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| Head lice are not easily spread by hats, pillowcases, sofa backs or rugs. | |
Newspapers love a good story. The
Globe and Mail,
one of Canada's most respected newspapers, warned readers about the
growing problem of super lice
—lice which have developed
resistance to the insecticides in the traditional treatments.
Hardy, resilient, tough to wipe out: No, I am not talking about head
lice but about the stories, mostly myths, surrounding the pesky, little
bugs.
When the Toronto District
School Board announced it was reviewing its
"no nits" policy,
a media fire storm erupted. The "no nits" rule, once common in schools
around the world, prevents those students with visible head lice eggs, nits, from attending school. The affected children cannot return until their
heads are declared nit free. The rule sounds reasonable but isn't.
Teachers, parents and even health care workers often misdiagnose head lice infestations. When the
Harvard School of Public Health
examined samples of head lice and nits, more than
40 percent of the samples had nothing to do with head lice. This is why a
"no nits" policy results in students being barred from school for such
things as hat lint or dandruff. Of the remaining samples, approximately
half or 30 percent indicated non-active infestations. Do the math. 70
percent of the samples were innocuous.
The
Toronto Star
fanned the fires of fear by conducting a highly suspect, online poll.
The loaded questions determined most readers believed "nits are damaging
to the kids." This came as no surprise since the story was replete with
myths. Readers were warned, "Lice are a common problem among young
children because they can be easily spread by sharing items like hats,
brushes or combs." No they can't. Completely untrue. A myth.
Research
has shown, and this is a quote, "the odds of head lice transmission via
hats of lice-infested children is sufficiently low to be considered
improbable and inconsequential."
With the school board in Toronto reconsidering its approach to the head lice problem, my local paper,
The London Free Press, decided to do a take on the story but with a local twist. The fact that neither the public nor the separate school board was
contemplating changes to the head lice policy should have made this a non-story
but it didn't stop the paper. A grabber headline, a big picture of a
concerned mother intent on protecting her young daughter from head lice,
a separate fact-box with the usual stern warnings and voilà: a head lice
story.
The Thames Valley District School Board cannot be faulted for being cautious. Without community
support a move to discard the "no nits" policy may fail. Progressive boards
which moved too fast have been forced to reinstate the discredited "no nits" policy
after facing a flood of complaints from angry parents and, in some
cases, teachers.
I contacted a school board in the States that had to
backpedal on its decision to drop its "no nits" policy. The person I talked to felt the
local newspaper was of no help in getting out the true head lice story.
The newspaper preferred yesterday's myths to
today's news.
Head lice are
not a health hazard,
they 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.
Possibly, The Free Press should have run a picture of a young mother who
no longer wants her children exposed to the possibility of being barred
from school for having hat lint. Don't laugh. Remember the study done
by the Harvard School of Public Health.
The little
critters, only as big as sesame seeds, are unable to hop, let alone leap
tall buildings, yet in the press they are called "super lice." There is
nothing super about them. After years of being controlled with
insecticides, the little bugs have done what insects do best—adapt.
Head lice have developed resistance to the insecticides in the hair
treatments used to fight them. This adaptation took no one by surprise.
But
this very adaptability may well be their undoing. After living
thousands of years as our uninvited guests, head lice are perfectly
adapted to life on a human head. Off the human head, they don't
fare so well. They die. (Reportedly,
55 hours off the human head and they're dead. That said, 72 hours without a blood feeding and they are done is a more often quoted time frame.)
With newspaper stories goading
them on, fearful parents toss out pillowcases complete with pillows.
Hats, scarves, coats are washed or even dry cleaned at some expense.
Toys are bagged and left bundled for weeks. Almost everything a
child with head lice has touched is considered contaminated by these frightened folk.
Rather than
focusing on the environment, parents should
focus on the affected child's head.
The fear-driven cleaning response is totally out of proportion to the
risk and this is thanks in part to the myths spread by our newspapers.
When
I contacted the local reporter who wrote the head lice story, she
referred me to her source, something she found on the Web. I thought,
"You can't believe everything you read on the Web." The reporter's nose
was so far out of joint because I dared to question her story, she has
not talked to me since. Clearly readers should not question journalists.
It's
claimed that Edward R. Murrow said of his own profession, "Journalists
don't have thin skins. They have no skins." Sadly, I have discovered
this observation on the sensitivity of many reporters to criticism is
all too accurate. In this age of the Internet, with the ability to check
any and all questionable claims, journalists would be wise to listen to
a little criticism.
Google enough sources and you will
soon realize there is a battle being raged 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 children's heads.
To get the whole story, the accurate story, I contacted the people behind the claims. My search led me to
Richard Speare,
professor emeritus, James Cook University, Australia. Speare is one of
the major players in the unraveling of the myth-riddled 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. One myth busted.
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. Researcher Deon 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 can be 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 next time I see a story in the
newspaper on head lice, I want to see a picture of a mother protecting
her child from unwarranted emotional trauma. This would be a great story
and this would be news.
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 hair on a human head. A human body hair won't do. Nor will the hair of a favourite pet.
Also,
the distance the egg is from 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
oh-so-close warm scalp, no hatching. It's that simple.
Adaptation is a weakness as well as a strength.
Now you
can understand why the 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 not many parents and
certainly not many reporters.
It is claimed head lice
have become difficult to eradicate. But it is not just head lice that
have developed resistance to the insecticides used. 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, poisonous chemicals to kill a benign pest.
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| Image courtesy: Community Hygiene Concern, Joanna Ibarra |
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
have neither the time nor 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.
One product available in Canada,
Nyda, combats head lice by using the asphyxiation method but kicks it up a notch. During an interview on
Radio New Zealand, Professor Rick Spears was asked, "How essential is a nit comb for getting rid of head lice and nits?" The professor answered:
With
some of the new dimethicone based products, some of the silicone based
oils penetrate the egg too, so the embryos die as well. In that case you
don't have to comb them all.
That's
Nyda! Nyda is a dimethicone based product. And it claims not only to
kill lice but also nits. In many cases one treatment is often sufficient, the
maker says. If necessary a second treatment ten days later guarantees a
lice-free head. No neurotoxins are involved. Nyda is safe but keep it
out of the eyes. You don't want a child fighting head lice to also be
fighting the caregiver, you, and the treatment.
I
chatted with a family that used Nyda as directed. The parents told me
that Nyda appeared to eradicate the head lice after just one treatment.
But the affected child was treated again after ten days just to be sure.
The family asked me not to go into too many details as they had
discovered the London school their child attends does not follow the "no
nits" policy but mum's the word. It is a school policy and not a board directive. The principal and teaching staff are clearly
enlightened.
The parents read The Free Press article
and realized the paper wasn't enlightened. The paper and the reporter
were still living in the head lice dark ages. Mythology still rules.
If it makes you feel
better, wash that toque, put those sheets in the dryer and set it to hot, bag
those toys, vacuum the floor and carefully dispose of the dust bag. 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 as
little as six hours. You see, the damn little things aren't so super after all.
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Other links:
Follow link and do a search of the pages for chapter titled Lousy Science.
