The CDC estimates that as many as 12 million Americans are infested with lice, and some of the standard treatments may be failing, giving rise to the alarming prospect of "super lice."
Mary Collar, a registered nurse in Waterville, has turned lice removal into a thriving business. She just opened All About Lice this year, but she has already treated close to 200 heads.
A year ago, Collar didn't know that much about lice, but that changed quickly one morning when her daughter was drying her hair and saw a louse squirming on the towel.
Subsequent checks found that 11 members of the family had been infested, including Collar.
"We called it the Lice Storm of 2014," she says.
And it's a storm that took weeks to pass, aggravated by misinformation and a plethora of over-the-counter treatments that proved ineffective.
"You can treat with those products repeatedly and I've had people in here tell me, 'I treated, like, every week and every week I have live lice the next day. Big ones.'" she says. "And I'm like, 'Yup.' Because you can't kill the adults with those products. They will not die."
And that's something new.
One recent study conducted by Southern Illinois University found that the lice in 25 states, including Maine, have developed resistance to the chemicals commonly found in over-the-counter lice treatments.
Out of 109 louse samples collected, researchers found that 104 displayed high levels of a genetic mutation known as the T1 mutation. And it's believed to have first appeared some 70 years ago, linked to early treatments for another variety of lice.
Dichlorodiphenyltrichloroethane, or DDT, was the insecticide of choice circa World War II for the typhus-carrying body louse. But Jim Dill, pest management specialist at the University of Maine Cooperative Extension, says its use had some unexpected consequences.
"What happens is a lot of times, insects have a different type of mechanism for breaking down products," he says. "One of the most common ones — and I don't want to get too technical — but it's called mixed function oxidase."
That's an enzyme that naturally occurs in the body of the louse and helps the insect process substances it might encounter.
Dill says when the lice started encountering large quantities of DDT, many were killed, but those that weren't developed mutations that made them more efficient chemical processors.
While DDT is no longer used, the standard treatment is an insecticide called permethrin.
"The breakdown mechanism is very similar," Dill says. "So even though you have two very dissimilar chemicals, the chemical that breaks it down within the body of the lice is the same and it's a very similar breakdown."
Dill says even as treatments have evolved, it's a fact that ectoparasites such as lice are highly adaptable and people are unlikely ever to be completely free of them.
That's unwelcome news for the nearly 200,000 Maine kids returning to school this year.
There's no reliable estimate of how many of them will be bringing head lice to class, but those on the front lines, such as Bangor school nurse Mary Wright, say they see cases frequently.
"It is something that is frightening to parents, it's upsetting to children, and it's a nuisance in every possible way, but it truly isn't any way that can affect the health of a person," she says.
So it's important to keep things in perspective, says Wright. Unlike body lice, head lice are not associated with any serious health risks, just itching and some serious annoyance, she says.
But there remains a lingering stigma that can traumatize a child. That, she says, does need to change.
"The cleanest, the most attentive person to their health and hygiene can get head lice," Wright says.
Fortunately, the days of kids coming to school with their heads shaven bald or reeking of kerosene — a common home lice treatment just a couple of decades ago — are over.
Wright doesn't even pull kids out of school when lice are discovered. Instead, they go home at the end of the day with a note to their parents.
According to Wright, in most cases an over-the-counter product, used correctly, will be sufficient. She also says she's had success with olive oil, which smothers the lice when applied.
Collar is less optimistic about most of the products commonly sold, with the exception of a new yeast-based treatment which attacks the integrity of the lice eggs.
The most important step, she says, is the tedious, painstaking, physical removal of the creatures and their eggs: the proverbial nit picking.
https://www.youtube.com/watch?v=Xj5hd_tZfyM
