Pediculosis Management in the School Setting

1. Pediculosis Management in the School Setting

2. Head Lice Facts Head lice (pediculosis capitus) are small parasitic insects that live on the scalp and neck hairs of their human hosts.   Head lice (pediculosis capitus) are small parasitic insects that live on the scalp and neck hairs of their human hosts.   Head lice (pediculosis capitus) are small parasitic insects that live on the scalp and neck hairs of their human hosts.  

3. Fact Lice do not fly or jump. NM School Health Manual – Section X 4/25/12

4. Fact Nits (egg sacs) are cemented to hair shafts and are very unlikely to be transferred successfully to other people. You have to literally pick them out (thus the term nit-picking)

5. Dr. Richard Pollock from Harvard has degrees in parasitology and entomology and has studied head lice for 20 years along with mosquitos, ticks, bedbugs, and other parasites. He is considered the country’s leading expert on head lice, pests and other parasites. In a recent webinar, he explained that there are lice specific to many species. For example, elephants, dogs, birds, rodents, gorillas all get lice; but they do not get “human” lice and humans do not get their lice.

6. There is even a book louse (liposcelis divinaturius). It is a distant cousin of these other lice but it feeds on and is injurious to the organic material in books and papers; and we all have them in our offices. This particular louse will not feed on a live host, but “may visit.”

7. Many parents and health care providers mistakenly believe that head lice: • …cause disease by direct harm and/or by transmitting pathogens (germs) • …are shared readily and cause epidemics • …have mutated to “super lice” and are resistant to all treatment • …can and must be eradicated • …can jump, fly and survive for weeks off the host • …or nits is a sign of neglect • …requires children to be quarantined and treated immediately

8. Dr. Pollack studies all kinds of mosquitos, ticks and other parasites that transmit pathogens. For example: 2 Ticks that transmit the pathogen that causes Lyme disease and mosquitos that transmit West Nile virus. 1 Eastern Equine Encephalitis from mosquitos which is a disease that has a very high morbidity rate or Tularemia, a plague- like infectious disease transmitted to man by the bite of an infected tick or other bloodsucking insect. 3 Yet, most of the questions he gets from parents relate to lice and which has no concern related to disease.

9. Summary of Condition • No disease is associated with head lice • In-school transmission is rare   • Common ages 3-11 years old, with direct head-to-head contact   • The ratio of time spent by school personnel related to the medical significance is way out of proportion.

10. “No Nit” Policies Policies that require a student to be free of nits to attend school, known as “no nit” policies, are based on misinformation rather than objective science. LCPS does not have a lice policy; however, in the past staff and parents have subscribed to a “No Nit” philosophywhich prompted LCPS Health Services to conduct this research.

11. Fact Misdiagnosis of nits is common by medical personnel and VERYcommon by non-medical personnel. Children could end up being exposed unnecessarily to harmful chemicals. Dr. Pollock says school nurses are the best at identifying head lice issues.

12. Practice Recommendation • Routine mass screenings are not indicated. • Symptomatic students will be evaluated. • If concerns, parent will be notified at the end of the school day. • Student will be checked prior to returning to the classroom.

13. The School Nurse’s Goals Are To: • Facilitate an accurate assessment of the problem • Minimize school absences • Prevent overexposure to potentially hazardous chemicals and…

14. …continued • Provide appropriate health information for treatment and prevention Please trust that your school nurse will act in the best interest of the population she serves.

15. National Association of School Nurses It is the position of the National Association of School Nurses that the management of pediculosis (infestation by head lice) should not disrupt the educational process. No disease is associated with head lice, and in-school transmission is considered to be rare. When transmission occurs it is generally found among younger age children with increased head-to-head contact. (NASN, January 2011)

16. Centers for Disease Control Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun…The burden of unnecessary absenteeism to the students, families and communities far outweighs the risks associated with head lice. (CDC, 2010)

17. American Academy of Pediatrics No healthy child should be excluded from or allowed to miss school time because of head lice. No-nit policies for return to school should be abandoned…Head lice screening programs have not been proven to have a significant effect…in the school setting and are not cost-effective. Parent education programs may be helpful in the management of head lice in the school setting. (Pediatrics, Official Journal of the American Academy of Pediatrics, 2010)

18. NM Department of Health Children, when diagnosed with head lice, should be sent home from school at the end of the day and return after the first treatment has been completed. Educate parents on treatment and management methods. It is an unjustified response to exclude any child from school due to head lice or nits.(NM School Health Manual, Office of School and Adolescent Health, 2010)

19. Position Statement Las Cruces Public Schools Health Services

20. Las Cruces Public School District Health Services supports the positions of • The New Mexico Department of Health • The National Association of School Nurses • The American Academy of Pediatrics • The Centers for Disease Control and Prevention which all state that the management of pediculosis (infestation by head lice) should not disrupt the educational process.

21. Questions? I have one, are you scratching your head yet?