Australian Infection Control
Volume 7, Issue 2
From Head lice appearance and behaviour: implications
for epidemiology and control
By A. M. Bailey, BDSc & Paul Prociv MBBS PhD FRACP FRCPA
Department of Microbiology & Parasitology, Univ. of Queensland
"Although more work needs to be done, the biomechanical investigations conducted, coupled with the minuscule size of this organism, support field reports that imprecise detection is a considerable problem and, also, that hair barriers (e.g. thick as well as longer hair) which prevent accurate detection, likewise hinder thorough louse eradication.
Fine-combing with hair shortening is ideal for removing resistant lice.
Fine-combing may aid examinations, but in some situations visual inspection with optical aids will be more useful; such screening tools should be used alongside clinical
judgement. For example, renewed egg deposition or patients' reports of distinct crawling and biting sensations may point to surviving hidden lice in thick hair.
Lice have shown a history of rapid development of resistance to all pediculicides and many product formulations themselves are unreliable. Prevalence and chronic conditions have risen noticeably since school based screening and rigorous manual methods (egg picking, fine-combing, hair shortening) were disregarded about 20 years ago. Because pediculosis is not self limited and can be caught repeatedly, long standing infestations due to late detection and eradication failures in close community groups will facilitate transmission. The study findings, thus, support the rationale for a traditional transmission prevention strategy in the form of expert screening to ensure early detection and completion of effective treatment."