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My daughter's daycare had a lice outbreak. What should I do?

There was a lice outbreak at my daughter's daycare. What steps can we take to minimize the risk of contracting lice in the first place?

Lice - which is diagnosed by small, wingless parasites on the scalp - is quite contagious. Usually lice spreads through direct contact, and daycare provides that environment for your daughter.

It's a common misconception that head lice is related to hygiene - it isn't. Anyone can get them by direct contact with an infested person (head-to-head contact, such as two kids drawing together, is most common. The parasites don't live long once they've left the scalp. Still, your daughter should not share hats, brushes and so on with other kids at daycare.

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The first signs of lice may be an itchy scalp. The itching occurs behind the ears or the back of the neck. It may take up to four weeks after the lice get on the scalp for the itching to begin. (And even after the lice are gone, itching may persist.)

To check for an infestation, look for "nits" (small white or yellow-brown specks firmly attached to the hair near the scalp) in a brightly lit room. Live lice are difficult to find, because they avoid light and move rapidly.

Treating lice with a shampoo containing 1-per-cent permethrin works well for most children. Use a nit comb, and be diligent about checking for and removing any nits on a daily basis.

A second treatment, seven to 10 days after the first treatment, is often needed to kill any nits that may have hatched.

If that fails, take your child to a doctor immediately for advice on the next steps.

Home remedies such as petroleum jelly, mayonnaise, margarine or oils have not been shown to consistently work.

Once there is an outbreak of lice, all close contacts and household members must be carefully checked.

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Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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