There are there types of lice that infest people. These are the Head louse (Pediculus humanus capitis), the Body louse (Pediculus humanus corporis), and the Crab louse (Phthirus pubis). All three types feed on human blood, and need the warmth of the human body to survive. The crab louse infests the pubic regions, and is not easily transferred in school of childcare settings. The body louse, although a scourge to humanity throughout history through its ability to carry Typhus, is not common in the US because it is easily controlled through proper hygiene. The head louse, however, is not uncommon, and not overly selective about whom it infests, although it does seem to prefer the hair of Caucasian or Asian people, rather than that of blacks - the hair can be clean, dirty, long, or short). Of these three, only the head louse is a major problem in schools.

Head lice live among the hairs of the head close to the scalp. They are usually grayish in color, but may range from grayish-brown to rust or tan. Adults are a little less than one-eighth inch long, about the size of a sesame seed. They are flat, wingless, and have claws which grasp hair very firmly so that they will not fall out, or be washed out of the hair. Their eggs, called nits, are glued onto hair close to the scalp. These n its are tiny, silvery, and oval-shaped. They sometimes resemble dandruff, but dandruff can be easily removed, while nits are firmly attached. Nits hatch one week after being laid, reaching maturity in another 7-14 days. Head lice may live 30-35 days as adults and lay 4 or 5 eggs per day. They may live up to 3 days, away from a human host, but rarely survive separation from a human for more than 24 hours. Nits that have dislodged from a host will not hatch without proper warmth requirements, but may remain viable for up to 30 days.

Although head lice do not pose a threat of disease, their blood feeding causes severe itching and discomfort, and can result in secondary infections. Itching may be the first sign of infestation. Some favorite feeding areas are behind the ears and at the nape of the neck. Persisting scratching by a child, and redness in these favored areas should cause suspicion of a lice infestation. It is necessary to carefully inspect the head and hair to determine if lice or nits are actually present.

Head lice are transmitted from person to person either through direct contact, or by contact with articles that have touched the hair of an infested person. Schools and childcare centers are prime transition zones because of the close contact between many students in a common area. Fall and winter are prime lice seasons as kids hang or pile jackets and coats in close vicinity, and may share scarves, ear muffs, or hats. Other transmission vectors are shared combs and brushes, upholstery, bedding, sports headgear, and earphones.

To prevent the possible spread of head lice, personal items should be stored separately in individual lockers. Use of common coat rooms should be discontinued if possible. If this is not an option, coat hooks need to be at least 12 inches apart. During fall and winter, when bulky jackets are common, students could be encouraged to hang their coats on the back of their chairs, or to place their jackets, scarves, hats, etc. into separate grocery or garbage bags for storage. Upholstered furniture, rugs, and floors should be vacuumed or cleaned often. Sharing of personal items should be discouraged. This may be accomplished through classroom education activities and discussions. In addition, a multitude of educational materials is available, geared to different age levels, from the National Pediculosis Association. Clean shared sports headgear and headphones. If there are dress-up materials in a classroom, all hats should be hard plastic, never straw or cloth. In the fall, it would be useful to send a generalized note home with students with information on head lice, lice prevention techniques, and symptoms of infestation. Remind parents that lice infestations can happen to anyone and are not hygiene-related. Parents are your best allies for maintaining lice-free schools.

When a student is found to have lice or nits, that student should be excused from school until treatment has been successful. Parents should be informed on proper measures of treatment for their child and control measures for the home. Siblings, friends, and adults of an infested student should also be checked for infestation. If they are at a different school, that school should be informed so that it can follow up on potential infestations. Upon return of a treated student, the school or center health practitioner should check the student before being allowed back with other children. Formerly infested students should be checked again in a week to 10 days to be sure re-infestation has not occurred. Continue to monitor a class where there has been an infested student for 4-6 weeks after discovery.

If a family member is discovered to have a lice infestation, inspect all remaining family members, including adults, daily for at least two weeks, and treat all infested persons. Contact friends so that those families may also check for possible infestation. Combs, brushes, barrettes, hair clips, etc. should be soaked in a pediculicide, or in hot water for at least 10 minutes. Wash all clothes, bedding, pillow cases, towels, etc. used by infested persons in hot, soapy water (at least 130 degrees F), and dry items on the hot setting of the dryer for 20 minutes. Items which cannot be washed in hot water should be dry cleaned or sealed in a plastic bag for 31 days at room temperature. When removing bagged items, take them outside and shake vigorously. Do not share personal items among family members. Any infested person should sleep in their own bed. Vacuum all pillows, mattresses, sofas, chairs, car seats, headrests, and rugs which may have been in contact with an infested family member. Contact your physician for a prescription treatment, or for advice on an over-the-counter treatment. Remove all nits after treatment. Treatment should be repeated 10 days after the initial treatment to be sure all lice and nits are dead. Continue to monitor family members for 4-6 weeks after you believe that all lice and nits have been successfully eradicated from the home.

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