Head Lice (Pediculosis Capitis)
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| Background
information, precautions, and recommendations to school personnel
relating to PEDICULOSIS CAPITIS (HEAD LICE) |
Download A
Guide for the Prevention and Treatment of Head Lice: |
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Introduction |
Recently,
there has been a significant rise in the incidence of pediculosis
capitis (head lice). This is a national problem and Miami-Dade
County is no exception. Head lice are not dangerous but they require
attention because they spread rapidly and are difficult to control.
Head lice dwell only in the hair and scalp and lay their eggs
(nits) on the shafts of the hair near the scalp. Lice themselves
are often difficult to see but the nits are small, whitish, teardrop
shaped eggs, which can easily be seen with the naked eye. In seven
to ten days, the young emerge as miniature replicas of the adults.
Under favorable conditions, they reach maturity in approximately
two weeks. The adult lives 20 to 30 days during which she may
produce 275 to 300 eggs. |
Transmission |
How do head lice get from one person to another? |
1. |
Direct
contact with an affected person’s head/hair. Lice
cannot jump, leap, or fly! |
2. |
Indirectly,
by placing clothing of an affected child in contact with
the clothing of an unaffected child. |
3. |
Indirectly,
by sharing such items as combs, brushes, hats, caps, scarves,
wigs, pillows and bedding. |
Signs and Symptoms |
How can you tell if a person has head lice? |
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Many affected children have no
symptoms; a few may exhibit persistent itching behind the ears
and the nape of the neck. |
Inspection |
How do you look for lice? |
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Examine students
who are itching. Lice move very rapidly though the hair. Nits
are most commonly found on the back of the neck and above and
behind the ears. In order to see the nits, use applicators to
part the hair carefully, beginning at the back of the neck and
the area around the ears. Discard applicators after use. Do not
use hands for inspection, they can become a source of transmission.
If nits are not found in these areas, continue to inspect the
rest of the hair. In order to avoid mistaking dandruff for nits,
attempt to pull the particle from the hair shaft. If it remains
attached, you have reason to suspect nits and therefore head lice. |
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Treatment and Prevention |
How can the spread of pediculosis
be prevented? |
AT
HOME: |
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It is necessary to treat the affected individual
and their personal articles such as caps, combs, brushes, towels,
bedding, and upholstered furniture. Since the highest potential
for spreading is among family members, special attention should
be given to making sure that family members are examined and
also treated, if necessary.
Simple vacuuming
may be the most effective environmental control measure. Fumigating
or using insecticides in the home, school or school buses is not
recommended by the U.S. Public Health Services.
A person identified
as having head lice or nits will need to use a medicated shampoo
or medicated cream rinse designed specifically for head lice treatment.
Two types of medications are commonly used: over-the-counter products
containing Pyrethrin and prescription shampoos and cream rinses.
Both types are effective. No published evidence indicates one
medication is superior to the other. Parents should follow the
specific instructions for treatment on the package label of each
product. A repeat treatment will be necessary 7-10 days after
the initial application.
Remove all nits.
You must pick nits out of the hair with fingers if they are
not removed by a comb. Hair must be nit-free before a student
can return to school. Inspect
all family members daily for at least two weeks. Use the name
treatment for other infested family members.
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AT
SCHOOL: |
The following steps are recommended for the
control of head lice in a school: |
1. |
Any time a parent reports a case of head lice, the school
should examine the heads of classmates, siblings, playmates,
and students riding a school bus, if transported. Screening
should be done by a person trained by the Department of
Health, School Health Nursing Office. |
2. |
School
personnel should examine the entire class when teachers
report students with signs and symptoms of head lice. |
3. |
Any
student found having head lice should be excluded from school
until they are free of lice and have no nits. |
4. |
To
insure that head lice do not establish a niche early in
the school year, it is recommended that elementary schools
examine their entire population four weeks after school
starts, the week before, and after spring break. Screenings
should be conducted on Fridays, whenever possible, to allow
the weekend for eradication and cut down on absenteeism.
