Head lice are disgusting, creepy crawly creatures. We can all agree on that. Most parents would rather pick up a yard full of dog poo than pick head lice out of their child’s hair. I used to be on the side of keeping kids with head lice at home. Then I scratched below the surface and dug up an interesting report – no-nit policies that forbid children from returning to school only add to the problem.
That information came to me from Prof. Richard Pollack, department of Immunology and Infectious Disease at the Harvard School of Public Health, who authored a major study for Harvard. Richard is considered to be one of the top experts on head lice and described no-nit policies as “excessive” and “counterproductive.” He said most school boards only developed them as a result of pressure from parents who were misinformed about their effectiveness.
First, head lice do not transmit disease and are not a public health issue so policies to deal with them should not be punitive, says Richard. Second, there’s the issue of mistaken identity. In a Harvard study, of thousands of samples of presumed lice and nits, more than half were discovered to be cookie crumbs, dandruff, dirt and knotted hair.
Third, there is no convincing data that excluding kids from school helps reduce the transmission of lice. But keeping kids away does add to the hysteria and stigma around head lice. I still remember a girl in grade four who was called “cootie head” as children accused her of having fleas.
As a result, many parents decide not to report when their child has head lice, which only increases the potential spread. Don’t get me wrong, parents should still make every effort to remove lice and nits but, Richard believes the best treatment is education. Teach your kids not to share hats and brushes or to share pillows at sleepovers. Just don’t keep them home from school.
On a recent school swimming trip with my daughter’s Grade 5 class, I noticed kids’ towels stacked 27 high, a highrise condo in the heart of “Lice-Ville”, with my daughter’s towel the penthouse.
Didn’t we just get the notice yesterday, “Lice have been found in your child’s classroom?” And yet all of the students are present today. How can that be? It’s simple. There is no rule in our school stating parents have to pick up a child once head lice are found.
In the case of kids going to school with head lice, tolerance appears to be trumping common sense.
The Canadian Paediatric Society states that “school exclusion due to the detection of the presence of nits does not have sound medical rationale”. But, according to the National Pediculosis Association (NPA), “Head lice are communicable human parasites that require blood for feeding, infest one’s hair and scalp, defecate, mate, and literally glue their eggs (nits) to hair to hatch new lice. This makes head lice a compelling hygiene issue for the people who have them. A chronic case challenges a person’s health and wellness.” Why would a child suffering from these symptoms want to sit in a classroom all day? Did you read the part about blood, defecating and glue?
You may be thinking, “education comes first,” but how much is being absorbed by those poor kids who are suffering as they squirm in their seats, scratch in frustration and distract everyone around them?
But I’m not an expert. The NPA says, “Head lice are parasites specific to humans and require blood meals to survive. They have been associated with bacterial infections including impetigo and rickettsial diseases.”
We need to be diligent about removing those students with lice and checking kids prior to returning to stop the cycle. Before they build a loft in that towel highrise.
Children with head lice infestation – 10 or more live lice on the scalp – should not return to school until they receive one properly applied treatment. An effective treatment will kill all head lice present on the scalp, but not nits (the eggs that attach to the hair shaft). Head lice, or pediculosis, can spread amongst school-aged children but is not associated with serious disease.
Lice cannot fly or jump from one person to another, they can only crawl. Transmission is often through head-to-head contact between children. ‘No-nit’ policies that require students to stay home until no nits are present are not successful in reducing the spread of head lice and are no longer recommended by most public health authorities.
Further, students’ loss of time from school could have negative academic and social impacts and parental leave from work or costs for child-minding could cause unnecessary difficulty. School boards ultimately decide how to manage head lice infestations.
It is difficult and takes commitment of the caregiver and child. A lack of understanding of the louse life cycle, transmission and the importance of nit removal can lengthen the time and money families spend dealing with head lice. Efforts to support families with management of head lice should ensure equitable access to information and economical treatment options.
Originally published in ParentsCanada magazine, August/September 2014.