CDPHE GUIDELINES FOR SCHOOL SETTINGS
HEAD LICE (PEDICULOSIS)
WHAT IS HEAD LICE (PEDICULOSIS)?
Head lice are common among children in all socioeconomic groups, and are not a health hazard or a sign of uncleanliness. Lice are the size of a sesame seed and feed on small amounts of blood. Lice lay oval-shaped eggs (nits) that are firmly attached to hair close to the scalp. Animals do not carry lice that can spread to humans, and human lice do not live on animals.
SIGNS & SYMPTOMS:
- Itching behind the ears and above the neck/ Some people will show no symptoms
- Nits hatch in 10-14 days. Adults live 3-4 weeks.
HOW IS IT SPREAD?
Head lice are spread by direct contact with the head of an infested person, or by contact with items used by an infested person (such as combs, brushes, and hats). Lice cannot hop or fly.
HOW LONG CAN A PERSON PASS THE INFECTION TO OTHERS?
A person is contagious as long as they are infested with live lice or nits close to the scalp that have not yet hatched.
PUBLIC HEALTH REPORTING REQUIREMENTS:
- Individual cases are not reportable. The school nurse/facility director should be consulted for specific concerns, or consultation with the state or local public health agency is available.
CONTROL OF SPREAD:
- EXCLUDE child with an active infestation.
- CHILD CARE: Children should be excluded until 24 hours after treatment has begun.
- SCHOOLS: Children should be excluded with an active infestation from the end of the school day until after the first treatment (nits need not be removed, although recommended).
- Students likely to have had direct head-to-head contact with an infested student should be checked for lice preferably by their parents/guardians at home and treated if live lice are found.
- Checking entire classrooms or schools has not shown to be effective at controlling spread.
- Parents/guardians of infested students should be instructed about in-home control measures and should check other household members for lice (give attached “How to Control Head Lice” to parents).
- Students clothing and personal items should be stored separately (hooks, cubbie holes, etc.). Teach children not to share personal items (like hats).
- Launder clothing and bedding in hot water (130F) for a minimum of 20 minutes and dried on the hot setting, OR dry clean. This should be done for items in the facility and at the home.
- Items that cannot be cleaned should be placed in a plastic bag for 2 weeks.
- Carpet and furniture can be vacuumed or gently ironed (not sprayed with insecticide).
- Combs and brushes should be soaked in disinfectant solution (1/4 cup bleach to 1 gallon of water) or lice-killing solution for 10 minutes.
- “No-nit” policies that require children to be nit free are not recommended because they have not been shown to be effective controlling outbreaks and may keep children out of the program needlessly.
Over-the-counter and prescription treatments are available. Treatment instructions should be followed closely. Flammable or toxic substances, such as gasoline or kerosene, should never be used. Nits can survive treatment, so a second treatment is often needed 7 to 10 days after the first treatment. Removing nits from the hair using a nit comb is recommended.
HOW TO CONTROL HEAD LICE:
- Shampoo the child’s hair (and other infested family members) with an appropriate shampoo or cream rinse, which is labeled for controlling lice. Some examples of lice shampoos or rinses include: A – 200 Pyrinate, Kwell, Nix, Rid, and R & C. These and other products are available at your local drug store, or they may be prescribed by a doctor. Be sure to follow the instructions on the label!!! Do not use remedies or products that are not labeled for controlling lice as these may not work, and they may even be harmful.
- Be sure to shampoo all affected family members at the same time! Any family member with nits (eggs) in the hair or with an itchy scalp should be treated.
- After shampooing, family members should change into clean clothes. Wash all dirty clothing, linens, and towels in a hot or warm wash cycle. Non-washable items may be dry-cleaned, or they may be vacuumed and sealed in plastic bags for two weeks.
- Soak combs, brushes, hair picks, etc. in hot (almost boiling) water for at least 15 minutes.
- Vacuum chairs, couches and other furniture where the children sit, sleep, or play in order to pick-up any loose nits or lice. You do not need to apply household pesticides.
- Be sure to shampoo everyone once again 7 to 10 days later!!! The timing is very important. In addition, remember to wash dirty clothes, vacuum furniture and treat combs and brushes on the same day.
- To better your chances for a successful treatment, take the time to remove nits from your child’s hair, preferably by using nit combs which are available at local drugstores. Nit removal is important as some of the eggs will survive the shampoo treatments.
HOW TO AVOID GETTING HEAD LICE:
Do not share hats, combs, brushes, scarves, or coats. Hang your coats separately. Do not hang or pile them on top of each other.