Tveden responds to Harvard on pediculosis

Subject: Article on nonpediculicides for lice
Date: Tue, 21 Aug 2001 11:01:15 -0400
From: "Steve Tvedten" <steve@getipm.com>
Organization: Get Set, Inc.
To: <rpollack@hsph.harvard.edu>, <harold.cohen@medec.com>

I read with interest your recent article (which also may be found/read at http://dt.pdr.net/dt/public.htm?path=content/journals/d/data/2001/0806/d2lice08a.html) in Drug Topics 2001;15:42, "Pharmacists: Beware of nonpediculicide treatments for lice". Seeing as you did not bother to contact anyone involved before you made your comments and assumptions, I thought I would comment on your "article" openly.

The question pharmacists truly must answer is what product they should recommend for head lice treatments: POISON "treatments" or nonpoison treatments. If you compare the active ingredients of a can of aerosol bug killer to the "safest" pediculicide poison, you will find the pediculicide is basically twice as toxic! Recently, pyrethrum and pipernoyl butoxide were declared carcinogens. For a pharmacist to recommend a carcinogen and/or a poison over a nonpoison is ludicrous, especially when pharmacists all over the U. S. are being sued because the pediculicide poisons are no longer "controlling" resistant head lice. While I have not field tested all of the products you mention, I am familiar with Not Nice to Lice. I read that you remain skeptical - "I remain unconvinced of the efficacy of [Not Nice to Lice] and related products," you also commented. "I would find it hard to recommend such a product." I have field tested Not Nice to Lice on over 50,000 children and have not seen it fail.

You also mentioned in the article that "Any of the OTC or prescription pediculicides can be fully effective in eliminating populations of head lice susceptible to the active ingredient within the product." In spite of your "confidence" in the use of these pediculicide poisons to "control" head lice infestations, the school nurses at every convention I have attended and thousands of parents have repeatedly told me these pediculicide poisons do not "control' head lice, even though "a pediculicide by definition kills lice." There are many "registered" pesticide poisons that kill pests by "definition," yet over half of our pest species are already resistant to them, e.g.:

Cockroach Resistance - Dr. Gary Bennett and Mike Scharf from Purdue’s Department of Entomology produced a table of cockroach resistance to major classes of insecticide poisons which appears in the July 1995 issue of Pest Control magazine:

INSECTICIDE CLASS	DECADE OF INTRODUCTION	YEAR OF FIRST REPORTED RESISTANCE
chlorinated cyclodienes	1940's	1953
DDT	1940's	1959
natural pyrethrins	1940's	1956
organophosphate	1950's	1965
carbamate	1960's	1976
pyrethroid	1970's	1988
bait active ingredients: abermectin, hydramethylon and sulfuramid	1980's	1992-95

They (Dr. Bennett and Mr. Scharf) then clearly noted "only after you have implemented non-chemical control strategies should you move ahead with the chemical control portion of a resistance IPM program. As we stated earlier, a potential exists for resistance to any product (poison) on the market today." Years ago the newspapers reported that the U. S. House of Representatives had a strain of cockroaches resistant to most forms of chemical attack.

I wholeheartedly agree with these articles, because volatile, synthetic pesticide poisons quickly create resistant pest species that are virtually not controlled by any amount of more dangerous synthetic poisons. People and pets, obviously, live longer than the average 3-month life cycle of a German cockroach (or head louse) and do not, therefore, quickly develop a resistance to these same volatile poisons and are still being poisoned/harmed by their application. Volatile, synthetic chemical poisons do not know the difference between a cockroach or louse and a cocker spaniel or child! You will find pests will not and can not develop a resistance to alternatives e.g., vacuums, traps, caulking, sanitation, protease enzymes and surfactants, hot air, fans, air currents, talcum powder and the other IPM non-volatile, alternative techniques I suggest in my book entitled "THE BEST CONTROL", and if used properly are far superior in control results and safety to "registered" POISONS. Use common sense and not dangerous, volatile, synthetic pesticide poisons.

