Talk:Head lice infestation

Assessment
Insufficiently referenced to meet B class standards. WhatamIdoing (talk) 02:37, 10 October 2008 (UTC)

New title?
The current title of this article -- Pediculosis humanus capitis -- is an unusual choice that I think should be changed. For example, none of the links in the DiseaseDisorder infobox list Pediculosis humanus capitis as a synonym for this disease. The WP:MEDMOS suggests using the ICD10 as a guide which lists for B85.0 "Pediculosis due to Pediculus humanus capitis". While this is precise, I think it's a bit wordy. I think I prefer the listed synonym of "Head-louse infestation". I would even be open to using "Pediculosis capitis", which is mentioned at MedlinePlus. I don't like the idea of using "Head lice" for the disease name because it's also used to describe the animal. Although, I wouldn't be opposed to changing the redirect at Head lice to this article in lieu of Head louse. Noca2plus (talk) 04:21, 10 October 2008 (UTC)


 * Moved to Head-louse infestation. Pediculosis humanus capitis now redirects here.  Head lice and Pediculosis capitis now redirect here as well. Noca2plus (talk) 16:32, 20 October 2008 (UTC)

Human disease
How can an infestation be a disease? a condition, perhaps? See pediculosis. Julia Rossi (talk) 11:03, 1 December 2008 (UTC)


 * In this context, I believe medical condition and disease are both correct. I think disease is more precise in that it implies illness, whereas condition does not.  Because head lice involves undesirable symptoms that lead people to seek cures, disease seems more appropriate to use over condition in this article.  Note that the World Health Organization lists pediculosis in Chapter 1 of the ICD-10 -- "Certain infectious and parasitic diseases".  So, use of the term disease in this context appears valid.  I have added a disease wikilink to the lead section; the disease article clarifies the semantics. Noca2plus (talk) 17:47, 1 December 2008 (UTC)
 * Well, the problem is that for some the condition of pediculosis is a disease (it causes dis-ease) and for others, it isn't (there are no symptoms). So you can't really say it's always one or the other. It's a condition for all, a disease for some. S  B Harris 03:34, 11 December 2008 (UTC)
 * I suppose this is true for a number of conditions. For example, Typhoid fever.  But I am entirely comfortable calling Typhoid fever a disease.  I suspect that this semantic issue is not specific to pediculosis (i.e., whether a certain condition is a disease or not), and that there is no general consensus on what constitutes a disease.  I recall that Buxton made quite a point in his book about pediculosis being a disease from which people suffer.  Perhaps it'd be worthwhile to cite that view in the text.  Although, I think it'd be inappropriate to include such a discussion in the lead. Noca2plus (talk) 06:28, 11 December 2008 (UTC)
 * We do have something in the article to that effect, which I have edited to make more clear: "Head lice may cause local infections, but are not a vector for epidemic microbial disease (see below). Head lice per se are a disease only if they cause symptoms. In the absence of discomfort or skin lesions, infestation is therefore only a condition and cosmetic problem for the carrier (not strictly a disease), though they may present a disease-transmission-risk for those others who will develop symptoms, if infected.". The question of what exactly constitutes a disease is of course a philosophical one, and sometimes the philosophy gets especially tangled if an organism I carry harmlessly might be a health risk for YOU. You bring up typhoid, but there are lots of others. Do the 40% of people who asymptomatically carry meningococcus, have a disease? Are they carriers of a disease, or just a potential disease? And I might easily get traveler's diarrhea if I travel far from home, from the normal GI flora of the people in that country, and vice-versa. So which of us has (or carries) the "disease"? S  B Harris 03:35, 13 December 2008 (UTC)

