It is the policy of We Speak For Ourselves, LLC. that any reports of pediculosis (lice) infestation be treated and that all measures are taken to prevent its spread.
There are three types of lice: head lice, pubic (crab) lice, and body lice. Lice are small insects that are about the size of a sesame seed. They are light brown in color but the color can vary. Lice move quickly and shy away from light. Diagnosis is more often make on the basis of the nits (eggs). Nits are tiny, yellowish-white oval eggs that attach themselves to the hair shafts with nature’s own super glue. The symptoms are as follows:
Intense itching on the scalp or behind the ears.
Scratching at hair/head.
Appearance of red bite marks and larger sores and scabs from scratching.
Appearance of white nits stuck to the base of the hair shafts. Viable nits may be found at any distance from the scalp. Nits cannot be washed or blown away. Nits cannot be washed or blown away. Nits are most often located at the nape of the neck, behind the ears, and at the crown.
Appearances of swollen glands in the neck or under the arms have been reported.
Pubic (crab) lice:
Intense itching in the pubic region.
Scratching at pubic region
Appearance of crab-like, tiny insects slightly larger than head lice. Crab lice can be found in other hairy areas of the body:
Intense itching of the skin
Scratching at the skin
There is not usually appearance of lice or nits on the skin but by looking at a person’s clothing, especially seams, nits and lice can be found hiding there. Lice live in the clothing and travel to the skin surface only to feed before going back into the clothing. Persons who don’t change clothes often are at a higher risk, but hygiene has little to do with it; lice thrive in clothes that aren’t frequently changed or washed.
Lice are transmitted through close direct contact with a person who has lice, or having direct contact with an object such as a comb, towel, pillows, hats, or an item of clothing that is harboring adult lice. Toilet seats can pass the transmission of pubic lice to another person.
How to report a suspected or confirmed pediculosis infestation:
Notify the Company Nurse immediately if suspicious of lice or if a confirmed pediculosis infestation has been reported or documented
Fill out and send an Incident Report part I to the Executive Director and Company Nurse.
When advised by the Company Nurse, a Pediculosis Letter (Attachment A) accompanied by the pamphlet “Head Lice Infestation” (Attachment B) may be distributed to employees, clients, and client’s family in day programs/residential programs where the infestation has been confirmed.
Treatment of pediculosis infestation in day programs:
When there is a confirmed report that an employee or a client has lice and has attended a day program, the facility will be cleaned with an approved cleaning agent and disinfectant within 24 hours. Thorough vacuuming should be done. It is rare that another person would contract lice in programs unless there is very close body contact, or sharing of personal items such as combs, brushes, pillows, and clothing.
It is not necessary to treat any other person at the program unless there is further evidence of adult lice or nits. Only those showing evidence of infestation should be treated.
Data has confirmed that shampooing hair first with Prell Shampoo will cause the pediculicidal shampoo agent to adhere better to the hair shafts.
After the person has been initially treated with a pediculicidal agent (physician order or an over-the-counter product) the employee and/or client can return to work and/or to the day program providing there is a statement from the physician or proof of an empty pediculicidal container. Daily checks for nits are advised for 10 days following treatment. If there is any evidence of re-infestation then repeat treatment and/or call the medical physician for further treatment instructions. Do not retreat for symptoms of itching only.
Treatment of pediculosis infestation in residential programs (e.g., FLA’s and apartments.)
Individual treatment involves the use of a pediculicidal product if prescribed by the physician. The National pediculosis Association discourages the use of Kwell Shampoo and its generic counterparts that contain the controversial pesticide, Lindane. Some literature recommends a product that contains a combination of pyrethrin and piperonyl butoxide. One is an insect killing substance derived originally from plants; the second enhances its louse-killing powers.
Manual/mechanical removal of lice and eggs is a non-pesticidal alternative for infants and pregnant women. Comb out all nits by using a combing tool manufactured for the purpose of nit removal. Nit final rinse of ½ water and ½ white vinegar may loosen nits for easier removal.
Treatment procedure: Explain process to client. Remove shirt and provide a towel to protect eyes. Do not treat in the bathtub or shower, but have person lean over the sink (this confines the lice product to the scalp/neck for head lice) and wet hair. Observe client’s skin carefully for secondary skin infections and/or cellulitis as scratching can cause excoriation of the skin and scalp which can lead to pyoderma and dermatitis or other secondary skin infections. No pesticides should be used if the person is pregnant, nursing, or has allergies to pesticides. No pesticidal medication should ever be used on lice/nits in the eyebrows or eyelashes. Avoid using any pesticides on open woundson the scalp or other parts of the body of the person to be treated or on the hands of the person who will apply the product. After applying gloves, nit removal can also be done with the fingernails manually. Place all adult lice and nits (eggs) obtained in a sealed plactic bag and dispose of in a trash receptacle. Clean comb with soapy hot water for at least 15 minutes. Following nit removal, have the person put on clean clothing and let hair air-dry. Keep all towels, linens, and clothing in a separate area/bag until it can be laundered and/or cleaned properly. Educate client and other clients in the household about not sharing items, bedding, towels, clothing, and other personal items. Document education on the Client Education Form.
Louse products do not kill all the nits, and survivors will hatch into crawling lice within 7-10 days. A daily nit check is advisable for at least 10 days following the treatment, retreat in 7-10 days if previously ordered by the physician. If there is evidence of new nits or newly hatched lice, notify the physician to get an order to retreat. Do not retreat on the basis of itching alone.
Machine-wash all clothing and bed linens that have been in contact with the infected person during the last three days. Articles should be washed in hot water and dried in a hot dryer. Non-washables can be dry cleaned or stored in a tightly sealed plastic bag at room temperature for two weeks.
Rugs, upholstered furniture, bedding, and any personal items that cannot be washed must be carefully vacuumed. Vacuum everything and everywhere possible. This includes mattresses, furniture, stuffed animals, helmets, and headphones, etc to pick up any living lice or nits attached to fallen hairs. Replace vacuum cleaner bag with a new one after thorough cleaning is completed and place the used vacuum cleaner bag in a sealed plastic bag in a sealed plastic bag and dispose of in the trash receptacle. The National Pediculosis Association and the CDC do not recommend the use of insecticidal sprays because they may be harmful.
Thoroughly clean toilets and other bathroom fixtures with an approved disinfectant agent and/or its equivalent.
Soak combs, brushes, hair barrettes, ribbons, and headbands in hot water for 5-10 minutes.
Prevention of pediculosis infestation:
Only liquid antibacterial soap should be used for showers and baths. Bar soap should only be used in residential programs where it is used by a single client and placed in a covered, labeled container for the client when not in use. Only liquid antibacterial soap should be used in all other programs.
No sharing of clothing, towels, bedding, stuffed animals, and pillows among clients.
Each client’s clothing, including towels and bedding, should be washed separately. Soiled linen and clothing should be kept in a covered laundry container in the client’s room until it can be properly laundered. The washer should be sprayed with an approved disinfectant spray and/or its equivalent after each client’s use and then followed with the rinse cycle before washing another client’s clothing and bedding.
Paper towels should be in all bathrooms including replacing hand towels in all residential programs for routine hand drying.
All kitchen towels and dishcloths should not be kept around the sink after their use; this can be a temptation for clients to use as hand towels.
Frequent vacuuming of the furniture is recommended. Daily vacuuming is preferred, but no less than once weekly in any program.
Bathrooms should be thoroughly cleaned daily.
Bathtub and showers should be cleaned thoroughly with a disinfectant-cleaning agent after each bath and then rinsed thoroughly before the next client use.