The Lumberton nurses felt that the lack of scientific information about head lice in the community had resulted in unwarranted absences from class, unnecessary expenditure of money on products and/or services and a pervasive sense of fear throughout our schools and neighborhoods.
In order to design protocol that was based in fact rather than fear, the nurses reviewed the results of research studies that had been published in a variety of scientific journals.
The purpose of this letter is to explain some procedures related to the management of head lice in school, and to offer some additional resources to you so that you, too, many become better educated on this topic.
The Procedures: Here are a few procedural highlights that may be of particular interest:
1. Exclusion The current recommendations by leading medical experts state that students with eggs and/or head lice should remain in school and not be immediately excluded. This is not to say that all children with identified cases of head lice will remain in school all day – the nurses will be the first to tell you that our Lumberton parents are very quick to arrive at school once we call them to say their child has head lice! However, immediate exclusion of these students is not considered necessary.
Why is exclusion NOT recommended by medical experts?
1) Although head lice are a nuisance, they do not cause disease and are not dangerous to the child or to others. Children with the common cold, which is easily passed from student-to-student are allowed to stay in school. Children with head lice, who are not sick and pose no risk of illness, should not be excluded from school.
2) By the time head lice is discovered, the child has usually had them for 3-4 weeks. Therefore it makes no sense to immediately exclude them from class.
3) No matter how careful staff is to protect the privacy of students, when a student leaves a class and does not return, the assumption is that the student has head lice. This can be unnecessarily embarrassing for the child and family.
4) Most importantly, school is not a high risk area for getting lice! Over the last 12 years, multiple studies have proven the school rarely is the site of lice transmission. The vast majority of cases of lice are spread by friends and family members who play or live together. In the rare case when spread of head lice has occurred at school, it is among very young children, in preschool or kindergarten and likely a result of playing closely together in ways that result in head-to-head contact.
Lice elicit an emotional reaction. “No-nit” policies were based on that reaction, not on scientific evidence of lice transmission. Scientific research has informed us that keeping students with eggs or even lice, out of school has not had an effect on the amount of head lice at school.
1. Disseminations of Information: As always, the certified school nurses will work closely with parents and children providing educational and emotional support. But, with the adoption of our protocol, and equipped with a wealth of scientific information, we continue to turn our efforts toward more meaningful, personalized attention to the child with head lice.
If active lice or nits (eggs) are found, the parent will be confidentially notified. The school nurse will provide information to the parents about proper treatment options. Parents of children with head lice will be encouraged to talk to others parents of close friends. Parents will not be informed of other children who have lice in school, as that is a privacy concern and the risk of getting lice from a classmate is very small.
Students with lice with be checked when they return to school and as needed (the nurse and the parent will devise a plan for working together to support the needs of the students).
Classroom head checks will be at the discretion of the nurse and only in the youngest grades. This is where the risk for transmission at school may be higher due to the types of play (involving head to head contact) that may occur more naturally within this age group.
Parents will be asked to complete a district treatment verification form upon their child’s return to school. Knowing what strategies have been used to address the infestation will allow the nurses to better serve the needs of each individual student.
Head lice are very common. They always exist in communities and in schools. No school is ever lice-free: just as no school is free of the common cold. After a close look at the scientific evidence available, your school nurses continue to approach this subject with the same high standards for delivering evidence-based care that we apply to the rest of our practice. Equipped with scientific knowledge, the support of our administration and the endorsement of the experts, we look forward to continuing to serve the students and the families of the School District of Lumberton with the highest standards.
Please feel free to contact us with your comments and questions.
Amy Hummel, BSN, RN, CSN
Alessandra Gambino, MS, BSN, RN, CSN
Kathy Barbieri, BSN, RN,CSN