7/31/18. LICE! It s an EPIDEMIC! Or is it? Laurie Moyer Lice Clinics of America. Introduction

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1 LICE! It s an EPIDEMIC! Or is it? Larie Moyer Lice Clinics of America Introdction 1

lice each year. In other words, an estimated 1 in 20 children have lice at any given time.

2 Is there a lice epidemic? Precise data on how many people get head lice each year is not available. The CDC estimates that between 6 and 12 million children between the ages of 3 and 11 contract head lice each year. In other words, an estimated 1 in 20 children have lice at any given time. These nmbers do not inclde mothers and other siblings who contract lice from their kids/siblings abot 50% of the time. 2

The resistance rate is 100% in 42 of the 48 states.

3 Has anything changed? Sper Lice! Sper lice are lice that are resistant to pesticide-based lice treatments. Sper lice have been fond in 48 states. (No samples were taken from Alaska or West Virginia. The resistance rate is 100% in 42 of the 48 states. The average resistance rate for all 48 states is 98.3%. Crrent effectiveness of permethrin-based prodcts is shown to be as low as 25%. Since 1998, the effectiveness has gradally decreased from essentially 100% to crrent levels. 3

4 So is there an epidemic? Misinformation 4

5 At the end of today s presentation yo will Be able to dispel a nmber of myths abot head lice Have a better nderstanding of lice, inclding the lice life cycle, mode of transmission, necessary environmental treatments, etc. Be familiar with available treatment options and their efficacy Have a better nderstanding of steps to take to prevent infestations The Basics What are head lice? Head lice are a hman parasite that feeds on blood, and travels from one head to another. Head lice are niqely adapted to be on a hman head. They wold never choose to come off a head and onto a pillow, hat, chair, etc. Who can get head lice? ANYONE. A person s degree of cleanliness or personal hygiene has little or nothing to do with getting head lice. A common misconception is that lice infestation is a reslt of poor hygienic practices. In fact, head lice actally seem to prefer clean hair over dirty hair. Where do they come from? Head lice have been arond for millions of years, and dried p lice and their eggs have been fond on the hair and scalps of Egyptian mmmies! It is believed that Cleopatra had head lice. 5

6 Clearing Up Some Common Misconceptions Lice do not jmp, fly, or swim. They are good crawlers, however, and will readily move from one person to another when the hair of the two people is in contact. Head lice do not carry disease. Pets cannot get head lice. Head lice are species specific and can only live on hman heads. Head lice cannot be caght (nor killed) by swimming. When lice are in water they go into a state of sspended animation, bt remain firmly locked onto the hair. This is how they srvive shampooing, rain, seawater, and swimming pools. Risk of transmission CAN occr with the sharing of towels. Transmission of head lice from theatre seats, airplane seats, or other means of environmental exposre is extremely rare. Head Lice Facts How are head lice spread? Head lice can be spread whenever there is direct head to head contact with an infested individal. Less freqently, lice are also transmitted between people by head-to-hand contact and by items sch as hats, hair ties, scarves, pillows, etc. However, this type of transfer is qite rare. Probably less than two percent of cases are transmitted by the environment. Almost always, head lice is contracted via head to head contact. Most lice cannot srvive off of hman host longer than 24 hors and they are niqely adapted for living in hman head hair. They generally do not like to leave the protected environment created within head hair. A stdy by lice researchers at Anton Breinl Centre for Pblic Health & Tropical Medicine tested 1,000 hats in for schools. Althogh the researchers fond 5,500 head lice on the heads of the stdents who owned those hats, they fond no lice on the hats themselves. 6

An allergic reaction to the bite of a head lose cases the itching associated with head lice, however only abot 40-50% of those

7 Head Lice Symptoms Head Lice are most commonly fond on the scalp, behind the ears and near the neckline at the base of the head. Symptoms can inclde a tickling sensation, or feeling something moving throgh the hair. An allergic reaction to the bite of a head lose cases the itching associated with head lice, however only abot 40-50% of those infested experience the allergic reaction. Most people have lice for a month before they are aware of the infestation, and oftentimes an infestation will be asymptomatic. 7

Nymphs (baby lice) are smaller, and can be black, clear, or even blood red.

hatch. After hatching, the remaining shell looks white or clear.

8 What do lice and their eggs look like? The adlt lose is no bigger than a sesame seed and is grayish-white or tan. Nymphs (baby lice) are smaller, and can be black, clear, or even blood red. Lice eggs, often called nits, look like tiny gray, tan, or brown dots before they hatch. After hatching, the remaining shell looks white or clear. Nits are literally gled to the hair shaft and are very difficlt to remove. Visal inspections for head lice are often ineffective. Viable eggs vs. hatched shells (nits) 8

9 So how do we treat it? Increasing nmbers of consmers are finding that the most poplar treatments for head lice inclding chemical shampoos and home remedies are largely ineffective. Head lice are rapidly evolving chemical resistance to many of the traditional pesticide-based control methods [which have never been able to kill eggs (nits) effectively and sally reqire repeated treatments]. Lose combs can be effective for removing lice and eggs, bt the comb-ot process can be very tedios, and many bsy parents do not have the time or patience for effective combing. In desperation, some parents resort to home remedies sch as bg spray, mayonnaise or kerosene, bt there is little hear evidence that these remedies are effective, and some home remedies can actally be harmfl. Treatment Options 9

