Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 11 - Bureau of Child Care Facilities › Subpart 55 - Child Care Facilities Licensure › Chapter 4 - REGULATIONS GOVERNING LICENSURE OF YOUTH CAMPS › Appendix 15-11-55-4-I › Attachment 11-55-4-11-55-4-I-A - RECOMMENDATIONS FOR THE CONTROL OF HEAD LICE IN THE CHILD CARE SETTING

Current through June 25, 2024
Head lice,
Pediculus humanus capitis
,
						are a common problem in children who attend child care in Mississippi. Although
						they do not transmit any human disease, they may be a considerable nuisance,
						and require conscious effort on the part of the child care staff and parents to
						control.
It should be understood that head lice can only be controlled in
						the child care center, not eliminated; they will occur sporadically, and will
						recur even after control efforts. The goal of control efforts is to reduce the
						problem and its impact, and minimize spread.
Head lice are not a product of poor personal
						hygiene or lack of cleanliness, and their presence is not a reflection on the
						child care center or the family.
More harm is probably caused by
						misconceptions about head lice than by the lice themselves.
1. IDENTIFYING INFESTED CHILDREN
By Screening:
It is important to establish a
						screening program. Children should be screened for head lice upon entry into
						the child care setting and periodically during the year. Staff members should
						be instructed in the technique of detecting head lice.
By Individual Case:
Any child suspected of
						having head lice (usually because he/she is scratching his/her head a lot)
						should be examined by a staff member who has been instructed in the technique.
						If infested, the child should be handled as described in Section 2, "HANDLING
						OF INFESTED CHILDREN."
If one child in a room is found to be infested, the whole
						room should be screened.
2.
					 HANDLING OF INFESTED CHILDREN
Exclusion:
An infested child's
						parent/guardians should be notified that the child has been found to have head
						lice and must receive the proper treatment before returning to child care.
						Treatment and removal of nits are described in Section 3, "TREATMENT." Care
						must be taken not to embarrass or stigmatize the child.
Return to Child Care:
The child should
						return to the child care center as soon as the first treatment has been given.
Nits (eggs) may still be seen even in an adequately treated child. This
						is not evidence of continuing infestation if the child has been properly
						treated and no adult lice are present.
3. TREATMENT
Individual:
Several effective pediculicides
						(lice-killing products) are available such as
						Nix®*  (permethrin)
						creme rinse (10 minute hair rinse) which is available over the counter and has
						ovicidal (egg or nit-killing) capability. It is the only over-the-counter
						pediculicide covered by Medicaid. The pyrethrin/pyrinate products (10 minute
						shampoos) include such products as Rid* , A-1000*,
						R&C®* ,
						Clear®*  and
						Triple-X®*  and are
						available over the counter at pharmacies.
						Kwell®* (1¢
						lindane), a 4 minute shampoo, requires a prescription. Central nervous system
						toxicity with lindane has been documented with prolonged administration.
Ovide®*
						lotion (Malathion 0.5¢) has been re-approved by the Food and Drug
						Administration (FDA) as a prescription drug for the treatment of head lice
						infestation in the United States. Treatment with any approved pediculicidal
						(lice-killing) product should be adequate.
One Treatment vs. Two Treatments:
Most
						products require 2 treatments. An initial treatment will kill adult and larval
						lice, but will not kill all the eggs.
A second treatment 7 to 10 days
						later, after the eggs left by the first treatment have all hatched, will kill
						the newly hatched lice before they mature and reproduce and will complete the
						treatment process.
Nix*  requires only one
						treatment since it is an ovicidal (also kills the eggs or nits); however, a
						second treatment is desirable since the product is not likely to kill 100¢
						of the nits. Ovide
*
lotion is also ovicidal and requires a second
						treatment 7 to 10 days after the first one
only
if crawling lice
						are seen.
Retreatment:
Pediculicides should kill lice
						soon after application. However, in some situations (e.g., a person is too
						heavily infested, pediculicide is used incorrectly, reinfestation or possible
						resistance to the medication), the lice may still be present. Immediate
						retreatment with a
different class or type
of pediculicide is
						generally recommended if live lice are detected on the scalp 24 hours or longer
						after the initial treatment.
Treatment of Infants and Children Less Than 2 Years
						of Age:
It is a rare occurrence for children in this age group to have
						head lice. It is generally not recommended to treat this age group preventively
						or just because someone else in the family has been treated. If a child of this
						age is found to have head lice, the parent/guardian should consult the child's
						physician for treatment. The safety of head lice medications has not been
						tested in children 2 years of age and under.
