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Nit-picking British face lice epidemic

On Oct. 31, while U.S. children go door to door hunting for treats, British children will be hunting for bugs in their hair.

The date marks National Bug Busting day in the United Kingdom, an event established several years ago to confront a head-lice infestation so widespread that it's being called a nationwide epidemic.

How bad is the situation in the U.K.?

There are now head lice in the House of Commons. Three members of Parliament (two Labor, one Liberal Democrat) have admitted publicly that they've had the itchy little bugs themselves.

It's so bad that the head-lice hot line in London is often shut down because overwhelmed workers can't handle the volume.

It's so bad it is estimated that anywhere from 40 to 100 percent of British schoolchildren can expect at least one _ but more probably several _ head-lice infestations during their primary school years.

(The level of annual head-lice treatment sales indicates between 13 and 26 percent of all U.S. children aged 13 and under need treatment; in the United Kingdom, the figure is 65 percent.)

"It's gotten out of hand," complains Patricia Gray, the visiting nurse at the Brackenbury primary school in west London. In the playground, she has seen "head lice crawling all over childrens' hair," she said. "They are larger now. Very visible."

"We have had parents in tears on the phone about this; they can't get rid of them," said communicable disease expert John Simpson. Last spring, he became chair of a special national "head louse working group" formed by health workers to confront what all agree is a burgeoning problem.

Everyone has a favorite culprit. For many British parents, it's the school nurse. Parents blame school nurses for the outbreak because they no longer inspect little heads, as they did decades ago but now instead prefer to send out brochures or conduct head-lice-control meetings.

Until the early 1980s, British school nurses were routinely called "nit nurses" because they spent the bulk of their days looking for lice eggs in children's hair. They would then immediately notify parents if any were found. In some instances, children were not allowed back to school until the lice were gone.

School nurses themselves blame both parents and general practitioners for the head-lice outbreak. Budget and time-harried National Health System doctors don't seem interested in lice or their treatment, the nurses complain. And parents "just won't take the problem on," said nurse Gray of the Brackenbury school, who was dismayed when a head-lice meeting at the school last year was attended by just three parents.

British nurses, parents, doctors and entomologists agree on one point: An arsenal of head lice insecticides in use in the United Kingdom appear to be failing dramatically.

Widespread use of over-the-counter products appears to have done little more than breed a new generation of hardy, insecticide-resistant lice. Meanwhile, there has been a recent scare in the British media, with reports that popular lice shampoos containing the organophosphate malathion may lead to nervous system damage or cancer.

The worst things head lice do, on the other hand, is contribute to the contagious skin disease impetigo. Mostly, they just cause itching and acute social embarrassment.

Head lice are such a social stigma that a survey has shown that 50 percent of all British parents whose children have lice "are unable to bring themselves to say to anyone they know, "We've got head lice in the family,' " said Joanna Ibarra of the U.K.'s top lice-fighting group, Community Hygiene Concern.

Not surprisingly, a child Ibarra will use as a nit-combing model on an upcoming BBC-TV show has agreed to appear only if her face is as well-concealed as someone fingering the mafia or the IRA.