CommunicabilityHead lice can be acquired by direct contact with an infected person (DOE). Neither able to fly nor jump, lice are unlikely to wander far from their preferred habitat (Pollack, 2000). A louse that has fallen from a human host to another surface will not survive long enough to infest a new host. Head lice are transmissible, but the potential for epidemic spread is minimal (Sciscione & Krause-Parello, 2007). Transmission of lice occurs most often among family members due to the close proximity of living conditions (Sciscione & Krause-Parello, 2007). The home, not the classroom, is the major site of contagion (Sciscione & Krause-Parello, 2007). Reports of ‘epidemics’ of head lice may generally be attributed to incorrect identifications and misdiagnoses. Head lice derive nutrients by blood-feeding once or more often each day, and cannot survive for more than a day or so at room temperature without ready access to a person’s blood. Generally an infested person has fewer than a dozen active lice on the scalp at any time, but may have hundreds of viable, dead and hatched eggs. Hatched eggs are nearly transparent (Pollack, 2000).SymptomsTickling feeling of something moving in the hairItching, caused by an allergic reaction to the bitesIrritabilitySores on the head caused by the scratching. These sores can get infected.(CDC, 2004)The most common symptom is itching. Individuals with head lice infestation may scratch the scalp to alleviate itching, and rarely there may be a secondary bacterial skin infection such as impetigo and local adenopathy. While the louse is living on the head, it feeds by injecting small amounts of saliva and taking tiny
amounts of blood. The saliva creates an itchy irritation (Frankowski & Weiner, 2002). The saliva promotes vasodilation and has anticoagulant properties that facilitate feeding. Lice feed and mate as often as every four hours and can do both concurrently (Sciscione & Krause-Parello, 2007). With the first case of headlice, itching may not develop for four to six weeks, because it takes time to develop a sensitivity to louse saliva (Frankowski & Weiner, 2002).Preventative MeasuresIt is probably impossible to totally prevent lice infestations (Frankowski & Weiner, 2002). Although lice have existed for over 2000 years, they continue to be common amongst children worldwide and elude eradication (DOE). “There is no scientific consensus on the best way to control head lice infestation in school children” (NASN, 2004). But, it is prudent to teach children not to share personal items. In environments where children are together, adults should be aware of the signs and symptoms of head lice infestation, and affected children should be promptly treated (Frankowski & Weiner, 2002).Nursing Assessment and InterventionThe “gold standard” for diagnosing head lice is finding a live louse on the head (Frankowski & Weiner, 2002). Studies suggest that a child with an active infestation is likely to have had the infestation for at least a month by the time it isdiscovered (Sciscione & Krause-Parello, 2007). Screening for nits alone is not an accurate way of predicting which children will become infested, and screeningfor live lice has not been proven to have a significant effect on the incidence of head lice in a school community over time. The tiny eggs, or nits, may be easier to spot within 1 cm of the scalp.
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- Fall '08
- Head louse, Pollack, Pediculosis, Body louse, Louse, Weiner