Split section -- The "no-nit" policy -- to new article?
The section on The "no-nit" policy now occupies about a third of this article. Although I think school policy with regards to head lice is a notable topic, I think a short summary would suffice in this article about the disease. The balance should be placed in its own article. The title of the new article could be No-nit policy. Although, the text covers issues such as periodic lice screening which are not part of the no-nit policy per se. Perhaps a more general title of School head lice policy is more appropriate with No-nit policy and the like redirecting to that location. Noca2plus (talk) 00:51, 11 December 2008 (UTC)
 * I agree-- it's overwhelming the article. As per WP:SS, see if you can write a summary. I'll add a {main} subarticle on School head lice policy, and as soon as you write the summary, we can put what's here, in that. Unless I hear strong objections from anyone? S  B Harris 03:37, 11 December 2008 (UTC)
 * Done. Noca2plus (talk) 22:50, 12 December 2008 (UTC)

Lead photograph not typical presentation
The current picture is NOT at all typical and should be removed or changed. 66.36.130.100 (talk) 00:59, 26 August 2009 (UTC)


 * If you have another photgraph to contribute, I'm sure it would be very welcome (Be Bold!). Please note that this article is about the human disease, and so IMO the lead photograph should clearly show a diseased human .  Unfortunately, there are very few photos available on commons showing the signs of this disease.  So while the lead photograph may be of an unusual presentation (this is debatable), we have few available choices.  Again, this implies that any photograph contribution you can make would be welcome. Noca2plus (talk) 22:13, 26 August 2009 (UTC)

Fact and citation check
(Part of the WikiProject Medicine effort)
 * bookmark good article - note to self. Casliber (talk · contribs) 07:05, 29 May 2010 (UTC)

Lead section
This section could benefit by additional references. For example, http://www.hsph.harvard.edu/headlice.html and http://www.cdc.gov/lice/head/factsheet.html are good overall general resources.


 * We don't generally have inline references in the lead as the material is covered (and referenced) elsewhere in the article, but we will use the sources. Casliber (talk · contribs) 23:12, 28 May 2010 (UTC)

Signs and symptoms
I’m not sure what the reference to Figure 5 refers to. This should either be removed or clarified.
 * Not sure either. removed. Casliber (talk · contribs) 23:12, 28 May 2010 (UTC)

There are no references within this section at all. A general medical reference should suffice for an appropriate citation, such as: http://www.cdc.gov/lice/head/factsheet.html#symptoms.

I disagree with the statement: Head lice per se are a disease only if they cause symptoms. There are plenty of diseases that are asymptomatic or have general symptoms that do not distinguish them from others. I recommend this statement be removed.
 * That second para is nebulous and some material is repeated elsewhere so removed Casliber (talk · contribs) 23:12, 28 May 2010 (UTC)

Causes
More references are needed in this section. Again, a citation such as http://www.cdc.gov/lice/head/factsheet.html#transmit would be good. - this has been fixed!

Transmission is a more precise and epidemiological word - great job!

Could further explain what infested means (sentence 1) How much less common is indirect transmission? Great last 2 sentences of the first paragraph. Change "attachment" to "attach" Could indicate what hair diameters they are specific to? Are body lice found on bedding/headwear/combs?

Overall, this is wonderful! Grade reading level is currently at post-graduate, I recommend spending a bit more time with Hemingway Editor to get it down to at least grade 14.

Diagnosis
This is made easier by using a magnifying glass or running a comb through the child's wet hair (wet comb method). The wet comb method is the most assured method of diagnosis and can be used to monitor treatment.[34] If there is uncertainty after using the wet comb method, a child can be referred to a health professional. However, head lice infestation is commonly overdiagnosed, with extinct infestations being mistaken for active ones. As a result, lice-killing treatments are more often used on non-infested than infested children.[35]

Simplified language in first sentence above

More references are needed here, such as http://www.cdc.gov/lice/head/factsheet.html#diagnosed.

A general medical text for the steps to perform for diagnosis would provide verification of the protocol written. A good starting point is http://children.webmd.com/slideshow-lice-overview.

What does Figure 4 refer to? Again, clarification is needed.

Prevention
This section needs to be verified through good citations. The use of rosemary oil requires verification, as well as the sentence on disinfection procedure. See, for example, http://www.diseasesatoz.com/head-louse-home-remedy.htm and http://www.emedicinehealth.com/lice/page4_em.htm.

