What’s as tiny as a sesame seed, but big enough to cost Americans in the neighborhood of $367 million to $1 billion each year?
Answer: head lice. Pediculosis, to be a bit more formal.
Crawling from head to head and sometimes comb to comb, hairbrush to hairbrush, hat to hat, earphone to earphone — you get the picture — they cause approximately 6-12 million infestations annually in the United States and cost a staggering amount in remedies, lost wages and school system expenses, according to Naomi Walsworth, health services coordinator for the Kenai Peninsula Borough School District.
The highest incidence of pediculosis is in youngsters in the 3- to 12-year old category, with about one in every 100 elementary school students in the United States infested each year and occurring most frequently in girls.
“It is not a sign of uncleanliness,” Walsworth points out. “All ages, socioeconomic, ethnic groups are affected.”
If you’re a louse, head louse, that is, here’s what life holds for you:
• Adult lice are 2-3 millimeters long, the size of a sesame seed, have six legs that grasp hair follicles and are usually tan to grayish-white in color.
• Females live three to four weeks. Once matured, they can lay as many as 10 eggs a day.
• Eggs are tiny, attached to the base of the human hair shaft, attached with a glue-like substance produced by the louse. Live, or viable, eggs are hard to see, most often visible at the back-of-the-head hairline. Empty eggs are easier to see because they appear white.
• Eggs are incubated by body heat and hatch in eight-nine days, but can take as much as 12 depending on temperatures. Once hatched, the “nymph” leaves the casing, the “nit,” and passes through three nymph stages during a nine to 12-day period before becoming an adult.
• A day and a half after reaching adulthood, lice mate and begin laying eggs.
• If untreated, the cycle repeats approximately every three weeks.
• Lice feed by injecting small amounts of saliva and sucking tiny amounts of blood from the scalp every few hours, resulting in itching. However, it may take four to six weeks for that itching to develop during an initial exposure.
According to KPBSD policy, no live lice will be allowed at school, with no distinction made between live nits or empty casings. A microscope can help tell the difference.
“Only children with live head lice will be sent home,” said a handout on pediculosis provided by the district.
Treated students can return to school provided no live lice are found and the daily process of removing any remaining nits is occurring.
What do you do if you find them on your child? Walsworth recommended a 21-day program that begins with cleaning the home, treating hair with lice shampoo, combing it out and removing the nits. Olive oil left on hair six to eight hours is recommended for pregnant women and youngsters under the age of 2. The olive oil treatment is repeated on days 2, 5, 9, 13, 17 and 21, followed the next day by combing out the hair, shampooing and removing nits once the hair is clean and dry.
Cleaning the home includes machine-washing clothing, hats, coats and bedding using a hot setting. Machine dry on a hot setting for at least 20 minutes.
Non-washable items should be ironed, dry cleaned or stored in sealed plastic bags for two weeks. Combs, brushes and hair accessories should be soaked in rubbing alcohol, Lysol or hot water for an hour and then washed with warm soapy water and rinsed. Carpets, upholstered furniture, car seats, etc., should be thoroughly vacuumed. Walsworth suggested not using pediculicidal sprays.
Alaska and elsewhere in the United States aren’t the only places on the planet to deal with lice. The prevalence in Australian schools ranges from 0 to 28 percent; in Brazil, 3.6-61.4 percent; in Britain, 2 percent; in Asia, a 0.7-59 percent and in Egypt, 0-58 percent.
“Lice cases occur in all elementary schools each year,” said Walsworth. “They are most common as school starts up and can often be found in places where students spend a lot of time, including clubs and before- and after-school programs.”
On the good side, she said the total number of incidents have not increased for KPBSD.
“Different schools have successfully dealt with the issue in creative ways,” said Walsworth. “Almost all have involved community education and active parent involvement.”
More information is offered by the:
• American Academy of Pediatrics Head Lice Policy and Clinical Report, August 2010: aappolicy.aappublications.org/cgi/content/abstract/pediatrics;126;2;392
• Centers for Disease Control and Prevention, updated Nov. 2, 2010: cdc.gov/parasites/lice/head/schools.html
• National School Nurses Organization (NASN) Head Lice (Pediculosis) Position Statement: nasn.org/Default.aspx?abid-237
McKibben Jackinsky can be reached at firstname.lastname@example.org.
Head lice: setting the record straight
• Head lice do not hop or fly.
• Head lice do not transmit disease. Itching, yes; but not disease.
• Head lice infestations are not easy to diagnose.
• Over-the-counter treatments do not all work the same way. Some are meant to be used on dry hair. Some are a shampoo or mousse.
• Head lice and their eggs live for less than a day away from the human scalp at room temperatures. In general, eggs found more than a centimeter away from the scalp are unlikely to survive.
• Over-the-counter treatments, pediculicides, should be rinsed from the hair over a sink rather than in a shower or bath. Care should be given to limit skin exposure and carefully follow instructions. These type of treatments should not be used for children under the age of two or by someone who is pregnant. Also, warm, rather than hot, water should be used.