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Head lice: Not so super (Includes interview)

It is proving as hard to rid our schools of head lice mythology as banishing the head lice themselves.

In light of ongoing studies, many school boards around the world are re-examining their head lice policies. Last month the Toronto District School Board announced that it is reviewing the no nits policy presently in force. The no nits rule excludes students from school until their heads are declared nit free. A month later the board is still reviewing the policy.

Other school boards, like the Thames Valley District School Board in London, ON, are not even contemplating making changes. The TVDSB cannot be faulted for being cautious. Without community support a move to remove the no-nits policy may fail. Progressive boards which moved too fast have been forced to reinstate the no nits policy after facing a flood of complaints from angry parents and, in some cases, teachers.

Head lice do not spread disease, on this everyone is in agreement. What they do is carry is a nasty stigma. They spread fear, stress and anxiety. The little critters, only as big as sesame seeds, are unable to hop, let alone leap tall buildings, yet recently they have been given the moniker “super lice.”

There is nothing super about them. After years of being controlled with insecticides, the little bugs have done what insects do best — and that’s adapt. Head lice have developed resistance to the insecticides in the hair treatments used to fight them. This development took no one by surprise.

But that very adaptability may be their undoing. After living thousands of years as our uninvited guests, head lice are perfectly adapted to life on a human head. Once off the human head, they don’t fare so well. They die.

In the past, fearful parents have tossed out pillowcases complete with pillows. Almost everything a child with head lice touched was considered contaminated. The fears and the responses were totally out of proportion to the risk.

Don’t believe me? Fine. But please don’t make just a quick check of the Web to prove me wrong. You will find lots of support for your fears but please remember, “You can’t believe everything you read on the Web.”

Google enough sources and you will realize there is a battle raging in the scientific community over head lice. I like to think one side studies lice in the lab while the other studies lice in their environment, in the community, in schools and on childrens’ heads.

To get the whole story, the accurate story, I began contacting the people behind the claims. My search led to Richard Speare, professor emeritus, James Cook University, Australia. Speare is one of the major players in the unraveling of the head lice story. Speare graciously responded to my email and attached a number of documents detailing some of his work.

Speare and his cohorts accepted that hats were considered high-risk items but could find little hard data supporting the all-too-common claim. The research team examined over 1000 hats in four schools. They also examined the students. The team found no head lice in the hats but over 5500 head lice on the students’ heads.

Researcher Deon Canyon calls the odds of catching head lice from a hat improbable and sufficiently low as to be inconsequential.

The Australians also investigated the possibility of contacting head lice from contaminated floors. 2,230 children were examined from 118 classrooms. A total of 14,033 lice were collected from the children but not one louse was recovered from a floor. Again, Canyon doesn’t mince words. He calls the risk of contacting head lice from a floor zero. It is, he says, another groundless myth.

The out-of-proportion fear and stigma attached to head lice can make the lives of our most sociable little children quite miserable. Why the most sociable? Because they are the kids most likely to be making the head to head contacts that are almost always the source of the problem.

The reward for their social nature is exclusion from school, isolation from friends, over-treatment and under support. Toddlers can find themselves ostracized by their best friends. It can be emotionally traumatizing. It doesn’t have to be this way.

The Centers for Disease Control and Prevention (CDC) in the United States has listed solid reasons for discontinuing no nits policies:

— Nits more than ¼ inch from the scalp are usually not viable and thus are unlikely to hatch.
— If nits are easily visible, they are most likely empty shells or nit casings.
— Nits are cemented to hair shafts and are unlikely to be transferred to other people.
— Misdiagnosis of nits is very common, resulting in children being banned from school in error.
— Misdiagnosis can result in a child undergoing unnecessary chemical treatment.

Female head lice glue their eggs to the base of human hair shafts close to the scalp. And it must be a human head hair. A human body hair won’t do. Nor will the hair of a favourite pet.

And the distance from the egg to the scalp is important. The eggs, called nits, are incubated by the warmth of the scalp. A growing hair can carry a nit too far from the warmth. It will fail to hatch. No head hair, no scalp, no warmth, no hatching. Adaptation is a weakness as well as a strength.

Now you can understand why the simple presence of nits does not indicate an active infestation. If the nits are easily seen, they are most likely not viable. Or the nits may be nothing but empty egg casing or bits of dandruff and the like, all misidentified by the untrained eye. The CDC knows all this but not all school boards and certainly not many parents understand how often misidentification occurs.

It is claimed head lice have become difficult to eradicate. But it is not just head lice that have developed resistance to the insecticides in use. Many parents have also developed strong resistance to the neurotoxins used in the treatments. More and more parents are hesitating to douse their child’s head with powerful chemicals to kill a benign pest.

The approach du jour is bug busting. A lubricant, often conditioner, is used with water to wet the hair. The lubricant makes it difficult for the lice to move quickly and thus avoid the fine-toothed nit comb sliding through the hair from the roots to the tips.

Bug busting is nit picky. The goal is to physically remove all nits and lice from the infested head. Many people don’t have either the time or the patience to see the process through. The failure rate is quite high.

Others believe an oil, such as coconut oil, will coat the bugs and suffocate them. It will certainly slow them down but lice are resilient. This approach has yet to find clear support from scientific testing but those wanting to asphyxiate the little critters may be on to something.

Some new products for combating head lice use the asphyxiation method but kick it up a notch. A recent product on the Canadian market claims to kill not only lice but nits. In many cases one treatment is sufficient, the maker claims. If necessary a second treatment ten days later guarantees a lice-free head. No neurotoxins are involved.

So wash that toque, put those sheets in the dryer set to hot, bag those toys, vacuum the floor and carefully dispose of the dust bag. It will make you feel better. But do try to relax, shake off your fears. Take comfort in the facts and forget the myths.

Remember: head lice are adaptable. And they’ve adapted to heads. Off the human head they are dead within a day or two. You see, the damn things aren’t so super after all.

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