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Overdiagnosis and consequent mismanagement of head louse infestations in North America

Classic from 2000

If your new school policy is based on this published paper you probably should take a closer look.

Abstract from

From Methods: "...we invited health care providers as well as nonspecialized personnel to submit specimens to us that were associated with a diagnosis of pediculiasis. Each submission was then characterized microscopically.” RESULTS: Health care professionals as well as nonspecialists frequently overdiagnose pediculiasis capitis and generally fail to distinguish active from extinct infestations."


Dr Pollack’s methods from this reference do not support his assertion that "The vast majority of kids who have nits are not currently infested, and quite a few were never infested" His abstract describes an opportunity screening sample obtained from volunteers who are apparently are seeking guidance as to the identification of a particular louse nit sample. It offers no quantitative information about either the majority of children infested or the identification skills of the typical parent, school nurse or teacher. It would be necessary to test a random sample of several schools and health providers to support the assertions in the Pollack post.

Based on the years of successful control of pediculosis utilizing the original schools policy and current the reports of failure of the “Pollack live louse policy, which has led to increased pesticide exposures in children, it is important for public health professionals to review the scientific support for Pollack's assumptions.

David Brown ScD.
Public Health Toxicologist

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