I find it amazing that every time an expert continues to use and/or recommend a "registered" poison over an alternative treatment they like to mention the term "sound science" or make a comment like you have in this article by saying the pharmacists "should clear their shelves of head lice products that don't appear to be based on any science." I find it amazing that you can discount all of these alternatives without testing any of them and then assume to call your opinion "science".

There is an old saying: "My mind is already made up and I do not want to be confused with the facts." Hopefully that is not the case here and you will be kind enough to read the following facts:

Ginesis Enzyme Cleaners and Shampoos - The 5th Edition of Truman’s Scientific Guide to Pest Control Operations described “The Ideal Pesticide”. “Ideally any pesticide will act rapidly on pests, yet be completely harmless to people, domestic animals, wildlife, and other aspects of the environment. Its residues would only last as long as was necessary to create the desired effect, usually for very short periods. It would also be inexpensive and readily available in necessary quantities, chemically stable (before application), non-flammable, and otherwise safe to use around homes or industrial sites. It would be easily prepared and applied, non-corrosive and non-staining, and it would have no undesirable odor. Unfortunately, no such (synthetic) pesticide exists.” Purdue University and Advanstar Communications (Pest Control Magazine) worked on this 1997 Pest Control Manual, but they were, obviously, still unaware I had begun field testing the perfect (pesticide) or Pestisafe® based on protease enzymes and surfactants. Ginesis Products’ protease enzyme shampoo (Not Nice To Lice) will never create any pest resistance problems, and the entire compound contains only ingredients that are considered non-toxic or GRAS (Generally Recognized as Safe) that are only active as long as they are liquid and can be used virtually everywhere, even when people are sick, under 1, over 60, pregnant and/or chemically sensitive to control even pesticide-resistant pests. Some Science: Maggots produce protease enzymes to help soften up their food so they can eat it. Insectivore plants produce and also use protease enzymes to digest their insect prey. Spiders and scorpions produce and inject protease enzymes to predigest their prey and all molting insects produce a small amount of protease enzyme to serve as a chemical “zipper” so they can split open their exoskeletons when they molt and increase twice their size; without the protease enzyme they would be trapped inside their own exoskeletons and be crushed to death by their own growth. The body surface of insects consists of a hard skin known as the cuticle - the major pesticide pathway is cuticular penetration. The insect cuticle is hydrophobic so that it can resist desiccation and drowning but the Ginesis protease enzymes and surfactants quickly and safely cut through this protective shell. Synthetic pesticide poisons use light oils, dusts and/or volatile solvents to help penetrate this same cuticle. Note: I have adjusted the dilution rate of Ginesis Products protease enzyme cleaner when I was spraying for spider mites and brown citrus aphids, and I found that unlike pesticide POISONS the lady bugs and other beneficials were not destroyed with the pest species. Protease enzymes are naturally-occurring, biological controls that have been controlling insects since the beginning of time.

Protease Enzymes - Ginesis Products Not Nice To Lice and Kleen 'em Away Naturally products both contain protease enzymes and surfactants and are virtually non-toxic - yet they quickly and safely destroy insect exoskeletons - when insects molt they inject a very tiny amount of protease into the "seam" of their exoskeletons - creating a "zipper" - so they can "step out". Obviously, Ginesis Products containing protease enzymes and surfactants will never create immune or resistant insects like synthetic pesticide poisons do. . According to the 1994 Journal of Clinical Epidemiology, the enzyme protease, found naturally in raw pineapple, papaya and other unprocessed and unheated foods, has also been shown to prevent cross-linking. Cross-linking is a process that occurs when collagen becomes hard, cross-links with other collagen fibers and prevents the skin from holding water and remaining elastic. Yoshihide Hagiwara, M.D. has said, "Enzymes are involved in moving our hands and legs, and even in the process of thinking. If enzymes were lost, all the functions of our (human) body would fail." (See also enzyme cleaners).

