Date: September 2018
Subject: Lice Advisory
In the last several years, there has been an increase in the number of cases of pediculosis (head lice) found in Alameda County. Many of the schools in Fremont have had scattered cases. Children with head lice will be sent home from school as soon as possible to start treatment. Parents will be contact when head lice is found and instructions for treatment are given to the parents. Students with nits only will not be excluded from school. The responsibility for the treatment of head lice rests within the home.
Students may return to school upon satisfactory treatment and after there is no visible lice upon re-examination. The goals of treatment are to contain the infection, to prevent overexposure to potentially hazardous chemicals, to minimize school absence, and to maximize the opportunity for student academic achievement.
How does someone get lice?
Head lice is usually transmitted
1. through close, personal contact with another infested individual;
2. through use of shared combs, brushes, and other grooming aids;
3. through sharing hats, caps, wigs, coats; or
4. through co-mingling of these items at the homes of friends, at school, at church or other public places
Many people are under the impression that lice become established on persons who are unclean. In the case of head lice, this is not true. Frequent bathing or shampooing will neither prevent lice nor eliminate an infestation once it has become established.
What to look for:
Head lice are elongated insects about this (---) long and are grayish white with dark margins when inspected very closely. Lice do not have wings and therefore, cannot fly. This makes them difficult to find in a person’s hair.
Since the insects are so difficult to see, the diagnosis or head lice infestation is frequently made on the basis is finding nits. A “nit” is a louse egg. Nits are teardrop in shape—smaller that this (0) size, and vary in color from yellowish-brown to white. The female louse attaches each nit to the hair shaft with a waterproof, cement-like substance. Thus, nits cannot be washed or brushed out the hair like dandruff or other debris that sometimes looks like lice to the naked eye. Nits can appear as very small specks, almost as if the middle of the hair shaft has a “split end.” Clusters of nits may be found in any section of hair, particularly behind the ears and at the nape of the neck. In mild infestations, a careful examination of the entire scalp may be necessary to detect them.
The most important components of head lice control are a single treatment with one of the following treatments, then a reapplication if live lice are found seven to ten days later. A nit combing should also be performed. Combing and removal of nits may help to reduce the duration of infestation. The California Department of Public Health (CDPH) recommends the combination of treatment and nit combing.
Treatment is directed at the infested individual and his personal articles (e.g. clothing, caps, combs, brushes, towels, bedding, etc.)
1. There are specific medicated shampoos and rinses available for head lice such as RID, NIX, Ovide, Spinosad, etc. RID is an over the counter medication. NIX, Ovide and Spinosad are available by prescription only. Apply head louse shampoo according to your physician’s instructions or instructions on the label. DO NOT OVER TREAT.
2. Have your child put on clean clothing after each treatment.
3. Repeat treatment in 7-10 days in order to kill newly hatched lice. While the shampoos mentioned above rapidly kill crawling lice, they may not kill all the nits. Therefore, it is important to remove/comb all nits to prevent re-infestation. The 7-10 day interval corresponds to the incubation period of a louse’s egg.
4. All family members should be treated whether or not there is evidence of infestation.
Decontamination of Personal Articles and Environment: e.g. clothing, caps, combs, brushes, towels, bedding, etc.) Since heat is lethal to lice and their eggs, many personal articles can be disinfected by machine washing in hot water and drying using the hot cycle of the dryer. Eggs are killed in 20 minutes at 140 degrees F, and crawling forms succumb to slightly lower temperatures. Items placed in sealed bags for two weeks to kill hatching lice (nits take six to nine days to hatch and are unlikely to hatch away from the scalp). Vacuuming daily until no children have lice decrease the remote possibility of lice transmission from the environment.
Bed linens should be laundered. Pesticide application in the home environment is not recommended.
As with all school health issues it is vital that the student’s privacy as well as the family’s right to confidentiality be maintained.