A message for Health Providers
Why is Bug Busting wet combing special?
To help parents and healthcare providers achieve a lasting solution to the persistent problem of head lice and nits, our charity developed the original Bug Busting wet combing method. Reliable detection, even when there are only a few lice present, and even in really curly hair, became possible. The unique, bevel-edged teeth of the Bug Buster and Nit Buster combs work brilliantly with gentle shampoo and hair conditioner. For treatment, there is no dependence on louse-killing formulated products. Instead, the Bug Buster Kit instructions explain precisely how you can simply break the life-cycle by periodically removing lice over the hatching period. Simultaneously you learn how to recognize any new incoming lice. No lotion can tell you if you have caught more egg-laying lice between doses. None can guarantee complete egg-kill. Since it became available, the UK Department of Health has advised use of a Bug Buster Kit alone as a treatment alternative to lotions, and that these should be combined with wet combing checks after use.
The Bug Buster Kit is a registered medical device on free NHS prescription for children since September 2002.
The Kit is no longer mentioned by name in the British National Formulary and non medical prescribers' formularies, because it is an appliance and currently only drugs are listed. This does not affect it's legitimacy for NHS prescription. On the prescription you are required to write 'Bug Buster Kit x 1'. Pharmacies can obtain supplies from AAH (pip code: 233-1783) or direct from CHC (tel: 01908 261501) You can find the Kit and DVD on our Products page.
An authoritative review of the effectiveness of current treatments for head lice was published in the Drug & Therapeutics Bulletin (Does dimeticone clear head lice? Drug Ther Bull 1 July 2007 45(7): p52-55). The full text is available via Infotrieve here. Read our summary and comments here.
A Bug Buster Kit alone proved four times more effective than neuro-toxic insecticide treatment for head lice in a randomised controlled trial, when parents followed the respective product instructions. The primary findings were reported in BMJ, Online First on 5 August 2005. Most families re-used their original Bug Buster Kit for detection and cure during a whole year (report to the International Congress on Lice, Argentina, October 2006). This independent study, led by Dr Nigel Hill of the London School of Hygiene and Tropical Medicine, was funded by a Big Lottery Fund research grant
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"For a balanced approach to all methods of eradication – chemical and combing – the best site I found was www.chc.org/bugbusting" Vass A. Website of the week, head lice. BMJ 2001;323:1136
Bug Busters want to get rid of head lice as much as those campaigning for the return of ‘nit nurse’ inspections in school. So we tested school nurse-style inspection v. parents using a Bug Buster Kit. We confronted epidemic levels of head lice amongst primary schoolchildren (first and middle school, aged 4-13 years).
Visual inspection results
With the parents’ consent, our staff checked 245 pupils in school using the traditional visual method, systematically parting the dry hair with their fingers and looking for evidence of head lice.
- Thirty eight (16%) had some evidence, largely nits, which are the empty eggshells left stuck to the hair when lice hatch.
- Of these cases, only on six heads (2.5%) were lice seen, which proved that the infestations were active. (It was possible that the other 32 heads had in fact been successfully treated.)
Bug Buster Kit results
No indication was given to the children themselves of the results of the inspection. All pupils in school that day were given a fun sticker and a Bug Buster Kit for use at home in the evening.
- Parents reported finding 133 cases of lice on schoolchildren (29.5% of 450 pupils attending the school) and another 47 cases in other age groups.
- Not only did parents identify 180 definite live cases as opposed to six found the ‘nit nurse’ way, they cured them using the Bug Buster Kit combs in wet, conditioned hair according to the instructions.
- Because all families started into the programme together on the same date, it thwarted the constantly circulating lice. Children, parents and teachers had a long rest from head lice, and organised another Bug Busting Day when they eventually crept back.
Why the Bug Busting way is better
- Most cases of head lice consist of only 10 lice or less, but they are still contagious. With the best will in the world, the school nurse cannot diagnose most cases because she has little time to check each child.
- In dry or even damp hair, lice move swiftly away from any kind of disturbance, avoiding detection. Our staff discovered that really wet lice stay still and ordinary shampooing is an excellent way to get them wet. Then ample amounts of any conditioner will keep them still while the hair is easily straightened with a wide-tooth comb and then methodically combed with a Bug Buster comb.
- The Bug Buster comb has been precision engineered to do the job of lifting out lice comfortably and accurately. By wiping both sides of the comb on kitchen paper between strokes you can quickly clean out any lice. They are much easier to see on the paper than on the head.
What the school nurse can do
In the UK, each school nurse is looking after at least 3,000 schoolchildren – she simply has not the time to search through their wet, conditioned hair for head lice. Her role is to make sure that her schools are aware of the Bug Busting head louse detection programme and to arrange support for the few families who cannot learn to use a Bug Buster Kit. Increasingly school nurses may write NHS prescriptions for Bug Buster Kits, which are filled free when children need treatment for head lice.
Ibarra J, Fry F, Wickenden C, Olsen A, Vander Stichele RH, Lapeere H, Jenner M. Franks A. (2007) Overcoming health inequalities by using the Bug Busting ‘whole-school approach’ to eradicate head lice. Journal of Clinical Nursing 16: 1955-1965
28 October 2008
Schoolnitnurse - epetition response
The Prime Minister received a petition asking:
“We the undersigned petition the Prime Minister to bring back the School Nit Nurse.”
The Government’s response:
"We appreciate your concerns about infestations of head lice in schools.
The Department of Health’s advice is that inspections by school nurses may not be sufficient to identify all cases of head lice in a school’s population. It is for schools to decide how best to deal with infestations of head lice. Exclusion of children with head lice is unlikely to be helpful and many schools prefer a “whole school” approach whereby all parents check their children and family members on the same evening.
It is for Primary Care Trusts (PCTs) and their partners to determine, on the basis of local health needs assessment, how many school nurses there should be or how they should be deployed. However, the Public Health White Paper, Choosing Health published in November 2004 made the commitment to provide new funding so that by 2010 every PCT, working with children’s trusts and local authorities, would be resourced to have at least one full-time, year-round, qualified school nurse working with each cluster or group of primary schools and the related secondary school.”
Further reading materials available on our Products page