Head lice infestations in daycare centers and schools are completely normal. This is the result of a study carried out in daycare centers and primary schools in Dresden. Until now, there has been insufficient data on the spread and frequency of the parasite. Thanks to the work of two TU Dresden biology students, we now know how common these little bloodsuckers actually are and that they have nothing to do with poor hygiene. Better information could help.

Feeling itchy yet? 

Head lice are 2-3 millimeter long parasites that live on the human scalp. They attach their eggs to the hair and feed on human blood. For many people, this topic immediately makes them feel queasy and compulsively scratch their heads, especially if they or their children have ever had lice. Head lice are the norm in daycare centers and schools, as a survey by Dresden biology students Patricia Cora Pusch and Luisa Kranich found out. The survey was prompted by the lack of data on the prevalence and frequency of head lice, despite the fact that head lice outbreaks are extremely common among children worldwide. The survey of head lice outbreaks in daycare centers and schools in Dresden should contribute to providing more clarity on how lice spread. The students sent their survey to all 259 daycare centers and 74 elementary schools in Dresden. The survey asked whether head lice infestations occurred in 2021, between 2016 and 2020, or between 2006 and 2015. Responses from the 15 elementary schools and 44 daycare centers that participated in the survey were evaluated anonymously.  

Head lice are normal 

The survey showed about 95 percent of kindergartens and a whopping 100 percent of elementary schools experienced a lice infestation between 2006 and 2021, with about 60 percent of kindergartens and about 87 percent of elementary schools experiencing an infestation in 2021 alone. The time of year had no effect on the number of occurrences.  

© Nele Lander

Children in schools and kindergartens have close contact throughout the day as they play in groups or in the playground. This makes it easy for head lice to spread, and means that the high numbers in these facilities come as no surprise. However, improper handling of an infestation also contributes to the high number of cases. If head lice are not found in time, not treated correctly, or not treated at all, they can spread rapidly. This is often due a lack of knowledge or even shame among those affected, as there is still a negative stigma attached to head lice. If someone has head lice, it is immediately associated with uncleanliness. People find it repugnant and are afraid of being infected themselves. However, head lice is not the result of bad hygiene, emphasizes Fabian Lander, specialist in pediatric medicine and pediatric infectious diseases at Carl Gustav Carus University Hospital Dresden. “You can’t get rid of head lice by washing hair with regular shampoo, so they really do affect everyone.” People with head lice often don't tell others because they expect negative reactions from those around them. Not only are head lice extremely unpleasant, they can also cause serious problems if not treated promptly and correctly. “Typical symptoms like an itchy head and neck can lead to open sores due to scratching if the infestation is severe,” explains Fabian Lander. “Head lice do not carry any diseases in Germany, but in the worst cases, bacterial superinfections can develop in the wounds.” The insomnia and emotional tension this entails can also endanger mental health.  

Must head lice be reported to the Public Health Office? 

There is no requirement to report head lice cases under the German Infection Protection Act. Only community bodies are required to report infestations to the health department. It’s difficult to ascertain how seriously these bodies take this duty, so the reliability and completeness of this data is insufficient. The study from TU Dresden now provides an important initial overview. 

What should you do? Keeping a cool head, even when it’s itching 

All parents are probably familiar with the lice outbreaks in schools. They are then required to check their child for head lice and provide treatment if necessary. The responsibility for this lies entirely with the parents. But what should you do if you think your child has head lice? 

1. The lice check
Parents should not only check their children for lice when they suspect they have them. Checking your child's scalp regularly can help detect and treat head lice more quickly. If you suspect lice, Fabian Lander advises that you use a lice comb to inspect damp hair that has been treated with a conditioner. Lice combs are available at pharmacies and drugstores. 

2. Do not conceal the fact that you have found head lice
If you do find head lice, you should inform the kindergarten or school as soon as possible, and anyone else with whom you had close contact. The school can then inform the other parents that there has been a head lice case and potentially prevent it from spreading.

3. Correct treatment is crucial
If there is an infestation, you should treat it as soon as possible and take it seriously. Anti-lice treatments from the pharmacy are very effective when used properly. These solutions, which are gentle on the skin, have been proven to be effective and contain ingredients that reliably kill lice. Please be sure to follow the instructions on the package. It is also important to repeat the treatment after around 10 days, as sometimes not all louse eggs are killed during the first treatment and larvae can hatch. If the treatment was not successful, this usually means the product was used incorrectly. Fabian Lander cites too short application times, sparing or uneven application of the product, excessive dilution or lack of repeat treatments as the most common errors. Children may only return to the kindergarten or school once treatment has been completed. 

4. Be on the safe side
Head lice are dependent on human blood, which is why transmission via objects such as clothes and cuddly toys is less likely. Nevertheless, pediatrician Lander recommends washing clothes, bedding and towels. Hairbrushes, clips and hair ties should also be washed in a hot soapy solution. Cuddly toys that cannot be washed can be stored in an airtight plastic bag in a warm place for three days to safely kill the head lice.  

5. Don’t be ashamed
As the study shows and pediatrician Fabian Lander confirms, head lice are completely normal and anyone can get them. If you treat them quickly and correctly, you can get rid of them quickly. Talking about the topic, educating yourself and informing others can help remove the negative stigma.  

Contact:
TU Dresden Press office