Here it is mentioned that the adult louse can live 1-2days while the intro mentions 3days and the treatment section mentions 2 days. Need internal consistency.

Here it is mentioned that brushes need to be "left outside" for 2weeks while the treatment section mentions 10min in boiling water. Need internal consistency. — Preceding unsigned comment added by 98.144.87.99 (talk) 04:13, 7 April 2015 (UTC)

Treatment
Medications

Resistance to several commonly used treatments is increasing worldwide, with patterns of resistance varying by region. Head lice have demonstrated resistance to permethrin, malathion, phenothrin, and carbaryl in several countries around the world.[24] A previous method used to delay resistance included using a rotating list of insecticides recommended by health authorities. The mosaic model is the current recommendation, in which it is advised to use one product for a treatment course, followed by a different insecticide from another substance class if the first treatment fails.[24]

^looks great! i made a few changes to language above  — Preceding unsigned comment added by Cheetah333 (talk • contribs) 18:25, 12 September 2022 (UTC)

In addition to environmental management, an outbreak of head lice infestation requires treatment of all who are infested at the same time (synchronous treatment) and evaluation of those who have been exposed or are suspected to have head lice. Synchronous ovoidal dimethicone treatment (maybe explain what this is?) has been shown to successfully manage and terminate outbreaks, and a single treatment is likely sufficient. Other treatment methods (such as??) can be repeated 8–10 days following initial treatment, and may sometimes require a third treatment. Outbreak status and treatment effectiveness can be monitored using the wet combing method.[33]

changed the first synchronous treatment to be a lower reading level if possible explain synchronous ovoidal dimethicone and clarify what other treatment methods are helpful

Epidemiology
Additional references are needed in this section, particularly from public health agencies to corroborate statistics. There is some redundancy about lice being more prevalent in girls than boys and lice not known to be disease-causing (in the section on vectorial capacity).

History
There is absolutely no information here at all. To begin, perhaps this source would be helpful: http://medent.usyd.edu.au/fact/headlice.html.

Society and culture
There is only one section under this heading (school policy); perhaps an expanded discussion on how head lice infestation is dealt with around the world would be appropriate to include here. Please see, for example, http://www.headlice.org/index.html and perhaps some communication with this group would help flush out this section a bit more.

The photo, Hunting lice by candlelight by Andries Both, ca 1630 (National Gallery, Budapest), is only appropriate if the history section or the society/culture section is expanded to discuss how infestation is dealt with outside the U.S.

Alcohol
This text was added

"Ethanol (common alcohol) is toxic in arthropods including lices and of very low toxicity in humans. "

The text translates to

"Cuasia bitter (bitter stick) is extracted from a shrub that grows in northern Argentina . The active substance which is extracted from wood and is chemically quassine is a hydrocarbon soluble alcohol. Popularly it is used as repellent as lice and louse . It is effective not only in alcoholic solution and in aqueous solution. This is as effective as a pure alcohol solution whereby you doubt your pediculicida effect " per se " and is irritative ."

No were in there does it say there is very low toxicity of alcohol in humans? Doc James (talk · contribs · email) 17:00, 3 May 2016 (UTC)


