Head lice roam among Sisters students

T. Lee Brown | Last updated Apr 09, 2024 9:20am0

Head lice are fairly common among school-aged children. Notifying parents of a small outbreak in multiple grades of Sisters School District, nurses called head lice “pesty nuisances.”

Sisters Elementary School (SES) nurse Jennifer Morris told The Nugget, “We’ve had off and on cases.” The recent letter or communication that went out to parents occurred “on request of a handful of parents that reached out to me over the last month.”

Morris said, “We were hoping spring break would settle things a bit... we’ve had maybe 12 cases that I know of since January. There’s been a few families that have had to do double treatments. There is circulation happening.”

Every spring, winter, and fall, a small number of head lice cases occur in the local schools. Usually, “it goes up in the winter as we’re wearing hats and staying indoors,” she said.

Morris pointed out, “it’s not a disease, it’s a condition. Yes it can be contagious, but it’s not detrimental to our health. So because of that our policy nationwide has changed, with the American Pediatric Association guidelines.We’re trying to help kids stay in school, we’re educating about head-to-head contact being the first line of prevention.”

Treating lice as soon as they are found is essential to slow further spread.

“Prevention is the best medicine,” the letter noted. Parents and guardians should check their students’ heads by combing through hair with a fine-toothed comb at least once per week. If a child has a friend with lice, perform the check daily. Also perform this check before and after any sleepovers.

The nurses advised that people: 1) Wear their hair in a bun, ponytail, or braids; 2) Don’t share brushes, combs, hats, headbands, or similar; 3) Avoid head-to-head contact; and 4) Do not share pillows.

Head lice spread rapidly. If they are found, nurses wrote, “We strongly encourage parents/guardians to contact the families of any play dates your student has had recently to let them know that their children may have been exposed to head lice.”

Schools, sports coaches, other parents, and daycare centers may also be notified. As for treatment, “Please contact your student’s doctor or talk with your pharmacist to choose the right treatment for your student.” Couches, chairs, and headrests can be a site of concern. (See “Treatments available for head lice” sidebar.)

Morris noted, “We’re always trying to stay current with county, state, and national guidelines, and updating our policies as needed.” Thus the schools no longer send kids home automatically if lice are detected.

Instead, if a student has a “confirmed live lice infestation on their head, parents/guardians will be notified and may pick their student up from school for treatment,” the letter stated.

Treatments available for head lice

T. Lee Brown

Head lice are making the rounds in Sisters schools and may find their way to other households (see related article page 1). Treatment is available and various methods can prevent additional spread.

Medicated Treatments

Special shampoos kill the lice that are currently living in someone’s hair. These over-the-counter treatments, which do not require a prescription, contain pediculicides such as pyrethrins or permethrin—not to be confused with “natural” or homeopathic treatments.

However, louse eggs typically remain viable even after use of medicated shampoos. Therefore, some experts recommend two rounds of treatment, the second round occurring 7–11 days after the first — even if no further lice, nits, or eggs are seen.

“Over-the-counter treatments are effective if directions are followed exactly and parents/guardians are diligent about daily head checks,” according to Sisters School District nurses in a recent letter to parents.

In the U.S., where malathion was formerly banned from treating lice, some doctors now prescribe Ovide. It contains malathion, terpineol, dipentene, and pine needle oil; this treatment kills some of the eggs, in addition to actual lice. Spinosad and benzyl alcohol (Ulesfia) are among other RX options.

Home, Family & Pets

If someone in your household has been exposed, steps can be taken to prevent further spread. When they’re not on a human’s body, lice survive only 1–2 days. Harvard Medical School recommends washing all bedding and towels in hot water (alternative: seal them in a plastic bag for two weeks).

Additional household tips include vacuuming all floors, and soaking combs and brushes in very hot water for at least 10 minutes.

Harvard explains, “because head lice are so contagious, experts suggest treating the whole family,” even those who don’t show symptoms.

Avoiding upholstered furniture for several days is a good idea, according to University of Rochester Medical Center dermatologist Dr. Mary Gail Mercurio.

“Contrary to urban legend, lice neither jump nor fly,” Mercurio stated in an article. “And it’s fine to continue cuddling your pets as there is no evidence that lice is spread by dogs and cats.”

Manual Treatments

In a letter from Sisters School District, nurses recommended “manual removal of lice/nits or occlusive methods” for those who do not wish to use medicated lice shampoo. School nurses emphasized using careful technique and “close surveillance” for 21 days.

Sisters Elementary School nurse Jennifer Morris told The Nugget, “There is a lice removal center in Bend, it’s an option for a treatment. It’s not going to take care of the household, but it’s going to treat the kiddo or the person who has lice.”

While the district does not endorse any particular business, Internet searches show a Lice Clinics of America location in Bend (see liceclinics

northwest.com/bend-lice-removal). Norris explained that lice clinics are an option “for people who are new to this, or don’t have good eyesight for checking for nits.”

Alternative Treatments

According to Sisters School District, “There is no medical evidence that homeopathic remedies are effective for killing lice. While certain non-medicated shampoos, oils, etc. may ward off head lice, these treatments will not kill them.”

Healthline.com would likely agree. Their researchers and writers compiled multiple studies from around the world, looking for results that might support use of coconut oil, essential oils, or herbal sprays for preventing head lice. Healthline concluded that there’s no solid evidence that any preventive sprays or lotions work effectively—even those containing chemicals like DEET, piperonal, and IR3535.

Prevention magazine interviewed experts and examined research, finding that a few small studies showed some promise for folk and herbal remedies like tea tree oil and nerolidol, but not enough to recommend their use. One meta-study by Australian researchers on “Antiparasitic Activity of Tea Tree Oil” found potentially “promising outcomes.”

Experts at Prevention concluded that the evidence was inadequate, lacking good sample sizes and rigorous study in the field. Some doctors stated concern that essential oils, which can be very strong and are not regulated by the Food and Drug Administration (FDA), may further irritate the already itchy scalp.

Nurse Morris added, “There’s just not enough medical evidence to say that homeopathic ways are beneficial... Tea tree oil is not FDA recommended, so I can’t stand by it from a nursing standpoint.”

She noted that allergic reactions to essential oils are fairly common. Some, including tea tree oil, are toxic if swallowed.

The district’s letter recommends that parents refer to the Center for Disease Control for more information on treatments, at http://www.cdc.gov/parasites/lice/head.

Note: This information has been compiled to help residents of Sisters Country consider their options. It should not be construed as medical advice from a health professional. Please consult your doctor, public health official, or health practitioner for actionable medical advice.