PEDICULOSIS
HEAD LICE
Margaret Jahn, MS, MPH
Freehold Health Dept.
GOALS
• Learn about head lice
– WHO, WHAT, WHEN, WHERE & HOW
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Biology
Treatment
Diagnosis
Prevention & control
HEAD LICE
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Infestation of Pediculus capitis
Parasitic insect
Hair, eyebrows & eyelashes
Excessive itching & scratching
Universal susceptibility
Unrelated to hygiene
HEAD LICE
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VERY common
Affects children 3-11yrs
Est. 6-12 million infestations annually
Spread from head-to-head contact
Feed on blood from scalp
DO NOT SPREAD DISEASE!
Nuisance!
BIOLOGY 101
• Life cycle – 3 stages
– Egg, nymph and adult
EGGS
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Called “Nits”
Laid by adult female
Cemented to base of hair (6 mm from scalp)
Hard to see
Resemble dandruff
~ 1 week to hatch
EGGS
NYMPHS
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Hatch from eggs
Look like adult louse
Mature after 3 molts
~ 1 week
ADULTS
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Size of sesame seed
6 legs with claws
Females larger
Lay up to 8 nits per day
30 day life span
2-3 meals of blood/day
Die 1-2 days off scalp
ADULTS
RISK FACTORS
• Not related to cleanliness!!
• Common transmission head-to-head
– Home
– School
– Elsewhere (camp, sports, playground etc.)
RISK FACTORS
• Uncommon transmission
– Sharing clothing, hair ribbons
– Using infested combs, brushes, towels
– Lying on a bed, couch etc. recently in contact with
infested person
DIAGNOSIS
• Misdiagnosis – VERY common
• Look for live insects
• Nits not always reliable
– Easily confused with dandruff, hair spray etc.
• Nits >1/4 inch from scalp – old
TREATMENT
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ONLY FOR ACTIVE INFESTATION!
Check household members & contacts
Treat all at same time
Supplemental measures
TREATMENT
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Over-the-counter medication
FDA approved
Pyrethrins or permethrins
READ LABEL
Do not re-wash hair for 1-2 days
Check 8-12 hrs after tx
– Slower moving, comb dead
– No dead – call healthcare provider
SUPPLEMENTAL
• Bedding, towels & clothing
– With in 2 day period
– Launder in hot water & dry
– Place in plastic bag for 2 weeks
• Vacuum furniture and floors of infested hair
CDC RECOMENDATIONS
• Students remain in school if Dx during
day
• Children return to school after
treatment
• Nits still present?
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O.K. as long as no crawling/ live insects
Burdensome absenteeism
Nits not easily transferred
Misdiagnosis common if not by health
provider
Freehold Township School Policy
REMEMBER!
WE ARE HERE TO HELP
Freehold Health Department
732-294-2060
QUESTIONS