Removal of nits:
The need to remove nits is
						somewhat controversial. However, removing the nits may prevent reinfestation by
						those nits hatching that may have been missed by the treatment. It may also
						decrease confusion about infestation when the person who has been treated is
						being re-examined for the presence of head lice, and it will avoid possible
						embarrassment to the infested child. Nits may be removed by the use of a nit
						comb or by manually ("nit-picking") removing them. Most of the nits that are
						easily seen and more easily removed with the nit comb are those that are
						grayish-white in color, have grown out one or more inches on the hair shaft and
						have already hatched. The new, viable nits are closer to the scalp (within
						about 1/4 inch) and are more of a brownish color. These nits are firmly
						attached to the hair shaft with a glue-like substance. There are commercial
						products available to help loosen the glue-like substance for easier
						removal.
Family:
Household members of a child with
						head lice should be examined for lice (by a family member who knows how or
						someone else knowledgeable about lice) and any infested persons treated as
						described above.
The one exception is any person over 2 years of age who
						shares a bed with the infested child should simply be treated
						presumptively.
If the child is less than 2 years of age, consult the
						child's physician for treatment recommendations.
4. ENVIRONMENTAL CONTROL
Child Care Facility/Household:
Clothing,
						cloth toys, and personal linens (such as towels and bedclothes used within the
						previous 48 hours by an infested person) can be disinfected by washing in hot
						water and drying in the dryer using hot cycles. Non-washables should be dry
						cleaned, or stored in airtight plastic bags for 2 weeks. Spraying with
						insecticides is
NOT
recommended. Fumigants and room sprays can be
						toxic if inhaled or absorbed through the skin. If there are cloth surfaces,
						such as furniture or carpet, with which the infested person's hair has had
						extensive contact, they should be
vacuumed
thoroughly. The head
						louse will not survive off the human scalp for more than 24 - 48 hours.
************
Questions about control methods, specific treatments, or
						special problems can be addressed to the local health department, the district
						public health office, or to the Office of Community Health Services - Division
						of Epidemiology, State Department of Health in Jackson.
************
(*Use of specific product names is for example purposes
						only, and is not intended as endorsement of specific brands over
						others.)
SAMPLE LETTER TO PARENTS/GUARDIANS
Dear Parent or Guardian:
Your child has been found to have head lice. Head lice do
						not transmit disease and they are not a result of lack of cleanliness. Children
						in child care settings get them commonly, sometimes more than once.
You should consult a pharmacist or your child's physician
						for a recommendation as to which of several effective products to use to treat
						your child.
As soon as you have treated your child with an approved
						pediculicidal (lice-killing) product, he or she may return to child
						care.
There are 3 steps in the successful management of
						head lice:
1. Treatment
					 (killing the lice with an approved medical treatment) - It is very important to
					 follow the instructions given by your physician when using prescription
					 medication. If you use over-the-counter medication, you should follow the
					 package directions. The other members of your family should be checked for head
					 lice and treated if they are found to have them. Persons over 2 years of age
					 who sleep in the same bed with the infested child should be treated regardless.
					 If a child less than 2 years of age is found to have head lice, consult the
					 child's physician for treatment recommendations.
2. Removal of the nits - The Mississippi
					 State Department of Health recommends that you attempt to remove the nits to
					 avoid reinfestation by those nits hatching that may have been missed by the
					 treatment. The nits can be removed by dividing the hair into sections and
					 working each section separately. Look for small grayish-white or
					 yellowish-brown specks that are attached to the hair shaft close to the scalp.
					 Nits are attached to the hair shaft very firmly with a glue-like substance and
					 are not easily brushed out. They must be picked out with the fingernails or
					 combed with the nit comb that usually comes with the lice-killing product. This
					 can be done outdoors under bright sunlight or indoors with a good reading lamp
					 as nits are sometimes hard to see.
3. Environmental control - Clothing and
					 personal linens (such as towels and bedclothes used by infested persons) should
					 be machine washed using hot water and dried using the hot cycle. Non-washables
					 can be dry cleaned or stored in an airtight plastic bag for 2 weeks.
					 Cloth-covered furniture and carpet that have been in extensive contact with an
					 infested person's head should be thoroughly vacuumed. Lice-killing sprays are
					 generally not necessary.
Signature:
Date