Transcript Pediculosis Management in the School Setting

Pediculosis Management in
the School Setting
Head Lice Facts
Head lice (pediculosis capitus) are small
parasitic insects that live on the scalp and
neck hairs of their human hosts.
Fact
Lice do not fly or jump.
NM School Health Manual – Section X 4/25/12
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)
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.
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.”
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
Dr. Pollack studies all kinds of mosquitos,
ticks and other parasites that transmit
pathogens. For example:
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Eastern Equine
Encephalitis from
mosquitos which is
a disease that has a
very high morbidity rate
or Tularemia, a plaguelike infectious disease
transmitted to man by
the bite of an infected
tick or other
bloodsucking insect.
Ticks that transmit the pathogen
that causes Lyme disease and mosquitos
that transmit West Nile virus.
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Yet, most of the
questions he gets from
parents relate to lice and
which has no concern
related to disease.
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.
“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”
philosophy which prompted
LCPS Health Services to conduct
this research.
Fact
Misdiagnosis of nits is common by medical
personnel and VERY common
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.
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.
The School Nurse’s Goals Are To:
 Facilitate an accurate assessment of the
problem
 Minimize school absences
 Prevent overexposure
to potentially hazardous
chemicals
and…
…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.
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)
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)
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)
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)
Position Statement
Las Cruces Public Schools
Health Services
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.
Questions?
I have one, are you scratching your head yet?