 * That's not what it says in Spanish. Who did that translation to you, Doc James? --RoRo (talk) 17:19, 3 May 2016 (UTC)
 * Google Translate which of course is a really poor translation. Doc James  (talk · contribs · email) 18:26, 3 May 2016 (UTC)
 * Copypasting from userpage discussion:
 * Ok, no Spanish sources: you may like to know every biologist who worked with insects and other arthropods knows ethanol kills all of them, I could find many sources for that affirmation alone, i.e. this one: "...It has been shown that at concentrations higher than 95%, commercial alcohol preserves DNA (Nagy 2010), but the use of highly concentrated commercial alcohol as a killing solution may be prohibitively expensive when needed in large quantities, such as in large-scale biodiversity sampling. In Brazil, for example, it is illegal to carry large amounts of commercial alcohol on long journeys, which could hinder its use in extensive field expeditions. Here we propose the use of ethanol fuel as a cheaper and logistically feasible alternative..." Szinwelski, N., Fialho, V. S., Yotoko, K. S. C., Seleme, L. R., & Sperber, C. F. (2012). Ethanol fuel improves arthropod capture in pitfall traps and preserves DNA. ZooKeys, (196), 11–22. Advance online publication. http://doi.org/10.3897/zookeys.196.3130 So what do you think, it's ok to put that claim in a pediculosis article? --RoRo (talk) 17:17, 3 May 2016 (UTC)
 * Alcohol has fairly high toxicity in humans. Is alcohol used to treat humans with head lice infection? That is the source I am looking for.
 * This ref says it is not used https://books.google.es/books?id=J5vE3Z_ZXJcC&pg=PA77 Doc James  (talk · contribs · email) 18:27, 3 May 2016 (UTC)
 * Well thanks for the reference Doc James. It's not of very good education to link to google.es from the English wikipedia, that was not neccesary, but the book is in English. About the paragraphs in the book you linked, you may know there's a big difference between internal application and external or topic application of a product. If I could read the same as you, you just gave an excellent reference for the line you just took out from the Pediculosis article. Let's see. "ALCOHOL. After water, this is probably the next most important solvent used pharmaceutically. Although ethanol (ethyl alcohol) is rarely used as a lone solvent for preparations for internal use, it is used in the manufacture of some of the galenicals used in pharmacy (e.g. tinctures, see Chapter 2). In extemporaneous dispensing it is normally used for the production of lotions for external application to unbroken skin. It is particularly useful if rapid evaporation is required (e.g. for insecticidal lotions applied to hair for the treatment of lice)..." I propose to keep the line on the Pediculosis article and to reference it with this paragraph until there is a reason to take it out. What do you think. --RoRo (talk) 22:17, 5 May 2016 (UTC)
 * I bet your silence is an "Ok, let's do it!" "I know we can do it!" --RoRo (talk) 16:26, 7 May 2016 (UTC)
 * Couple of things. First I was in Spain yesterday. Second I send the last fair bit of time on airplanes.
 * So what we need is a ref that says alcohol is useful as a treatment for head lice. I have not seen on yet. Doc James  (talk · contribs · email) 18:32, 7 May 2016 (UTC)
 * So there's the original proposed line, or some wording of it: "Ethanol (common alcohol) is toxic to arthropods including lice and is harmless to humans in an external application." There are references for it and it's inside the scope of the article. It looks that anybody here (I assume there is people here) sees any harm in adding that line to the article. --RoRo (talk) 22:06, 7 May 2016 (UTC)
 * What ref says alcohol is used for treatment? Or that it is harmless as an external application? Doc James  (talk · contribs · email) 01:47, 8 May 2016 (UTC)

Addition
I am not seeing this text as being supported by the ref

"Ethanol (common alcohol) is toxic to arthropods including lice and is harmless to humans in an external application.

JF Marriott. 2010. Pharmaceutical Compounding and Dispensing. p.77: https://books.google.es/books?id=J5vE3Z_ZXJcC&pg=PA77#v=snippet&q=lice&f=false p.77:"ALCOHOL. After water, this is probably the next most important solvent used pharmaceutically. Although ethanol (ethyl alcohol) is rarely used as a lone solvent for preparations for internal use, it is used in the manufacture of some of the galenicals used in pharmacy (e.g. tinctures, see Chapter 2). In extemporaneous dispensing it is normally used for the production of lotions for external application to unbroken skin. It is particularly useful if rapid evaporation is required (e.g. for insecticidal lotions applied to hair for the treatment of lice)..."

Ethanol as an arthropod killing solution, e.g. Szinwelski, N., Fialho, V. S., Yotoko, K. S. C., Seleme, L. R., & Sperber, C. F. (2012). Ethanol fuel improves arthropod capture in pitfall traps and preserves DNA. ZooKeys, (196), 11–22. Advance online publication. http://doi.org/10.3897/zookeys.196.3130 "...It has been shown that at concentrations higher than 95%, commercial alcohol preserves DNA (Nagy 2010), but the use of highly concentrated commercial alcohol as a killing solution may be prohibitively expensive when needed in large quantities, such as in large-scale biodiversity sampling. In Brazil, for example, it is illegal to carry large amounts of commercial alcohol on long journeys, which could hinder its use in extensive field expeditions. Here we propose the use of ethanol fuel as a cheaper and logistically feasible alternative..."