School classrooms and indoor areas used for physical education
must be thoroughly vacuumed when infestations occur, and
during school holidays if vacation is less than 10 days.
Lice can live as long as ten (10) days off the host. |
The principal will have the responsibility to coordinate the
following procedures: |
| 1. |
Designate
two or more school personnel to inspect students and identify
lice or nits. The use of trained parent volunteers is suggested
when head lice present a serious problem at school. |
| 2. |
Exclude
from school any child found to have head lice. |
| 3. |
Recheck
children previously identified with head lice and not readmit
them until the designated school person has inspected and
determined the child had no nits in the hair. |
| 4. |
Count
the absence of a child identified with lice or nits as an
excused absence. After 3 days, absences should be counted
as unexcused. When a student has been absent for an extended
period (10-15 days), the principal should make a referral
to the school social worker for follow-up. The school social
worker will counsel the family and assess the family’s
need for a Social Service referral. Ongoing communication
and coordination among the principal, Public Health Outreach
Nurse, and school social worker should take place. |
| 5. |
Enforce
the separation of children’s belongings. |
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| Control Procedures: |
Schools
should take the following steps to bring occurrences of head lice
under control: |
1. |
Vacuum
carpeted classrooms daily during and outbreak and on holidays
if holidays are less than 10 days. Careful vacuuming is
probably the most effective environmental control. Contents
of the vacuum canister/bag should be disposed of immediately
(after vacuuming) in a plastic bag. Fumigating or using
insecticides in the home, school, and school buses is not
recommended.
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2. |
Provide
individual storage space or lockers for student’s
individual belongings. Assign individual hooks for hanging
clothing. Segregate student’s coats, sweaters and
towels. Clothing should not be jammed together on coat hooks
nor piled on the floor. Each student’s personal items
may be placed in a paper grocery bag. The bag should be
discarded at the end of the week and replaced with a new
bag on Monday.
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3. |
Steps
should be taken to insure that the clothing of one student
is not kept in contact with the clothing of others. In classrooms
where students cannot retain their clothing and other items
at their assigned seats, individual paper bags should be
provided and labeled with the student’s name. This
type of control measure helps to eliminate cross contamination.
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4. |
Audio
headsets, helmets, and other items in prolonged intimate
contact with the hair of more than one student should be
thoroughly wiped with alcohol after each use. An individual
cotton ball can be moistened with isopropyl alcohol for
this purpose. No cotton ball or alcohol wipe should ever
be used more than once.
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5. |
During
an outbreak, all activities requiring close person-to-person
contact should be temporarily suspended. Certain physical
education activities such as tumbling on mats should be
curtailed during periods when head lice are occurring in
the school. Mats should be washed and/or vacuumed.
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6. |
Temporarily
discontinue classroom activities involving “dress-up”
clothing, costumes or hats. Put clothing in plastic bags
for 10 days. Hats are not recommended to be used as part
of “dress-up”. |
7. |
Permanently
assign resting mats, towels or pillows, or have students
keep their towels in an individual paper grocery bag. Towels
should be taken home and laundered on a weekly basis. |
8. |
It
is wise to consider the introduction of a brief unit of
instruction relating to recognition and treatment of head
lice. |
| Upon return to school, each student must be accompanied
by a parent or an adult. Each student will be inspected
for lice and nits by trained personnel. Evidence of nits
or live lice is grounds for immediate exclusion from school.
The principal shall designate which persons will be responsible
for inspection and re-inspection of students. |
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| NOTE:
In case of serious lice infestations in a school,
the principal may exercise extra precautionary measures
such as class inspections, examination of students
prior to their admittance to class, separation of
clothing and belongings, or other hygiene measures
necessary to curtail the spread of the pediculosis
capitis (head lice). Health education programs can
be an important step. |
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