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District sticks to no-tolerance policy on lice

July 5 2006;  The Gainesville Sun

With pressures to cut down on student absences and scientific research down playing the chances of spreading head lice, many of America's schools are giving the blood-sucking pests more headway in their classrooms.

It used to be a given that schools would scan every child's head and send home anyone infected until he or she was cured. Those policies are disappearing, and infected children are returning to class before they're rid of the microscopic pests.

Officially known as pediculus capitis, head lice are parasitic insects that survive only by sucking blood out of human heads and necks. They lay eggs known as nits in human hair and can crawl from one head to the next, but cannot fly or jump.

There's no known long-term damage when head lice attack, but they do cause itchiness and irritation. There's also a stigma that comes with having head lice, even though hygiene is not a factor in contracting lice.

In Alachua County Public Schools, the old rules are still in effect.

"We don't go in like gang busters, but if a teacher thinks there's a problem, we do go in and do a check on the heads very discreetly," said Health Services Director Pat Hughes.

Parent volunteers used to check every head in elementary schools, but that stopped when Alachua County hired enough nurses to have at least one in every school.

"We know what to look for," Hughes explained, so the mass screenings were no longer necessary. When cases are discovered, children are taken out of class immediately; they and their parents get a consultation about getting rid of the lice; and they're sent home to deal with them. Infected children can't return to class until a nurse checks their heads and confirms they're lice- and nit-free.

Other schools throughout the country are lightening their policies.

The Los Angeles Unified School District lets children return to school with nits still in their hair, as long as they've used a treatment. The Iowa City School District allows children with live head lice to come to school, as long as they also get treated first.

And in Kentucky in September, the Kentucky New Era called it "controversial" when Todd County's School Board in Elkton dropped its longtime rule requiring a doctor's note to prove an infected child was lice-free. Now students just have to bring in a box top to show they used an over-the-counter lice treatment.

The lice policies made headlines as parents spoke out against the loosened policies, but school officials insisted it was medically sound - and educationally necessary.

"Attendance is a benchmark you get graded on. Schools have failed because one kid missed one additional day," Allentown, Pa., School Board President Jeff Glazier told the Wall Street Journal after his district dropped its no-nit policy altogether.

The newspaper reported that other school officials blamed No Child Left Behind, which also has attendance requirements in order for school tests to count.

The changes in the rules began in the late 1990s, when the American Academy of Pediatrics and the Centers for Disease Control and Prevention each recommended schools abandon "no-nit policies."

Harvard's School of Public Health agreed in a study that said there was no evidence that keeping infected children out of school decreased the spread of lice. Researcher Richard Pollack called no-nit policies "imprudent, as they are based on intolerance, hysteria and misinformation rather than on objective science" and said mass-screenings were "misguided" and often failed.

But not everyone agrees with the research.

"This is politics and product marketing, not public health," said Deborah Altschuler, director of the head lice awareness group, the National Pediculosis Association, who thinks companies selling lice-killing products supported the research in order to sell more products.

"Children should not be in school if they're infected with lice. Period. End," Altschuler said. "The pendulum will swing back. (School officials) will be reminded why they had those policies in the first place."

Both Altschuler and Harvard's Pollack said the most dangerous aspect of head lice is the methods used to get rid of them.

Some substances with strong pesticide elements can be toxic. In fact, Alachua County's Schools aren't allowed to distribute shampoos with powerful chemicals in them. The district's nurses offer a natural, oil-based treatment and otherwise refer students to the Health Department.

Altschuler recommended manually removing lice or using a comb specially-designed to remove lice. And she said the best remedy is prevention: checking children's heads for lice regularly.

Most of Alachua County's head lice cases are among young girls who pass the lice during sleepovers or share hairbrushes or accessories. On the rare occasion that a middle or high school student has lice, Hughes said she takes special care to keep it confidential and consults with the child where their peers won't be able to overhear.

As a preventative measure, she said most schools have gotten away from using blankets and pillows during nap time, and they're required to vacuum every day.

When a child is infected, every insect and nit must be removed, even if the school nurse ends up having to do it, Hughes said.

"Unless you get rid of those eggs, they just keep coming back."