The following article on safe and far more effective alternatives to pediculicides entitled: Safe Head Lice Control - is adapted from The Best Control by Stephen L. Tvedten.

The problems - The head louse, (Pediculus humanus capitas) (DeGeer), causes considerable skin irritation as it feeds on human blood or crawls on the body. Itching is the most common symptom of head lice infestation. A louse cannot hop or jump. It can, however, crawl fast. It is usually transmitted through close personal contact. Medical historians trace head lice infestations back 9,000 years! In the U. S. head lice are not "known" to spread disease or cause serious injury.Head lice infect an estimated 6 - 12 million U. S. children every year! The really lousy part of this is many children are treated repeatedly with dangerous, volatile, synthetic pediculicide poisons that no longer control the lice and these poison shampoos tend to "weld" the nits to the hair shafts, virtually guaranteeing at least a second "treatment," all of which is not nice to children. In order to control resistant lice, some health departments and physicians have been mislead to believe children should keep these neurotoxic over-the-counter and/or prescription pediculicide poisons on their children’s heads - under a shower cap - for 3 - 8 hours! None of these "treatments" remove the nits. The real control problems are the nits that remain attached to the hair shaft (even if no longer on the head) because they may hatch and "reinfest" for up to 10 days later. Nits resemble tiny white grains and may contain developing lice. The May 2001 issue of Pediatrics noted, "Most children with nits alone will not become infested." If there is no evidence of live lice infestation, do not treat with any poison! Simply wash the nits away with a nit remover, e.g., Not Nice to Lice® Shampoo. The position of nits on the hair shaft usually can distinguish between current and past infestation because female lice attach their eggs to the hair shaft at the scalp. In 1 week, the time it takes for a louse egg to hatch, the average human hair grows about ¼", carrying the egg with it. Therefore, nits more than ¼" from the scalp usually either have already hatched or will never hatch. Among the reactions to pediculicide poison shampoos or pesticide-based lice "treatments" are seizures, mental retardation, many different allergies and respiratory problems, strange tingling, burning, itching, attention deficit disorders, brain tumors, leukemia, cancer and even death.

Safety is the most important factor in your choice of lice and nit removal techniques because the infestation does not present a health risk to the children. Pediculicides (POISONS) are all classified as neurotoxic agents and they do present a health risk to you and your children. If you doubt this, read the MSDS! There are no pediculicide poisons in Not Nice to Lice® enzyme shampoo, but as with all cleaners, keep them out of your eyes.

I would PERSONALLY not use any pediculicide POISON to "treat" a child if there were/are safe and far more effective alternatives. It would seem to me that the objective of any caring pharmacist would be to find someone who has not assumed that all the alternatives are ineffective (and all of the poisons are still "effective") without testing any of them or without asking the individual companies if they have independent efficacy data before assuming they don't. My last comment is to point out that when you ass-u-me anything, you make an ass out of you and me. I thought you might like to read an article from National Pediculosis Association's Progress, Vol. 13, No. 1, Winter/Spring 1997, "The Hazards of Treating Head Lice"

When treating my child for head lice, I never thought about the harm I could be bringing to him. I thought about the anxiety all mothers feel when they find bugs in their child’s hair. Never imagined that I might actually be causing Jesse’s death. If I had only known or even had a clue.

In telling my story, I have decided to remain anonymous because talking about what happened is so difficult. It requires me to confront my demons, and I don’t know if I will ever be able to do that. These memories remain vivid nightmares that haunt me through the night. If I think about my role in Jesse’s pain and suffering, I’ll never make it through the day. I fought so hard to help him live, it’s hard to confront the fact that I may have contributed to his death.

