School nurses battle stubborn foe head lice Some say pest shows increasing resistance to traditional cures

January 28, 1998|By Elaine Tassy | Elaine Tassy,SUN STAFF

It's wintertime at Harman Elementary School, and the nurse knows it by the amount of nitpicking going on. Literally.

In recent months, the heads of hundreds of Anne Arundel County students have been infested with six-legged lice and their rice-shaped eggs, called nits, which experts say have become harder to kill in the past year.

"It's the time of year for it," said Donna Mullenax, Harman's school nurse. In cold weather, she said, lice travel from coat to coat in cloak rooms and from head to head when students stay indoors in close quarters.

At Harman, which has about 600 students, Mullenax had checked about half of the students before the Christmas vacation and found a dozen with lice.

School nurses around the county checked about 3,000 students in October and found 179 students had lice; a month later, nurses checked 3,400 students and found 184 had them. A similar number of cases were found in the same period in 1996.

Lice, wingless insects that live for about 48 hours without a host and as long as 30 days with a host, lay four to six eggs a day and are a constant problem in public schools.

The difference this year, said Gene Saderholm, program manager for county school health services, is that "we're seeing parents that are telling us that it's very difficult to get it taken care of."

School nurses are checking students' heads -- starting with one student and moving on to siblings and classmates and siblings' classmates -- and sometimes make home visits and pass out lists of suggestions on how to control the pests.

Mullenax recently juggled visits from a student with a bloody nose and another with asthma while describing how she checks heads, keeps infected students from being teased and helps parents get rid of the lice.

She pulls on rubber gloves, seats the students under fluorescent lights and begins rooting through their hair, parting it with her fingers and searching for the tiny bloodsuckers, some gray and others black and flealike, "almost like a gnat but a little bigger," she said.

"They like the thicker part of the hair, where they can hide," she said. Boys, she has found, tend to have lice above the ears and at the crown of the head, and girls get them at the nape of the neck.

Black students tend not to get them -- girls because their hair is often oiled with substances lice cannot grip, boys because the hair is often cut so close to the head.

If she finds lice, she is likely to also find nits, sticky eggs attached to hair shafts.

If she finds any, she sends the student home until all the lice and nits are gone. Some students have returned the next day; others have been out for a week.

Mullenax recommends over-the-counter anti-lice shampoo treatments, which cost $6 to $9. If parents cannot afford that, she supplies them free.

Parents have complained during the past year that such popular anti-lice shampoos as Nix, Rid and Kwell have given unsatisfactory results, said Robin G. Todd, an entomologist with Insect Control and Research of Catonsville, which tests insect-control products.

"We get calls from some fairly desperate mothers and fathers," he said. "It's certainly a problem I'd say over the last year is getting worse and worse."

Some lice have a natural resistance to certain enzymes in anti-lice shampoo, he said. Parents should try various brands of shampoo if the first try fails because they have different active ingredients. "Assuming they use it correctly, using [one type of shampoo] again and again is not going to enhance the effects," he said.

Nurses are careful to help students avoid embarrassment about having lice. "There's a stigma that lice are associated with dirtiness, when the fact of the matter is they like clean hair, clean heads," Mullenax said. "We try to convince them it's not their fault; it's like when you go out in the woods and get a tick."

If students have lice, she tells them privately so that others don't make fun of them. But some students see the pests as a ticket out of school, she said. "I've had a couple who liked to announce it -- 'I have head lice. I'm going home.' It's like something special in some way, that they get to go home," Mullenax said.

Fighting lice Anne Arundel County School Health Services recommends the following:

Using an over-the-counter lice-destroying shampoo and follow directions carefully. Or get a prescription from a doctor.

Using a blow-dryer, a metal-toothed comb, warm vinegar or a combination of those methods to help loosen nits, which can then be picked off with tweezers or fingers.

Checking all family members. Those who share a bed with a lice-infested person should be treated whether or not lice or nits are found, and all family members with lice should be treated at the same time.

Getting lice and nits off towels, bed linens, hats and coats by dry cleaning them or washing them in hot soapy water, then drying them for 20 minutes or ironing them to kill the nits. Pillows can be wrapped in plastic to suffocate living lice or nits.

Vacuuming rugs, car seats, chairs and sofas to make sure lice do not reproduce, then throwing away the vacuum bag.

Pub Date: 1/28/98

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