We would like to inform you that a case of head lice has been discovered in our center. Please check your child’s head carefully before bringing him or her back to the center.
Why Do These Tiny Bugs Create Such an Uproar?
The thought of head lice frightens, disgusts, and angers many parents. Almost immediately they ask, “How did this happen?”; “What should I do?”; and “Who brought this to the center?” Yet head lice, or “pediculosis,” ranks just behind the common cold and ear infection as the most frequent communicable disease in children. Head lice primarily affects preschoolers and elementary school children, and occurs most often in the fall when children go back to school and are in close contact with each other.
But what are head lice? Lice are tiny insects that feed on human blood. They are about the same size as a sesame seed and are usually dark tan, brown, or black. When living on a human host, adult lice have about a 30-day life span and feed on human blood every three to six hours. Adult lice are also difficult to see on the scalp, and attach eggs (nits) to the hair shaft with a glue-like substance that cannot be washed out or blown away. A female louse, if mated, may deposit more than 100 eggs in her lifespan. The eggs hatch in about one week and in another nine to 12 days, the young lice are fully mature and ready to lay their own eggs. Generally, an infested person has less than a dozen active lice on the scalp at any time, but may have hundreds of eggs (Pollack, 1997).
Although head lice do not spread disease and, in most cases, cause few problems for the host, they do cause an itch that shouldn’t be scratched. Scratching the scalp may break the skin and introduce bacteria that causes skin conditions such as eczema and impetigo.
Treating Head Lice
- Medication: There are several medicated shampoos, such as Rid, A-200, and Nix, as well as creme rinse, or gel, that are available without a prescription. These medications are not drugs; they are insecticides designed to kill lice and their eggs. Therefore, it is essential to follow the instructions for careful use. Do not use medication to treat lice in the eyebrows or eyelashes.
- Removing lice and eggs: Do not reapply a medication if it does not kill all the lice. Instead, find and remove every single nit from the child’s head. Have the child sit comfortably under a bright light so you can see the eggs. Inspect the hair in small sections, and repeatedly comb hair toward the scalp (“back combing”). Although most medications include a plastic nit comb, you may want to purchase a sturdier metal comb. The National Pediculosis Association (781-449-NITS) sells a new metal comb called the Lice Meister. This comb has a larger handle and longer, tapered teeth (National Pediculosis Association, Inc., 1997). Clean the comb frequently to remove any caught lice or eggs. It may take several hours to remove all the lice and eggs. Be sure to wash your hands carefully after combing, and sterilize the comb by soaking it in hot (not boiling) water for 10 minutes. Check the hair daily for several days to be sure all lice and eggs are removed. Check with a physician before removing nits from eyebrows and eyelashes to avoid serious eye injury.
- Cleaning the environment: Adult lice can survive almost 48 hours away from a host, but eggs can remain viable for almost a month (Pollack, 1997). To prevent reinfestation, clean or vacuum anything the child’s head may have contacted. Thoroughly clean all towels, sheets, blankets, clothes, combs, and hair accessories. Hot water or hot drying temperatures (above 130 degrees) will kill stray lice and eggs. Seal non-washable items, such as stuffed toys, in a tight plastic bag for two weeks. Vacuum carpets and furniture carefully to remove lice.
Preventing Live Infestation in the Center
- Arrange the classroom to minimize contact and the sharing of clothing and other objects. Do not permit children to share clothing, hats, or hair accessories, or cots and linens. Store children’s sleeping mats and blankets in their individual cubbies, and wash them weekly. Wash and disinfect cots weekly, vacuum the carpets at least once a day, and do not use insecticides or other chemical treatments for head lice in the environment.
- Develop and implement a head lice control policy. Parents should receive information on this and other policies when their child enrolls in the center, and understand that such policies are to protect their child, and ensure quality child care.
- Notify the parents and prepare the child for pick-up if an infestation is discovered. Avoid making a big deal of the issue or making comments that may embarrass the child or parent (National Pediculosis Association, Inc., 1997).
- Notify all parents that lice infestation has been found and solicit help in eliminating the problem and preventing reinfestation.
- Check each child’s entire scalp and hair for lice and eggs. These checks should occur daily for two or three weeks as each child arrives. Children who have nits should be sent home for nit removal. Include information on how to check for lice in your regular staff training program.
- Carefully clean the center. Wash all dress-up clothes, linens, cots, and objects which the child may have contacted. Vacuum all carpets thoroughly.
Charlotte Hendricks, H.S.D., is a certified health education specialist. She specializes in the health and safety of young children and can be reached by e-mail at firstname.lastname@example.org.
National Pediculosis Association, Inc. (1997). Child care provider’s guide to controlling head lice. Newton, MA.
Pollack, R.M. (1997). Head lice: Information and frequently asked questions. 34 Harvard School of Public Health (HSPH) Home Page. Dept. of Immunology and Infectious Disease, Harvard School of Public Health, Boston, MA.
The National Pediculosis Association’s (NPA) “Child Care Provider’s Guide to Controlling” is an excellent resource for child care providers. Contact the NPA at 781-449-NITS, or visit their website at www.headlice.org.
A reproducible parent information sheet and mini-poster on head lice is included in “Hip on Health,” the parent information series published by the American School Health Association.
Contact Charlotte Hendricks at email@example.com for more information.
The American Head Lice Information Center website is www.headlice-info.com.