The number of children per family, the sharing of beds and closets, hair washing habits, local customs and social contacts, healthcare in a particular area (e.g. school), and socioeconomic status were found to be significant factors in head louse infestation. Girls are two to four times more frequently infested than boys. Children between 4 and 14 years of age are the most frequently infested group.
Behaviours
Feeding
All stages except eggs are blood-feeders and bite the skin four to five times daily to feed. They inject saliva which contains an anticoagulant and suck blood. The digested blood is excreted as dark red frass.
Position on host
Although any part of the scalp may be colonized, lice favor the nape of the neck and the area behind the ears, where the eggs are usually laid. Head lice are repelled by light and move towards shadows or dark-coloured objects in their vicinity.
Transmission
Lice have no wings or powerful legs for jumping, so they move using the claws on their legs to move from hair to hair. Normally, head lice infest a new host only by close contact between individuals, making social contacts among children and parent-child interactions more likely routes of infestation than shared combs, hats, brushes, towels, clothing, beds, or closets. Head-to-head contact is by far the most common route of lice transmission.
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