HEAD LICE FACTS
Few conditions cause so much concern and anxiety in schools and homes as head lice infestations. Lice are parasites of the human host. They are not known to transmit communicable diseases in the United States.
Studies conducted by the Centers for Disease Control revealed that lice:
occur in all socioeconomic levels regardless of age, sex, or standards of personal hygiene
are dependent on human blood for nourishment
do not jump, hop, or fly
are spread by direct or indirect contact
are more commonly found on females than males
are more commonly found on children than adults (younger elementary school children are at a greater risk than older elementary children)
infestations are rare among African-Americans
- occurrence rates do not significantly differ between long and short hair
Pediculosis control programs should be established within each school district. Some school districts have adopted a nit-free policy. A nit free policy promotes greater accountability on the part of parents, and thus simplifies the administrative task for school personnel.
The National Pediculosis Association has endorsed the No nit Policy as an essential component of thorough lice control. Some additional medical and social advantages of removing nits (eggs) after treatment include:
Prevention of self-reinfestation caused by the survival and hatching of eggs.
Prevention of transmission to others caused by nymphs hatching and moving to other heads during the week between the two treatments recommended by many manufacturers.
Elimination of diagnostic confusion (were these eggs here before or do they represent a new infestation)?
- Encouragement of families to check children more often in order to comply with institutional or community standards, thereby promoting preventive behavior.
However, it is the discretion of each local school district to develop a policy that meets their community values and standards. Programs should include education about prevention and control, screening and treatment components as well as exclusion and readmission criteria.
Parents should be informed at the beginning of school and throughout the school year that head lice screening is conducted as needed. Parental consent is not required prior to screening for head lice.
It is important that we treat any child being screened, especially those suspected of having head lice, tactfully and sensitively. In order to avoid any loss of a child's self-esteem, do not make them feel guilty, ashamed, or stigmatized.
It is recommended that another staff member be present when screening or rescreening a student whose parent is not present to witness the outcome.
Inspect any child with observable signs or symptoms promptly.
Directly inspect the hair and scalp in order to detect the presence of crawling lice or nits. Observe for movement on or near the scalp especially at the nape of neck and behind the ears.
- If several students in a classroom are infected, then screen all children in that classroom and close associates.
IDENTIFICATION OF HEAD LICE AND NITS
Head lice are small, light gray insects that are difficult to see because of their size and coloring.
A live nit is usually located within 1/2 inch from the scalp.
- Symptoms include irritation and itching of scalp, especially back of neck and behind the ears; presence of small light gray-brown insects and/or their eggs (nits) which are attached to the base of hairs
Transmission usually occurs from person to person after direct contact with someone. Indirect contact with infested personal belongings, such as headgear, combs, brushes, and clothing, occurs frequently. Higher rates of infestation occur in schools where chidden share lockers or coat hooks, and in the home where bedding, clothes, and furniture are shared.
PREVENTION AND CONTROL IN SCHOOLS
To prevent head lice, avoid direct contact with infected persons and other objects such as brushes, combs, hats, coats, earphones, etc.
Examination of contacts: when an infested student is found at any time during the school year, the student's close contacts should be examined. When a student is identified as having head lice, all students in a classroom should be screened.
Classroom activity: during an outbreak of head lice, classroom activities such as dancing, wrestling, or games involving the wearing of costumes or hats should also be suspended. Do not share common combs or brushes during the school photo sessions.
Classroom tables: during an outbreak of head lice, group-work activity around tables should be suspended, or students should be allowed to occupy only every other seat at the tables.
Buses: whenever possible, during an outbreak of head lice, no more than two students should be allowed to occupy a bus seat at a time.
Read about the successful control and prevention of headlice in Kentucky Schools, by clicking here.
OTHER ITEMS IN THE ENVIRONMENT
- Hooks in cloakroom should be individually assigned.
- Hats and scarves should be kept in coat sleeves or pockets rather than in piles on shelves.
- During an outbreak of head lice, each student should keep his clothes separated from those of all other students at all times.
- Resting mats, towels, or pillows for younger children should be permanently assigned and kept separated while in use and during storage.
- Students should never share towels in locker rooms.
- Carpeted classrooms should be vacuumed daily during an outbreak of head lice.
- Health room linens and disposable paper used on pillows should be changed after each use.
Fumigation of schools, buses, and homes for pediculosis is not necessary and is to be discouraged. Vacuuming is important.
Source: Adapted from guidelines issued by Parasitic Disease Control, Center for Disease Control, Atlanta, GA 30333.
RECOMMENDATION TO THE SCHOOL
Any student identified as having head lice and/or nits (eggs) present in the hair should be isolated and sent home.
When head lice has been detected, the child's parent or guardian should be asked to come to the school and take the child home. When the parent arrives, the appearance and location of nits on the child's head should be demonstrated to the parent. This serves two purposes:
- It clearly demonstrates that the child is infested, which the parents may not believe if the child is merely sent home with a note.
It enables the parent to see what a nit looks like and thus accurately examine other family members.
If a parent or guardian cannot come to school, the student should be sent home with a letter of explanation to the parents. The note should define the problem, offer methods of treatment, request that other family members be examined for infestation and treated if necessary, request that all clothing and bedding used by infested family members be either:
- laundered in hot water
- dry cleaned
- or, dried for 20 minutes in a dryer on high heat, and
- request that the home be vacuumed
Provide written notice to parents when infestation has been identified.
Institute plans for treatment as recommended by local health department.
The child should be readmitted to school after treatment has been applied. The child's head should be rechecked prior to readmission. If treatment appears to have been satisfactory, the child may return to the classroom. If not, he/she should be excluded until treatment is adequate.
School personnel should reexamine the student in ten days to assure all lice and nits have been adequately eliminated.
- Treatment should be repeated 7-10 days after the first treatment.
Reinfestation will be a continuous event as long as adult lice are present and serve as a source of eggs (nits), that is, while the lice remain alive on the infested person or in the clothing and until the eggs in the hair and clothing have been destroyed.
Treat with a pediculicide medication available at drugstores with or without a prescription (follow directions carefully).
Remove dead lice and all nits with a Nit comb or by hand.
Examine all other family members for the presence of lice and nits, and treat if any are found.
All clothing and bedding used by any family members who was treated should be laundered in hot water, dry cleaned, dried for 20 minutes in a dryer on high heat, or sealed in a plastic bag for ten (10) days.
All combs and brushes should be washed in hot water.
Carpets and upholstery should be thoroughly vacuumed.
- Any infested family members should receive a second treatment within seven to ten days.
HEAD LICE LINKS
- National Pediculosis Association
Description and biology of head lice