News - Niagara Falls Review: Feel Lousy? You might have lice

Feel lousy? You might have lice

Treatment for head lice may cause more harm than the pests themselves

By KAREN GRAM

Tuesday, October 3, 2003

VANCOUVER - Lice. I had them, and my dad was horrified. He said it must have to do with the hygiene of my East Vancouver neighborhood. The only time he got lice, he added, was when he was a political prisoner in a Nazi concentration camp.

"It's not a hygiene thing," I said trying to ignore the suggestion my dad thinks my neighborhood is like a concentration camp. "Even your granddaughter in West Vancouver has it, so do the grandchildren in North Vancouver.

I got it from my daughters, who got it from, well, we're not really sure where. At first, we thought it was summer camp, but no one else at camp reported it. Now, we wonder if they got it playing in a hammock with an infested cousin.

"It's a proximity thing," I explained. If you are close to someone with lice, you can get lice."

I was right, of course. Head lice infestations, especially in elementary schools, are as common as calls for school uniforms.

Erica Weir, Women's Health Scholar in Family and Community Medicine University of Toronto, wrote recently in the Canadian Medical Journal that lice affect about 10 per cent of primary grade schoolchildren and their families each year.

"The condition has been stigmatized by the false belief lice are attracted to dirty scalps and unkempt hair, but the lowly louse with the lofty name - Pediculus humanus capitis - does not discriminate on the basis of hygiene. The only essentials for this wingless parasite are hair to cling to and scalp blood to feed on," said Weir.

Weir says it takes about 30 seconds for lice to move from one infested head to another, which means prolonged head-to-head contact is usually required before they spread. Children ages 3 to 10 years and their families are infested most often, girls more so than boys. Infestations can also be started by wearing infested clothing, such as hats and scarves, by using infested combs or towels, or by lying on beds or pillows used by an infested person. However, lice found in the latter locations are mostly sick, aging or dying and carry little capability of infecting a person. If a louse falls off a person, it dies within one to two days.

At my children's school, notices go home at least once a month notifying parents that someone in their child's class has lice and parents should check their own children's heads to make sure the mites haven't spread. They don't identify the sufferer because lice isn't a reportable disease - it's not even a disease. The Centre for Disease Control simply calls it a nuisance. So, no agency keeps track of how frequently it occurs, but the principal at my children's school says if he told kids to stay home because of lice, they'd have empty classrooms.

In most school boards, a notice goes home every September reminding parents of the common nuisance and urging them to regularly check their children's heads, even if no outbreak has been reported. The notice tells parents to coat wet hair with lots of conditioner and then comb through it with a fine toothed nit comb. The lice can't run on the slippery conditioner and get caught in the comb.

If parents find lice, most school boards recommend parents treat the child with one of the chemical treatments you can get from the pharmacy.

That is what most people tell you, including doctors.

But the Vancouver Coastal public health department recommends against the chemical treatments, urging parents to comb with a cheap conditioner every four days for two weeks (longer if you keep finding live lice).

So does the Centre for Disease Control. Based on an extensive review of the literature, they say wet-combing is just as effective as pesticidal treatments. This treatment is based on the life cycle of the louse. You are combing out the full-grown lice and the nymphs.

Research is starting to turn up potential for harm from the chemical treatments. A study published in the Canadian Medical Journal in August found that Lindane, a common pesticide used against lice, "has several serious neurotoxic effects, ranging from dizziness, headaches and paresthesia, to seizures and even death."

The U.S. Food and Drug Administration recently advised these effects are more common in young children, elderly people and people weighing less than 50 kilograms. It ordered new labeling and says Lindane should only be used after other treatments have failed.

But I wouldn't want to use it, even as a second-line treatment. Not when the FDA reports one-fifth of the people suffering such awful effects used the Lindane as recommended and for the first time.

Other studies, most notably in Australia, have found other pesticide treatments, such as Nix, which contains Permethrin, become ineffective the more often they are used. The resistance to the pesticides could be really localized. The researchers found the children at one school in Brisbane, which recommended Nix, were far less likely to get rid of the beasties in one treatment than were the children at another school in the same city where it wasn't recommended.

Unfortunately, a lice infestation requires more effort than simply ridding the head of lice. Any headgear the child has worn and bedclothes he or she has used needs cleaning to ensure it is lice and nit free.

Vacuuming is recommended as the best way to remove lice or fallen hairs with nits attached from upholstery, rugs, cars and stuffed toys. Bedclothes may be heated in the dryer for 30 minutes to kill remaining lice and nits.

For hair, we stuck with the non-toxic option - conditioner. We wet-combed every day even while camping, never feeling secure we got everything the day before. It wasn't easy, as my children have long, fine hair the nit comb yanked out of their scalps like a bully in the school yard. It took hours. The only consolation for the kids was I let them watch TV if we were home while I combed. Oh, the garbage that went into their brains as I cleansed their scalps. Still, I took comfort that I wasn't inadvertently harming them with toxins and our hair shone like a silver fish, er, better make that moon.

Getting lice is a hassle and a discomfort, but it isn't the health scourge it's made out to be. It's damnably itchy, but the hardest part of it is not taking it personally when friends and neighbors react with horror. It's the stigma they are reacting to, not the reality. They just need more information.

Bust lice, I say. But keep your head.

P.S. I love you, Dad.