The nightmare began in 1984 when there was an outbreak of head lice in the elementary school. Several children were discovered to have head lice, including my second son. Our pediatrician prescribed Kwell® shampoo never telling me anything other than the fact that it could cause eye or skin irritation. I used the Lindane shampoo on my family, sprayed the house, and had it exterminated. I had a refill of the Lindane so I used it twice that first time on all of my children. I did all of the shampooing myself. About two months later, I watched Jesse playing "Superman" as he jumped from the couch to the love seat. When he was in midair he caught himself in the stomach and appeared to be in a lot of pain. My husband, realizing that I was worried, told me to take him to the emergency room. After being examined, the doctors told me that Jesse had an enlarged spleen which I thought had been caused by his accident. The doctors decided to do some blood work and found that his lymphocytes and white blood cell count was irregularly high.

Not knowing the cause, they decided to keep him overnight to do a liver and spleen scan. The next morning they sent us home with some iron drops for an iron deficiency. When the drops didn’t bring his hemoglobin up, they scheduled Jesse for a bone marrow biopsy. By that time, I already suspected the worst. I had researched the possible diagnoses and knew his symptoms pointed to leukemia - acute lymphoblastic leukemia. Jesse was hospitalized for six weeks until he went into remissions through chemotherapy. I stayed with him the entire time. The doctors asked a lot of questions about our background. Had there been a history of leukemia? Was there chemical exposure? There were no questions about pesticides or treatments for head lice so I didn’t make the connection. It never crossed my mind. Never.

Jesse responded well to chemotherapy. He never looked sick. He was resilient and the entire family pulled for him. Our entire focus was on getting Jesse well. He was only two at the time. Eventually, things got back to normal as Jesse ingested chemotherapy orally once a week for three years. The doctors told us that if he relapsed it would happen within six months after coming off chemotherapy. We were excited to pass the six month and then ninth month marks. We were finally feeling more at ease about his recovery and Jesse’s entry into the first grade.

Prior to the start of that school year in 1987, I shampooed all of the kids’ hair. We always hear about increased cases of head lice when children go back to school and it always strikes a chord with me because I am very hygiene conscious. So I went to the store and bought NIX® over the counter and used it on all of us - including Jesse. It was nine months after his remission.

About six-to-eight- weeks after, Jesse’s cancer came back. The doctors were shocked because his type of cancer had such a high cure rate and he had passed the none month mark typically indicating a complete recovery. It boggled everyone’s mind. Because there was no perfect match for a bone marrow transplant, he was put on a new two year protocol for chemotherapy with new drugs. The doctors believed he had a 70% chance of remission. Jesse did well. When he came off the second protocol he was doing well. About six-to-eight months later I shampooed the kids’ hair again for back-to-school. Six-to-seven weeks later Jesse relapsed again. We took him to a prominent medical facility on the East Coast for a bone marrow transplant. My daughter, who was now 16 months old, was an identical genetic match. It was in 1991 and we lived there for long periods of time while the transplant was conducted., Jesse skated through the entire procedure and the doctors felt it went well.

We came home and everyone felt good about things. Jesse had stayed out of school for five months so that his immune system could get back to normal. It was mid-August 1992, and I again shampooed the kinds’ hair with NIX® because it was once again back-to-school time. We went on vacation for a week and when we returned we took Jesse in for lab work to find that he had relapsed again and this time he was completely full of leukemia. In a "normal relapse" after a bond marrow transplant experts usually find that they missed some of the original chromosomes from the leukemia patient. They resurface, multiply and divide and create leukemia again. Jesse was one of the twelve documented cases in the world where the patient had relapsed even though the tainted cells had been completely removed. This was a red flag to me. When I received the news, I panicked that my daughter’s marrow was leukemic, but the doctors told me her marrow was perfectly clean. Jesse’s relapse indicated that there is something in the environment that may be triggering transformation.

