Atlanta mother Randy Foster had done all the typical things to get rid of the head lice in her daughter’s hair. She bought the chemical cream rinses, vacuumed the carpets, bagged the toys and picked out the eggs, known as nits, with a metal comb.
None of it worked. After more than six weeks of frustration, Foster tried a decades-old treatment — Vaseline, slathered on the scalp — to smother the lice. It worked.
“Nobody warned me about how hard it was going to be to get rid of them,” Foster said. “No one told us how this was going to turn our lives upside down.”
Foster said she believes her daughter, Chelsea, may have been infested with lice that had developed resistance to typical chemical treatments — a trend that may afflict scores of families and schools, experts say.
Although scientists are unable to say how widespread the problem of “super lice” may be in the United States, other countries have documented a rise in resistant lice. And researchers at the Centers for Disease Control and Prevention in Atlanta acknowledge that they are seeing significant anecdotal evidence of tougher bugs.
“We’re seeing a lot of frustrated parents, lots of frustrated physicians and lots of frustrated school nurses,” said Sue Partridge, spokeswoman for the CDC’s Division of Parasitic Diseases. Lice outbreaks — whether due to “super lice” or just widespread, inconsistent follow-up care — are now “a major concern for school nurses,” Partridge said.
With the first weeks of school behind them, teachers and public health workers are bracing for a bumper crop of head lice this year.
“We’ve always seen some cases,” said Tammy Hamilton, spokeswoman for the Cobb County, Georgia, Board of Health. “But in the past few years, we’ve noticed a dramatic increase.”
Many schools are trying to control the insects with new no-nit policies, which require students to leave school immediately if a nit, or lice egg, is found. And public health workers are stepping up prevention efforts, urging parents to check their children’s scalps every Friday night and suggesting that some schools bag hats or coats as students walk into the classroom.
Foster never dreamed that an itty-bitty bug could be so persistent. She doused her daughter’s hair in over-the-counter lice products. They didn’t work. She went through Chelsea’s hair with a metal comb, looking for nits, or lice eggs. When that didn’t work, she picked out nits strand-by-strand and cut them out.
She cleaned the house, the toys, the clothes and the linens — repeatedly. And after researching books and Web sites, she finally slathered Chelsea’s hair in Vaseline, videotaped the special moment for posterity, and capped her hair overnight. That finally killed the bugs.
“It was really long and ugly and exhausting,” said Foster, who said she kept Chelsea, then 3 years old, still for the daily inspections with stacks of videos and “lots of bribes” for six weeks. “I put my poor kid through hell. She was a real trouper.”
Jayketa Singleton, a health services clinical adviser to the Atlanta public schools, said Foster’s story is not uncommon.
When talking to PTA groups last year about how to combat lice, she said she heard parents repeatedly vent their frustration over fighting lice.
Anyone, regardless of economic status, can get lice. Even Cleopatra owned a nit comb.
“These are not children with dirty hair,” Thompson said about the cases she has seen. “These are children well cared for, with clean hair.”
But girls tend to have higher numbers of lice and nits, because they often have longer hair and they tend to do more head-to-head activities that promote the spread of the insects, experts say.
And lice tend to attack whites, Asians and Hispanics more than African-American boys and girls, experts say. The reason: The texture of African-American hair makes it difficult for nits to attach. Hairstyles that are either extremely short or tightly braided discourage an infestation.
When a lice outbreak occurs, things often degenerate into a blame game, which can complicate efforts to solve the problem. Parents blame the schools for not being aggressive enough in stopping infestations by keeping common areas of schools free of lice and sending infested students home. Schools blame parents for inconsistent follow-up treatment for lice. Public health workers say once a child has lice, the parents must be diligent about shampooing, nit-picking, cleaning and vacuuming their homes for at least a month to make sure all bugs are dead.
A second complication is that lice treatment can be expensive. Americans spend about $100 million a year on cream rinses and shampoos that contain delousing agents, according to the National Pediculosis Association. And Nix, the No. 1 lice treatment, has raked in more than $40 million each year since 1997, when annual sales of the over-the-counter product doubled, according to its distributor, Warner Lambert. A family can easily rack up a $60 to $70 bill to treat a single lice infestation. Chemical cream rinses, which need to be used twice within one week, cost between $10 and $20 a pop per person. And fine-toothed nit combs cost between $10 and $15.
But the greatest hurdle to combating lice in the past decade has been that more parents are finding that typical treatments — such as permethrin, the active ingredient in Nix — don’t seem to be working anymore.
A survey taken at the 1998 annual meeting of the National Association of School Nurses found, for instance, that more than 80 percent of the respondents reported an increase in the failure of chemical treatments to stop lice outbreaks in the past year.
And a recent unpublished Harvard University study found more than 200 lice, harvested from the heads of 57 children, survived in petri dishes treated with permethrin. In contrast, the researchers showed that 67 lice from children in the Philippines, who use chemical treatments far less frequently, quickly died after exposure to permethrin.
The CDC has not seen definitive evidence of “super lice” in the U.S., although they have been identified in other nations. But experts acknowledge lice studies are rare, since the bugs are neither glamorous nor dangerous and only live on humans, making laboratory studies of lice virtually impossible.
Parents and school nurses say they don’t need scientists to confirm what they see every day.
“We are definitely seeing something new,” said Thompson, adding that about 20 percent of her student body contracted lice last year. “And it’s causing real nightmares for everyone involved.”
