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Lice not so nice

By Theresa Mueller
November 14 2007;  The Sheboygan Press

Sharing is a skill adults teach children early in life. Unfortunately, sometimes youngsters share unsavory pests namely head lice without anyone knowing until its too late.

According to a report by the American Academy of Pediatrics, head lice, or pediculosis capitis, infestations are common among children 3 to 12 years of age, with anywhere from six to 12 million infestations each year.

Registered nurse Sharon Daun, school nursing supervisor for the Sheboygan Area School District, said it is difficult to estimate how many cases of head lice occur in Sheboygan County each year because it is not a reportable condition, and it may occur when children are not in school or day-care settings. But reporting head lice to school and day-care facilities is important to help prevent infestation in more children, according to local health officials.

"Most schools have someone designated to check children for lice," said registered nurse Jean Beinemann, program supervisor for the Sheboygan County Health and Human Services-Division of Public Health. "Parents definitely need to tell the school about cases of lice so other students can be checked."

The public health department offers information to families and training resources to schools upon request, Beinemann said. The department has online information available, including a form letter that can be sent home with students if lice cases are detected in the classroom. The letter encourages parents to check their children for signs and symptoms of head lice, and offers basic information about lice.

Life cycle of a louse

Lice, which appear clear when just hatched, can change to a grey, brown or rust color. They are about two to three millimeters long, about the size of a sesame seed.

The adult female louse can lay several eggs a day on a human hair shaft, and can survive on its host for two to four weeks. The eggs, known as nits, hatch into nymphs in about seven to 10 days, and the nymphs then mature into adults in eight to 14 days. Both nymphs and adults feed on human blood at least twice a day.

Detective work: Finding lice and nits

Lice are often discovered when a child scratches his scalp excessively or complains of an itchy head. Upon inspecting the scalp, small scabs or tiny spots of blood can be seen as evidence of head lice. Scratch marks from the child are also visible in the affected areas.

Nits are often easier to spot than live lice because the nits stay in place on the hair shaft. They are pearly white in color and look like small droplets smaller than the head of a pin. They are found on individual strands of hair approximately one inch from the scalp. Nits can be distinguished from dandruff and other hair debris because they appear to be "glued" to the hair shaft and are difficult to remove.

Nymphs and mature lice scurry on the scalp to avoid being disturbed, which makes them tricky to find. The presence of nits is often the first clue that live lice are near.

Going in for the kill: Lice treatment

Once head lice have been detected, prompt and thorough treatment is the best way to get rid of lice and prevent re-infestation.

There are countless over-the-counter treatments available which include insecticidal shampoos that can kill live lice, and fine metal-toothed nit combs to remove the lice eggs.

"Some lice have become resistant to a lot of the products on the market," according to Daun. "So removing nits and cleaning the home are very important."

Both Daun and Beinemann recommend a thorough cleaning of the home environment, including vacuuming carpeting, furniture and car seats, as well as laundering and drying (at high temperatures) all clothing and bedding that comes into contact with the infested child. The nurses suggest placing stuffed toys in sealed trash bags for at least two weeks to kill any live lice or nits that might hatch.

Common misconceptions about lice

When it comes to heads, lice are not picky. The only thing research has shown is that they prefer warm areas like the nape of the neck or behind the ears. The pesky little creatures don't care whose head they call home, according to the local experts.

"Families need to understand that it (head lice) is not associated with a certain socio-economic group or overall cleanliness," according to Beinemann.

Human head lice are not spread between humans and pets, and lice, since they have no wings, cannot fly or jump. They simply crawl from one host to another, or travel from infested items brushes, combs, hats, towels, hats and pillows to unsuspecting hosts.

A variety of "home remedies" can be found online, but most have not been proven successful, and some are downright harmful. Caustic chemicals like kerosene or pet flea shampoos are dangerous and should never be used on a child.

Prevention always the best medicine

Although there is no 100 percent effective way to prevent head lice, children should be discouraged from sharing personal items such as combs, brushes, hats and clothing. Storing personal belongings in separate lockers or cubbies and avoiding head-to-head contact is highly recommended, Daun said.

The next step: Check, check and re-check

Schools and childcare centers have varying head lice policies. Some schools have adopted a no-nit policy, which means a child must be completely free of live lice and nits to be allowed back in school. This often causes an extended absence from the educational setting.

When live lice are found on a child, a parent is notified and the child is sent home. In the Sheboygan Area School District, treatment with over-the-counter insecticidal shampoos is encouraged, but only for family members who have been determined to have an actual infestations.

The district encourages diligent checking and re-checking of heads to remove live lice, as well as nit-picking to remove all eggs. If a child has been treated and no live lice are found, she may return to the school setting. Re-treatment in seven to 10 days to kill any additional lice and continued nit-picking is also recommended. The district's goal is to have children return to school as quickly and safely as possible, with the least amount of instructional time missed, according to Daun.

"No child should miss a lot of school over head lice," she said.

Schools and families must maintain an open line of communication to help prevent the spread of lice, according to Daun.

"Parents don't need to be ashamed that their child has head lice," Daun said. "It's important to talk with teachers and staff honestly so that all children can be cared for in the school setting."