It was at this time that I began to make the connection between Jesse’s relapses and the head lice treatments. The week before we went for the lab work, I found two lumps at the back of Jesse’s neck. That’s when it hit me. Every time I used head lice treatments, Jesse relapsed. I broke into a cold sweat and started to panic. I was eaten up with guilt so I talked to my sister who is a nurse midwife in the area, as well as the doctors at the bone marrow unit. They told me that thousands of children use head lice shampoo each year and that not many get leukemia. But I am close to these people and they know me all good well. Even if they believed my theory, they would never admit it to me because they know it would destroy me. I went to the library to research in the hope that I could proved that my suspicions were wrong. What I found devastated me. I found an EPA pesticide fact sheet which defined Lindane as an isomer of benzene hexachloride. I also found that there was sufficient evidence to support the dangers of exposure to benzene and that many reports associated leukemia with benzene exposure. That explained the Lindane I used, but I also used so much NIX ® after which Jesse consistently went into relapse. So, I looked to find a correlation with NIX ® and Lindane and found an issue of Chemical Engineering News which had an article on the phasing out of chlorinated hydrocarbons. It included a specific chart which included a listing of endocrine disrupters. synthetic pyrethroids such as Nix ® were included in the chart with different herbicides, fungicides and pesticides. They were all in the same category in terms of their effects. And the negative effects were many.

I had never heard about the National Pediculosis Association or the concept that it teaches. I was born in a time when you pulled out a can of RAID® or OFF® spraying it freely to avoid bugs and mosquitoes. I never considered those chemicals as dangerous. They were just part of everyday life. I never considered it until this nightmare happened to me. I now understand that everything is in balance in your body until something knocks that balance starting a chain reaction. Lindane knocked the balance in Jesse’s body. I just didn’t have a clue. Why didn’t I figure it out before it was too late?

Jesse went in for another transplant and he did very well. Soon after he went into seizures and they never understood why. He even pulled out of that. He was amazing. On the 4th of July he had trouble breathing and we took him to the hospital. It was the beginning of the end. The chemotherapy has caused his lungs to harden and he had trouble breathing. They gave him oxygen but he wasn’t getting better. They did a lung biopsy and found pneumonitis, a hardening of the lung tissue. He ended up on a respirator. When he began moving air in the bottom part of his lungs, they turned down the respirator but his lung tissue was still sore and fragile. As he took his breath his lung tissue tore. Soon after he had a heart attack. His blood pressure dropped. They put in a pacemaker. finally, his blood pressure was so low that I was told that even if his blood pressure rose, Jesse would never be the same. That was when I knew he was gone. That was when I stopped praying he would live. Jesse died on September 11, 1993.

Jesse was my soul mate. There has never been, and will never be, another person in my life with whom I connected as I did with Jesse. I go through life like a robot now, feeling betrayed and existing only for my other children so they will have a Mom, even if her spirit is broken. I will never be the same. I’ll never smile again, not inside anyway.

Today, the Leukemia Society’s brochure states the only two known causes of leukemia are radiation and benzene. I have learned that there isn’t a system that’s out there to protect mothers and children like Jesse and me. People need the facts. If I had done this knowing the facts, that would be a different story. But that isn’t the case. I believe the lice sprays, the Lindane and the NIX® contributed to Jesse’s illness and death. I feel the same about my husband’s leukemia which was diagnosed in 1992. The kind he has takes five-to-ten years to appear, supporting my contentions. He has been given the same prognosis as Jesse. Fearful for where this will all end, I can only hope that my story will help others.

"A Mother’s Story" is only one of many tragedies associated with the hazards of "treating" head lice with pediculicide poisons. Since May 1994, the NPA’s National Reporting Registry has received hundreds of adverse reaction reports associated with all the commercially available lice and scabies pesticidal treatment products.

Each year hundreds of thousands of poorly informed parents apply potentially harmful pesticides to their children’s scalp or skin to kill head lice or scabies. Education is vital. There are too many families yet to be reached and too many children unnecessarily put at risk. Help us to reach parents before they treat their families.

Well, Dr. Pollack, the "ball" is in your court; I have asked people who wish to comment on your article, to do so directly to you and/or Drug Topics. If you would like to test the efficacy of Not Nice to Lice, I will be happy to arrange for some samples to be sent you.

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