Lice

Background

Human lice are parasites that live on or in the skin of a person. There are three species important in humans and the commonest is human head louse. Other forms are the human body louse and pubic louse.

Infestations occur worldwide especially in areas of overcrowding. It may take between 1-4 weeks following exposure for persons to begin to show symptoms and individuals can spread the organism until all the lice and eggs have been treated and destroyed.

Head lice are more common among school-aged children, where the practice of sharing combs or brushes makes it easier for the lice to move from person to person. In contrast, body lice that are seen more in areas of poor sanitation, reside almost exclusively in soiled clothing, only leaving the clothing for a feeding. Pubic lice are usually sexually transmitted and can also be spread through infested bedding or clothing.

Signs and Symptoms

This depends on the type of lice infestation, however there are a number of common features namely:

·        Itching, scratching, skin irritation and inflammation as a reaction to the louse bite;

·        Small blue spots can appear where the louse has bitten;

·        Mild fever and malaise in cases of heavy infestation; and

·        Scratching can lead to breaks in the skin that can become infected with bacteria

Management

·        Clothes, bedding and fomites: washing in hot water (50ËšC) or dry cleaning or place in plastic bags for 1 week.

·        Vacuum mattresses.

·        Sexual partner(s) within the last month should be treated.

·        Wash the affected area and apply appropriate pediculocide formulation (cream, lotion or shampoo) according to package instructions

·        May re-treat after 1 week if no clinical improvement.

·        Itching may be controlled with antihistamines such as hydroxyzine or diphenhydramine, as well as mild topical corticosteroids

Prevention

·        Check children's heads every week for lice/eggs.

·        Notify your child's school, day care or babysitter if your child has head lice.

·        Children with head lice should be treated and may attend school, day care or babysitter as usual.

·        “No Nit” policies in schools are not based on evidence and are not recommended.

·        It is advisable to treat all family members with lice at the same time

·        Do not share combs, towels or other personal items.