Here is a letter from the mother who led the fight for children in her community of Bristol Township:

To: Bristol Township Board Members:

On April 23, 2006, I found head lice on my son. This will be the second time he has had lice since attending Emerson Elementary School. The first time was 3 years ago. I remember the date, 2/13/2003. This was the day before he was to have eye surgery at Wills Eye Hospital. All I could think about was “Please let me kill all the lice, and not let one crawl down his hair when the doctor is doing his surgery”. He was infected again exactly 30 days later. The school told me at that time, that my son was the only child with it. After I spoke to parents at the school, I found that there were at least 8 other children in his class that had head lice then. Others went back to October 2002. Through the years lice have been an issue for the school. One year, a class had to stop at the nurses station, put their belongings in bags, then proceed to have their heads checked by the nurse. They were then allowed to go to class. This year I know of problems with lice since October again. When I went to the school this time, our school nurse, informed me of the new National Nit Policy. She explained what this detailed.

1. If a child has lice, they only have to show proof of treatment, to return to school.
2. If this child has nits after treatment, this child can return to class.
3. If a child is found to have lice, they will be returned to class and return home with the rest of the students at the end of the day.
4. The nurse does NOT have to send out a letter to inform parents that lice are in the school or classrooms.
5. The classrooms do NOT need to be checked after a fellow student is found to have lice.

As to proof of treatment. I have treated my son 4 times the week of 4/23 and it wasn’t until the 4th treatment that it finally worked. Doctors orders, 5% permethrin cream under shower caps for 14 hours. That is a very long time for my family to have very strong chemicals on their heads. One treatment MAY NOT be the answer.

As to a child returning to class with nits. Nits are unhatched lice. They will hatch in 7-10 days. When they hatch they are called Nymphs. They can hatch at any time. The strand of hair can fall out at any time and can hatch that day, crawl up someones body and attach to a hair strand for further infestation. I am aware of a “treated” student, in April 2006, that was returned back to school with nits.

Again, if a child is returned to class with lice, they can still infect other students with the lice. There are 2 classes right now that have 32 students and sit closely beside each other. It's very easy for one to rub onto another and infest each other.

Parents should be informed with the first outbreak of lice. This is so important so that we the parent can check our childrens heads regularly. We do NOT need to know who has it. This is NOT our concern. We just need to be informed. The best way to control lice is to be aware of a situation. Lice infestation could occur over and over if ALL the parents are not informed of this. This would help control the lice problem and would help NOT to over treat our children. This overtreating of chemicals is very dangerous to humans. If we have to continue to overtreat, and if a child gets sick from overtreatments, there could be liability issues. Treatments only help for the initial infestation. There is no prevention treatment for lice, only communication and awareness. Lice are becoming resistant to chemical treatments, and will take more and more treatments to kill them. If we don’t stop infestations right away, we may NEVER be able to.

As far as the students being checked. This again, is so important. The faster the nurses can check the classrooms for other infected students the faster we can keep this under control. When I came to talk to the school nurse on Monday about my son having lice, she told me that she will check the classes, but not until Wednesday. Many students may have been infested by then, if the parents hadn't been told. Would you like or would you send your child to school to sit in a close quarter classroom of students with lice, for days, and not get checked?

The nurses told me that lice are not a disease only a nuisance. There are studies now showing that body lice and head lice are conspecific. Body lice can cause typhoid. This was a major killer in World War 2. We are lucky to have treatments. Some 3rd world countries have to put dung in their childrens hair. They are barely making a living. Could you imagine if we had an epidemic like that? Ticks spread Lymes Disease, Mosquitoes spread West Nile Virus, what will they find next with blood sucking lice?

Beauticians must refuse clients with lice. Beauty shops are fined and closed down if the state finds lice in the establishments. Prisoners brought into the PA Department of Corrections must be deloused and treated before they are brought into the general population of the prison. They are treating convicted felons better than our faculty and students.

I know this could be time consuming for the nurses, but it has been done for years. I am a Professional Dog Groomer. When a dog enters into my grooming shop that has fleas or ticks, it has priority over any other dog there. Bathed first, treated, and insects removed. On occasions I have pulled 300 + ticks off a dog. This is very time consuming, but this is my job and my reputation. I would not want any of my other clients pets to return home with an infestation they didnt come in with. I am very proud that my children go to Bristol Township Schools. I am asking the School Board to stand behind us and PLEASE don't let our schools get the reputation of always having head lice. It is up to the individual township to decide their own policies for not only treatments but also to educate parents of the importance of not letting children back in school with nits and also for the nurse to check students heads thoroughly before they are allowed to re-enter school.

As the parents of Bristol Township, we ask you to PLEASE , DO NOT ABIDE BY THE NATIONAL NIT POLICY. Thank you for taking your time and listening to our concerns.