Head Lice in U.S. Schools
Head lice (Pediculus humanus capitis) are ectoparasitic (blood-feeding) insects that seek refuge in the hair of humans. Most commonly these creatures are found on the scalp, however occasionally they can be seen in the eyebrows/eyelashes as well. Even though head lice feed on human blood periodically, they’ve not been proven to frequently transmit diseases. A single female louse lays 6-7 nits (eggs) every day, and while she will only live for about a month, in this time period she will produce almost 150 eggs. All eggs will hatch within 7-10 days of being birthed, and within 2 weeks they’ll be fully mature adult lice. Such rapid reproduction makes the spread of lice very difficult to control, especially in congested environments such as classrooms, buses and playgrounds.
Head Lice Transmission in Schools
Head lice infestation (Pediculosis) in United States schools affects an estimated 5-15 million children from ages 3-12 every year. While infestations are more common in preschool and elementary school children, pediculosis is frequently transmitted to the friends and family of the infested child. Pediculosis is usually transmitted through the contact of items such as hats, brushes, combs, apparel, desks, seats and any other object that people share or are in close proximity to. Lice do not hop like fleas, instead they crawl, however they can live up to 24 hours on an external surface without a blood feeding. Therefore they have plenty of time to find a new host once they’ve departed from the previous.
Studies have shown that children who engage in sporting activities, such as baseball and football, are more likely to contract head lice infestations. This is especially true in schools that use public helmets and padding equipment that is shared between the students. Daycares have also been shown to have a higher transmission rate, possibly due to the fact that younger children tend to be more intimate with each other when playing. Children also take naps in daycare centers, and the lice may transfer via the mats or blankets. Although head lice is more common in younger children, it also exists in adolescence that attend junior high and high school. Once again teens that play sports are at an elevated risk because they may share towels and other sporting equipment in the locker rooms.
Although all races are at risk for contracting pediculosis, infestations are much less common amongst African-Americans. Caucasians and Hispanics are much more likely to contract pediculosis, as are children with longer hair. Studies have shown that children that live with siblings also have an elevated risk of contracting pediculosis.
Head Lice Prevention in Schools
A proactive approach is the best way to prevent the spread of head lice. Since head lice are irritated by shampoos and conditioners, regular hygiene is a good way to decrease the susceptibility of infestation. Although bathing regularly decreases your chances of contracting pediculosis, it will not prevent it altogether. The only way to guarantee complete immunity to pediculosis is to shave one’s head completely bald. Even the cleanest individual can contract head lice, therefore it is not viewed as a sign of uncleanliness by those who are educated. Since head lice cannot be completely prevented, the best approach is to minimize infestations by conducting regular inspections.
Due to their speedy reproductive nature, head lice infestations are best controlled when they are discovered early. Trying to rid a child’s head of lice once the infestation has become severe can be very difficult, as lice are very resistant parasites. As pediculosis is more common during the winter and fall months, most U.S. schools conduct periodic inspections during the beginning of the school year. In fact, September is known as the “National Head Lice Prevention Month”.
Head Lice Inspection in Schools
During head lice inspections, the school nurses are responsible for conducting a thorough examination of the student’s scalp. The inspections are done under very bright lights, usually with the aid of a magnifying glass or magnifying lamp. In some cases the school nurse will treat the infested child upon discovering the head lice. If the school nurse plans to treat the infested child, the hair is usually shampooed before inspection. All tangles are removed and the hair is thoroughly brushed with a disposable comb, to make the hair more manageable. The hair is then divided into segments by hair ties and the scalp is examined in sections with the aid of disposable wooden sticks. All inspections are done using disposable plastic gloves that are changed between each screening. If infestation is discovered, the nurse will instruct the guardian to inform all of the children’s close friends and family members so they can conduct an inspection as well.
Head Lice Treatment in Schools
Although some cases of head lice infestation are discovered by parents, most cases of pediculosis are discovered during routine screenings at schools. When the school nurses have discovered the head lice infestation they follow standard protocol in contacting the guardian’s of each student at the end of the day. The parent’s are then given an information sheet that will educate them about the prevention and treatment of pediculosis. The eradication and prevention of pediculosis transmission is a joint effort between the schools and the students’ parents. Parent’s should instruct their children not to share headphones, helmets, bookbags, combs, brushes, hair bows, or other items.
Since head lice can transfer from surface to surface and survive for up to 24 hours without blood, all high risk surfaces will need to be cleaned and/or removed from the classrooms. For example, bookbag racks and beanbag chairs should be removed temporarily until the outbreak is controlled. Eradicating pediculosis outbreaks and infestations can be a difficult process, so it requires an aggressive approach that incorporates preventative measures, parent and student education, and the correct usage of pediculicides. Regular pesticides are not effective at killing head lice, and pesticides can also be harmful to student health, therefore the use of pesticides is highly discouraged.
Head lice are treated with special pediculicide shampoos. It is important to follow the instructions on these shampoo bottles thoroughly, and to follow up as directed. A very important part of treating head lice is keeping the child’s environment clean. Linens and apparel should be washed thoroughly in hot water on a high heat cycle to kill the lice and their eggs. Any surfaces such as carpets or beds should be thoroughly cleaned and vacuumed. Any items that cannot be cleaned in a washing machine or with a vacuum should be sealed in an airtight container for a week to kill the lice and their eggs.