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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.

Section 3. Summaries of Infectious Diseases

Pediculosis Capitis 1

(Head Lice)

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS: Itching is the most common symptom of head lice infestation, but many children are asymptomatic. Adult lice or eggs (nits) are found in the hair, usually behind the ears and near the nape of the neck. Excoriations and crusting caused by secondary bacterial infection may occur and often are associated with regional lymphadenopathy. In temperate climates, head lice deposit their eggs on a hair shaft 3 to 4 mm from the scalp. Because hair grows at a rate of approximately 1 cm per month, the duration of infestation can be estimated by the distance of the nit from the scalp.


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ETIOLOGY: Pediculus humanus capitis is the head louse. Both nymphs and adult lice feed on human blood.


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EPIDEMIOLOGY: Head lice infestation in children attending child care and school is common in the United States. Head lice are not a sign of poor hygiene, and all socioeconomic groups are affected. Infestations are less common in black children than in children of other races. Head lice infestation is not influenced by hair length or frequency of shampooing or brushing. Head lice are not a health hazard, because they are not responsible for spread of any disease. Transmission occurs by direct contact with hair of infested people and, less commonly, by contact with personal belongings, such as combs, hair brushes, and hats. Head lice can survive only 1 to 2 days away from the scalp, and their eggs cannot hatch at a lower ambient temperature than that close to the scalp.

The incubation period from the laying of eggs to the hatching of the first nymph is 6 to . . . [Go to Full Text]


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