How to get rid of lice and more.

Health and medicine explained.
Nov. 1 2005 12:48 PM

Your Health This Month

How to get rid of lice and stave off the avian flu. Plus, Spiesel's Third Law of Pediatrics.

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Strategy: Getting rid of lice is time-consuming and painstaking, partly because of their life cycle. I recommend that parents begin by shampooing a child's hair with any kind of shampoo and water as hot as is comfortable. (The bugs definitely don't like heat.) Follow this with a commercial product that loosens nits. Then comb out the bugs and nits with a good-quality fine-toothed nit comb (I have tried Pronto brand loosener and lice comb and thought they worked well; others recommend Clear brand. The National Pediculosis Society—which, I should say, doesn't agree with my recommendations—sells its own comb). Don't worry, though, you've missed some.

Next comes old-fashioned nit-picking. Inspect the hairs by hand and pick out any additional nits you spot. I find it helpful to use a binocular magnifier from a hobby shop—the professional ones are too expensive—and a really bright light to help with the job. Don't worry, you've still missed some.

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Next, drown the remaining pests by applying oil to the hair. Any kind of oil will probably do, but olive oil has the benefit of leaving the hair shiny (and it's a bit classier). Apply the oil liberally, really wetting the hair and rubbing it down well into the scalp, where the bugs hang out. Then cover the head with a shower cap and leave it on overnight. The next morning, any lice on the head should be dead. But the nits you missed won't be and must be removed. So shampoo the oil out and nitpick again. You still won't succeed in getting all the nits out, no matter how hard you try, though you will get almost all of them. The few remaining ones will hatch. So you need to repeat the overnight-oil, shampoo, and nit removal cycle probably three or four times, with one or two days between cycles.

After 11 days or so you will have drowned all the possible hatchlings. Things that may have head lice in them—hats and pillows—can be disinfected by putting them in a sealed bag for two to three days to allow any wandering bugs to die. (A louse out of the egg can't live off the scalp for more than 24 to 48 hours, since it requires heat and food—they are bloodsuckers—to survive.) If you're in a hurry, dry cleaning or hot-water washer-and-dryer treatment will kill them faster.

My contribution to lice-ology: I developed a shampoo that makes lice and nits glow, and thus easy to find and remove. It is an invention sadly never picked up by a manufacturer, even though Calvin Trillin thought it almost worth a Nobel Prize nomination. Frankly, though I am proud of my idea and it works very well, it is a convenience, not a necessity. The world has done just fine without it.

Peanuts: Preventing them from molding—and preventing liver cancer

State of the Science: Liver cancer is a common and serious problem in parts of Africa where people eat a lot of peanuts and corn stored under hot and humid conditions. A common mold (Aspergillus flavus) that grows on peanuts and corn produces aflatoxin, a cancer-causing toxin. Aflatoxin contamination is not a problem in the United States because production, storage, and inspection standards are routinely high. In Africa, however, aflatoxin from the mold is almost certainly the explanation for the high rate of liver cancer (hepatitis B plays a role, too). Though there are some experimental methods for eliminating aflatoxin from foods—exposure to ammonia may work—none are practical for farmers in the developing world.

Prognosis: Now a study by P.C. Turner and colleagues, mostly working at the University of Leeds in England, has shown that low-cost, low-tech interventions can significantly lower the aflatoxin contamination of African staple foods. The fixes: using the sun to fully dry peanuts laid out on fiber mats (instead of an earthen floor); sorting the dried nuts and discarding moldy or damaged ones and then storing the good ones in natural fiber bags (instead of plastic). The most expensive suggestion was to raise the stored peanuts with $10 wooden pallets and to sprinkle a little locally made insecticide underneath. The total cost for all the interventions is about $50 per household for the first year and less in subsequent years since most of the supplies can be reused. It's worth noting, though, that the annual per capita gross national product is only about $1,100 in Guinea, where the experiment was performed.

Benefits: It's hard to imagine a more cost-effective intervention. Farmers will become healthier and more productive; their children will be protected from the growth-retarding effects of aflatoxin; their animals will fare better, improving the protein available in the food supply; and fewer resources will be needed to care for the sick. Not glamorous, but awfully worthwhile.

Avian Flu: How we'll someday catch it

State of the Science: Influenza is a virus that is constantly undergoing change. It's commonly assumed that this innate instability—or "hypermutability"—is the reason that the current avian flu (H5N1) will mutate and target human populations. But when H5N1 someday transforms into a virus that moves efficiently from human to human, the change probably won't be the result of random mutation.