10 LICE CLINICS OF AMERICA NITPICKING AND COMBING LICE REMOVER KIT NIX/RID LICEFREEE/ VAMOUSSE SKLICE TREATMENTS REQUIRED 1 Utilizing the AirAlle FDAcleared medical device 3+ At home maintenance and combing reqired 2 At home maintenance and combing reqired 3+ At home maintenance and combing reqired 2 At home maintenance and combing reqired 2 At home maintenance and combing reqired ACTIVE INGREDIENT Heated Air Varies Dimethicone Permethrin/ Pyrethrm Benzyl Alcohol Ivermectin MODE OF ACTION Dessication Manal removal Smothering Nerotoxin (pesticide) Dehydration Paralysis (pesticide) EFFICACY* 99.2% Kills live lice and eggs. Not Pblished Treatment failre is high. 97% Kills live lice only. Does not kill eggs. 25% 85% High pesticide resistance Kills live lice only. in US. Does not kill Does not kill eggs. eggs. 71%-76% Kills live lice only. Does not kill eggs. COST $139 For garanteed, oneand-done treatment. $270 (on average) Based on $90/hr. and 3-5 hors. $30 $14-$18 $10-$25 $320 Often not covered by insrance. WARNINGS People treated mst be able to sense temperatre. None Keep ot of eyes. Skin irritation. Flammable. Keep ot of eyes. Potential nerotoxicity when crossing a bloodbrain barrier. Home Remedies Mayonnaise Apple Cider Vinegar Olive Oil Vegetable Oil Cocont Oil Coca Cola Hair dye Essential oils There no scientific stdies testing the efficacy of most home remedies. Most are treatments sggested from mom to mom. Shirley Gordon of Florida Atlantic University says her research shows parents try to treat lice at home an average of 5 times before seeking help from their healthcare provider. 10

11 Cetaphil OTC lotion sold in the health-and-beaty aisle of retail stores. A dermatologist pblished a paper in the Sept isse of Pediatrics showing that Cetaphil can be sed to kill lice. The stdy applied Cetaphil to the head, dried it, and then left it on between 8 and 24 hors. They did this weekly for 3 weeks. According to the paper, that reslted in 97 percent efficacy in one stdy and 95 percent efficacy in another. The mode of action is sffocation. Pediatricians may recommend this treatment to their patients becase it is cheap and non-toxic. Factors to consider: Cost Time involved to treat Efficacy 11

12 Recrring Infestations When someone has recrring infestations it s likely that the original infestation has never been flly cleared. Treating the Environment 12

13 Yo Don t Need to Treat Yor Home! While many lice experts think that a thorogh cleaning is an essential part of lice treatment, that is simply not based on scientific evidence. Nearly all head lice are dead within 15 hors of coming off a host. Eggs won t hatch off of a host. It is recommended yo wash and dry (on high heat) pillow cases, sheets, and clothes worn within 24 hors prior to treatment. Yo DON T need to do anything with yor frnitre. Lice are not environmental pests, so pesticide sprays for frnitre, bedding, carpet, stffed animals, and cars are nnecessary (and generally do not work). It is NOT necessary to bag stffed animals and bedding for 48 hors (or 3 weeks). Brshes, combs, and hair accessories can be placed on the top rack of the dishwasher, or soaked in hot (not boiling) water for 20 mintes. They can also be placed in a plastic bag in the freezer for 10 hors. Researchers at Anton Breinl Centre for Pblic Health & Tropical Medicine fond no lice or eggs on the floor of 118 school classrooms even thogh 466 stdents from those classrooms had infestations to the tne of 14,033 lice. Prevention 13

14 Prevention Avoid head-to-head contact dring play, sleepovers, or other activities at home, school, and elsewhere. Do not share combs, brshes, or towels. Family members shold be assigned separate brshes/combs. Do not share clothing sch as hats, scarves, coats, hair ribbons, or barrettes. Machine wash and dry clothing, bed linens, and other items that an infested person sed or wore dring the previos day sing a hot water landry cycle and high heat drying cycle. Do not se fmigant sprays or fogs; they are not necessary to control head lice and can be toxic if inhaled or absorbed throgh the skin. Preventative sprays that contain peppermint, rosemary, or tea tree oil can, while not a garanteed preventative, can deter a head lose from climbing onto yor head. Weekly se of Active Rinse (Dimethicone) soltion will prevent a lice infestation. Lice are not Gross They are simply a highly adaptable species with a particlar fondness for hmans. Their prpose on this planet? To keep s hmble, of corse, and to remind s to slow down and take a good look at or kids. 14

15 Lice Clinics of America-Central WI 2819 Post Rd. Stevens Point, WI (715)

FACTS & MYTHS ABOUT HEAD LICE

FACTS & MYTHS ABOUT HEAD LICE Head lice are generally misunderstood. Below are facts and myths about lice. FACTS Head lice do not fly (they have no wings), jump or hop About half of all infested individuals