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Rapid Responses: Rapid Responses published:
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Nit picking: monkey business!
- Jairaj Kumar C, Arunachalam Kumar (16 August 2005)
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Nit comb makes plain common sense
- Mira de Vries (17 August 2005)
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Easy formula to get rid of head lice!
- Satheesha Nayak (17 August 2005)
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Re: Nit comb makes plain common sense - If only common sense were so!
- Jairaj Kumar C, Arunachalam Kumar (19 August 2005)
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Nit comb makes plain common sense
- Andrew Cook (19 August 2005)
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Nit comb makes plain common sense - If only common sense were so!
- Mira de Vries (22 August 2005)
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Jairaj Kumar C, Intern Kasturba Medical College, Mangalore 575001, India, Arunachalam Kumar
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Among the more exotic (and certainly novel) methods of dealing with head lice is using ‘trained monkeys’ for the onerous task. In some parts of rural southeast India, mendicants offer the services of ‘bonnet macaques’ (Macaca radiata) for nit picking. Many a infected child, reluctant to go through the trauma of vigourous combing (the village-craftsman make the wooden comb, a thin plate of finely toothed on both edges), and loath to subject itself to a soaking of the head with neem oil, and rebellious against any attempt to shave off the locks – is packed off to the monkey man. No child worth his mettle refuses to squat for an pretty engrossing session hunched in front of a meticulously fastidious monkey, which then proceeds to clear the scalp of the parasite – with a motley crowd of truant schoolboys watching with show with much merriment. How effective or efficient this monkey business is, we have no idea: but I report this rather, unique method, along with some others we have observed, used in interior India. Competing interests: None declared |
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Mira de Vries, chairman Assoc. for Medical and Therapeutic Self-Determination the Netherlands
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It doesn’t take high-paid medical researchers to discover that proper and regular use of a nit comb is more effective than toxic pharmaceuticals. It takes plain common sense, and perhaps some parental experience. Not only is the nit comb more effective, but also safer, including repeated and long-term use. It is an effective preventive measure as well, and is environmentally friendly, not to mention inexpensive. In spite of all the pharmaceutical propaganda to the contrary, combating the harmless head louse is not a medical matter, but one of simple hair hygiene. Competing interests: None declared |
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Satheesha Nayak, Selection Grade Lecturer Melaka Manipal Medical College (Manipal Campus) International Centre for Health Sciences, Manipal
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I read a series of articles published in BMJ regarding head lice. There were a lot of responses to the articles and various formulae were given to get rid of head lice easily. I remember one incident that happened to one of my friends. He saw an advertisement “Easy formula to get rid of head lice; for a cheap price” He and his family members were sick of head lice and had applied various medications but the results were poor. He decided to go for this easy formula and sent the asked amount to the address given in the advertisement. Many other people also sent the money to the address given in the advertisement. After a week, most of them got their parcels of so called “easy formula”. When they all opened, they found two stones and a small paper with the writing “keep the lice on one stone and kill it with the other stone” on it. It made them laugh a little in spite of losing their so called “nominal amount”. Competing interests: None declared |
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Jairaj Kumar C, Intern Kasturba Medical College, Mangalore 575001 India, Arunachalam Kumar
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While fully endorsing that nit combing is ideal, to some of us here in the less privileged parts of the globe, coming across more than an ocassional case of acute nephritis in primary schoolers,through secondary infection from ectoparasite induced vigorous skin scratching, and to a lesser extent, scalp scratching - the author's christening of the head louse as "harmless" needs a rebutal. The Pediculus humanus capitis, along with Sarcoptis scabei(scabies)infestation, are two of the causes of renal infections in the paediatric age groups of non-metropolitan India. As about the article's comment on hygiene being the best defence, the New York City Department of Health & Hygiene website <http://www.nyc.gov/html/doh/html/cd/cdped.shtml> clarifies that 'A common misconception is that lice infestation is a result of poor hygienic practices. In fact, it is actually believed that head lice prefer clean hair to dirty hair.' Competing interests: None declared |
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Andrew Cook, SpR PHM Solihull PCT, B91 3BU
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Mira de Vries will be aware that many interventions once viewed as 'plain common sense' are now recognised as worthless. Some interventions today viewed as 'plain common sense' are probably of no theraputic value - but no one has done the work to demonstrate whether they are or not. He can be happy that someone has demonstrated that what he views as 'plain common sense' is actually of value. I for one will take Hill's randomised controlled study (BMJ 2005;331:384-387) as more compelling evidence of effectiveness than anecdotal, if well meaning, reports. Competing interests: None declared |
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Mira de Vries, chairman Assoc. for Medical and Therapeutic Self-Determination
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Just to clear up a misunderstanding: Jairaj Kumar quotes the NYC government site, which states that: "it is actually believed that head lice prefer clean hair to dirty hair." The point of this statement is that shampooing alone does not prevent head lice. My point is that proper hygiene for children and others at risk for head lice includes regular and correct use of the nit comb. Parents, especially in the "first world," should realize that they, not the schools or pharmaceutical companies, can keep lice off of their children’s heads. Competing interests: None declared |
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