A scalp infection caused by head lice, Pediculus humanus capitis, a common parasite in children. Outbreaks are common in schools, especially among children between the ages of 5 and 11. The infection is transmitted through use of personal items such as hair ornaments, combs, hairbrushes, hats, scarves, or coats or through direct contact between the heads of two children. Lice, which feed on blood obtained by biting the skin, cause itching, especially around the ears, in the occipital area, and at the nape of the neck. Long-standing infestations may produce chronic inflammation. The adult louse is seen rarely; diagnosis usually is made through the presence of eggs (nits), which appear as whitish sacs attached to the hair.