Sociedad Argentina de Pediatria. Actualización en pediculosis. http://sap.org.ar/docs/publicaciones/pediculosis.pdf: "La cuasia amarga (palo amargo) se extrae de un arbusto que crece en el norte de la Argentina. El principio activo que se extrae de la madera es la cuasina y químicamente es un hidrocarburo soluble en alcohol. Popularmente se lo usa como repelente de piojos y como pediculicida. Es efectiva únicamente en solución alcohólica y no en solución acuosa. Así es tan efectiva como una solución pura de alcohol por lo cual se duda de su efecto pediculicida “per sé” y es irritativa.""

In fact the ref says "when used in products for external use, problems have been encountered because of the volatile nature of the solvent. Asthma attacks have been precipitated... This problem was considered so serious that a number of aqueous formulations were designed"

That is not "harmless".

The read is about pitfall traps not human lice http://doi.org/10.3897/zookeys.196.3130 This one is not in English http://sap.org.ar/docs/publicaciones/pediculosis.pdf Doc James (talk · contribs · email) 05:58, 19 May 2016 (UTC)


 * FWIW here are more sources I found while I was looking this up before weighing in. Both are from 2015...


 * We conclude that the hydroethanol extract of M. azedarach has the potential to be used as an alternative treatment for pediculosis, mainly because it demonstrates effective pediculicidal activity. Furthermore, this treatment does not need to be obtained by complex techniques and is produced from simple materials such as ethanol, water, fresh leaves, and branches of the plant. However, future studies should be conducted to evaluate the toxicity of the extract.
 * 5% Benzyl alcohol was the first nonneurotoxic pediculicide approved for treatment of head lice in children older than 6 months. It is nonneurotoxic and kills head lice by asphyxiation. Pruritus, erythema, pyoderma, and ocular irritation are its usual side effects... Spinosad, benzyl alcohol 5% or malathion 0.5% may be used, in case of resistance, for those older than 6 months and 24 months, respectively. However, in younger patients, manual removal or an occlusive therapy is recommended. PMCID 4458933
 * To say definitively that alcohol is effective with no toxicity to humans does not appear to be supported by the recent literature. —PermStrump  ( talk )  07:45, 19 May 2016 (UTC)
 * maybe (as pointed out by PermStrump)...could say "is partially supported, in certain instances"--Ozzie10aaaa (talk) 11:33, 19 May 2016 (UTC)
 * I think the certain instances should be qualified a little bit though since the recommendation is for a mixture that's diluted to 5% benzyl alcohol, there are some side effects, and it's only recommended in cases of resistance to first line treatments. —PermStrump  ( talk )  18:35, 19 May 2016 (UTC)
 * These sources are about Benzyl alcohol rather than ethanol.
 * We have a nice review here that states "Benzyl alcohol may be more effective at eradicating lice than placebo. However, we don't know whether benzyl alcohol is more effective than insecticides or other treatments used in routine clinical practice."
 * Will add. Doc James  (talk · contribs · email) 19:18, 19 May 2016 (UTC)

Wiki Education assignment: UCSF SOM Inquiry In Action-- Wikipedia Editing 2022
— Assignment last updated by Edupp1993 (talk) 00:36, 17 September 2022 (UTC)


 * You had some very solid edits. Information was well put together in a manner that was easy to understand and the information that was added is really helpful to understanding this overall process. Jassysingh530 (talk) 18:22, 12 September 2022 (UTC)
 * I agree. I think especially the introduction has very relevant, yet relatively simple to understand information. The complex scientific words are linked for further explanation which makes it easier to read. Icduggan (talk) 22:56, 14 September 2022 (UTC)