting children from the misuse and abuse of pesticides, has focused its efforts on helping parents make informed decisions about treating their children and themselves for head lice. For many years we apologized for head lice (pediculosis), saying that it was not a 'designer disease". Pediculosis as a health problem did not have "cause" appeal. There were no legions of workers to help get the word out. On the contrary, head lice have long been a distasteful subject to many people which makes the NPA's mission a difficult one.

At the basic level, the NPA's mission is to encourage schools, camps, child care centers and other facilities where children congregate to adopt appropriate and standardized lice management programs. Bogged down with a full plate of other issues - many of them important as well - these facilities have often assigned lice a low priority. The result in 1998 is a childhood population endemically infested with blood-obligate parasites and often on the receiving end of over-zealous, potentially harmful and often repeated pesticide applications.

Looking at the big picture, complacency about head lice fosters a complacency about public health standards. How can parents be expected to deal with an emotionally charged issue like AIDS for example, if they have never been expected to play a role in controlling even a widespread communicable disease like pediculosis?

Lice management programs can serve as a model of responsible public health behavior. By promoting rational responses to children with head lice, we at the NPA are working to create a climate of accountability in which parents can become resourceful and self-reliant for the sake of their families and their communities. Parents can learn not only to accept their role in keeping their children lice-free, but also to embrace the highest public health standards.

It is important to remember that no commercial remedy on the market today is 100% effective in killing both lice and nits. Moreover, there is documentation that lice have developed resistance to a variety of the available treatment products. Reports to the NPA's National Reporting Registry document the fact that treatment failures are common. Frustration and disruption abound while everyone involved suffers.

The NPA recommends that communities learn about head lice before an outbreak occurs. Parents need to know what head lice and their eggs, called nits, look like. They must also know how to screen, detect, and remove lice and nits. The NPA recommends a special comb to accomplish this public health measure (Editor's note: As a public agency, the DOH cannot recommend a particular product).

The NPA has long discouraged the continual reliance on any one particular treatment of choice. Product recommendations must be fit to the specific needs and vulnerabilities of patients, their families, and their communities. Public health education, awareness, routine screening and the earliest possible detection of an infestation remains the best preventive edge against the head louse.

From the Doctor's Desk:
by Gary Krigman, MD
Medical Director

The perpetrator wreaks havoc each year at schools throughout the city. It moves from person to person in discrete, inconspicuous ways and may cause mild discomfort or obvious unsightly infestation on hair shafts. Occasionally it may be seen creeping across one's forehead searching for territories to conquer.

ITS NAME: pediculus capitis or also known as the human head louse.


ITS CRIMES: Public menacing and disorderly conduct. It not infrequently is responsible for inciting parents to riot or causing public commotions.

ITS DEFENSES: It is armed with enzymes which allow its eggs (nits) to adhere to, hair shafts. They mature and hatch producing a new generation, immediately ready for combat. Over time, they have developed defense mechanisms which make them resistant to our arsenal of medications.

We are increasingly aware of our need to strategize and develop a citywide plan against the enemy. Our efforts must be directed toward public health education to parents, children, and school staff. As each school year begins, a vigorous campaign should begin. We certainly cannot completely eliminate the menace, but as the public becomes more knowledgeable and as control measures are instituted we should gradually see a reduction in the spread and hysteria.

Our charge is to develop informational materials which introduce the topic to all parents and prepare them for the possible eventual outbreak at their school. Providing this information at the start of the school year would hopefully reduce the myths that conditions at the school or that specific children are the root of the problem.

As a public health program, our efforts should be directed towards prevention and public health education. It is not our role to promote specific products or treatment. We can acquaint parents with the variety of possible treatments and special measures to follow to result in complete elimination of head lice and nits.

Our policy remains a "no nits" policy in spite of the controversy over the necessity to exclude children with visible nits if they have been treated. Our position is that it would be unrealistic to expect school staff as well as Bureau of School Health staff to distinguish dead nits from live nits. Thus, we must help parents and children through this "inconvenience". We must be prepared to answer questions regarding pediculosis when posed to us; to assist school administrators and staff in implementing protocols for identification and control; and overall to provide the necessary support which schools require to deal with a time consuming, unwelcome perennial menace.



-- send this page to a friend --

The National Pediculosis Association,® Inc.
A Non-Profit Organization
Serving The Public Since 1983.

The National Pediculosis Association is a non-profit, tax exempt
organization that receives no government or agency funding.
Contributions are tax-deductible under the 501c(3) status.

© 1997-2009 The National Pediculosis Association®, Inc. All images © 1997-2009 The National Pediculosis Association®, Inc.