|
“We Are Bigger Than Head Lice” |
September 6, 2001
Sixty health professionals as well as parent “head checkers” traveled to
Newport, Vermont to kick off National Head Lice Prevention month for
back-to-school at the “We Are Bigger Than Head Lice” conference held in
the state’s Emory Hebard Building in Newport. Organized by Joanie Austin,
R.N. and Denise Rowell of Orleans Supervisory Union, the symposium was
considered a great success! It is the first time the “No Nit Policy” as a
public health standard was debated with representation by important
players on both sides of the issue. Typically “expert panels” on the
subject are organized as marketing tools by public relations firms
representing manufacturers of lice products.
Austin insisted that a balanced forum was necessary since recent decisions
against the “No Nit Policy” appeared to be strictly one-sided. She is one
of a growing number of school nurses finding their voices in disagreement
with positions taken by the American Academy of Pediatrics and the
National Association of School Nurses. Austin invited Deborah Z.
Altschuler, President of the National Pediculosis Association® (NPA), a
nonprofit organization established in 1983 and Vermont’s Dr. Barbara
Frankowski, a pediatrician and representative of the American Academy of
Pediatrics section on School Health. Austin explained that the confusion
about head lice management negatively impacts school nurses as well as the
children in their care and that she has found the “No Nit Policy” a
mainstay in keeping pediculosis problems to a minimum.
Altschuler began the morning session with her address “Because it’s not
about lice, it’s about kids.” She pointed out that many communities
arrived at “No Nit Policies” having learned the hard way that having no
policy creates confusion adding unnecessary risks for inappropriate
responses. Altschuler focused attendees on the Prothrow-Stith public
health model -- stressing basic goals of routine screening, early
detection and removing nits before it becomes a huge task. The NPA’s “No
Nit Policy” puts dismissal from school as a last resort after all
efforts have been made to educate parents in advance of outbreaks,
enabling them to respond appropriately without panic, and with every
opportunity to safely send kids to school lice and nit free.
Pharmacist Jack Ruggles of Barton, Vermont, briefly described the various
head lice treatments available at most pharmacies. He said the biggest
pediculosis problem pharmacists have is dealing with distraught and
frantic parents eager to find a cure. He acknowledged the problems of
treatment failure, the potential for misuse and the misleading claims made
by manufacturers and via the Internet.
The highlight of the conference was the after lunch debate between
Altschuler and Frankowski. It may be surprising that there would ever be
debate about removing lice eggs from children’s hair; however each woman
presented her side of the argument. Frankowski insisted she “wouldn’t
mind” if after a case of head lice she had residual nits. Altschuler, on
the other hand, doubted that Frankowski “would want to be known by her
patients as the pediatrician with nits.”
There was considerable agreement about protecting the children and
differences of opinion stayed mainly with exclusion issues. Frankowski
stated that exclusion would be unfair to lower socio-economic groups who
may be unable to get treatment. Altschuler responded that abandoning the
“No Nit Policy” for this reason alone was analogous to throwing out the
baby with the bathwater. Altschuler agreed fully that the “system” needed
to be there for those who need help for whatever the reason – a realistic
goal only if others who are able are held responsible for sending their
kids to school lice and nit free. Both sides agreed overwhelmingly to
avoid using products that contain lindane or malathion.
Though no debate winner was formally declared, the local school
superintendent sitting in the back of the conference room turned to the
school nurse sitting at his side at the end of the six hour session and
said, “Not to worry – we’re keeping our No Nit Policy!” |
|
