Transcript Head Lice - Glen Ridge Borough

Head Lice
Presented by:
The Glen Ridge Board of Health
Contact Information
• Borough of Glen Ridge (973)748-8400
• Glen Ridge Board of Health
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Donna Lifson, MD – President
Jacqueline Yustein – Vice President
Sujana Chandrasekhar, MD
Elizabeth Baker
Deborah Priestman, RN
Mike Sherman, PhD
Chris Valerian, MD
Donna Heinzen, PA
Policies
• Glen Ridge currently joins many other school districts and day
care centers to enforce a “no-nit” policy, requiring that children
be excluded from school until they are “nit-free.”
• Due to scientific evidence and research that shows “no-nit”
policies are ineffective in controlling transmission of head lice,
the following entities do not support or recommend them:
• US Centers for Disease Control
• American Academy of Pediatrics
• National Association of School Nurses
• The State of Michigan’s non-exclusionary lice policy is effective
in preventing the spread of head lice, while keeping children in
school.
• The Glen Ridge Board of Health therefore recommends that
policy changes be made to allow children back to school once
treatment has been initiated.
Impact of Exclusion (no-nit) Policies
• 4-8 million children in the US are over treated each year.
• 12 to 24 million school days are lost annually.
• Missed workdays cost by parents having to stay home with their
child costs $4-8 billion annually.
• Psychological impact to child and parent caused by teasing
and/or anger directed at infested child/family.
• Anxiety over head lice often leads to inappropriate treatments
that pose health hazards to child and household.
What are head lice?
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Lice (singular louse) are tiny, wingless
insects that survive by feeding on
human blood. They cannot jump or fly
and do not burrow under the skin.
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Head lice are not known to spread
infectious diseases from person to
person and should not be thought of
as a medical problem.
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Head lice are certainly a nuisance, but
they are not generally considered a
health hazard.
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They lay up to six eggs per day,
attaching the eggs (called nits) to
strands of hair close to the scalp.
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Generally, nits found more than ¼ of
an inch from the scalp are dull yellow
in color and no longer carry a live
louse.
Empty nit case
Hair spray droplets
Dandruff
Hair casts
Viable nits
Centers for Disease Control and
Prevention (CDC) School Guidelines
• "No-nit" policies that require children to be free of nits before
they can return to school should be discontinued:
• Many nits are more than ¼ inch from the scalp. Such nits are
usually not viable and very unlikely to hatch to become
crawling lice, or may in fact be empty shells, also known as
casings.
• Nits are cemented to hair shafts and are very unlikely to be
transferred successfully to other people.
• Misdiagnosis of nits is very common during nit checks
conducted by non medical personnel.
• The burden of unnecessary absenteeism to the students,
families and communities far outweighs the risks associated
with head lice.
www.cdc.gov/parasites/lice/head/schools.html
Updated November 2010
American Academy of Pediatrics
Head Lice Guidelines, Aug 2010
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Head lice are not a health hazard or a sign of poor hygiene and, in
contrast to body lice, are not responsible for the spread of any disease.
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No healthy child should be excluded from or miss school because
of head lice, and no-nit policies for return to school should be
abandoned.
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Informed school nurses can help with diagnosis and suggestions about
treatment.
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Because head lice are usually transmitted by head-to-head contact,
parents should carefully check a child’s head before and after attending
a sleepover or camp where children share sleeping quarters.
aappolicy.aappublications.org/cgi/content/full/pediatrics;126/2/392
National Association of School Nurses
Nit Free Policies in the Management of Pediculosis
It is the position of the National Association of School Nurses that
nit-free policies disrupt the education process and should not be
viewed as an essential strategy in the management of head lice.
DESCRIPTION OF ISSUE:
Families and school staff expend innumerable hours and resources
attempting to eradicate infestations, expending equal efforts on live lice
and their nits.
RATIONALE:
Rarely, if ever causing direct harm, head lice are not known to transmit
infectious disease person-to-person. Furthermore, current research does
not support the conclusion that enforced exclusion (nit free) policies result
in reduced transmission of head lice.
Adopted: November, 1999
http://www.nasn.org/positions/nitfree.htm
Michigan School Head Lice Prevention
and Control Policy
• Any student with live lice may remain in school until the end of
the school day.
• Immediate treatment at home is advised.
• The student will be readmitted to school after treatment and
examination. If, upon examination, the school-designated
personnel finds no live lice on the child, the child may reenter
the school.
• Any student with nits (farther than ¼” from scalp) should be
allowed in school.
• Parents should remove nits daily and treat if live lice are
observed.
Michigan School Head Lice Prevention
and Control Policy, cont’d
When member of school staff suspects a child has head lice:
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Restrict child from activities involving close contact (i.e. hugging) or
sharing personal items with other children.
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Notify school/facility administration.
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Contact parent (verbal communication preferred). Immediate removal
of the child is unnecessary. The child can be sent home at the end of
the day (allowed to ride school bus home).
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A letter should be sent home to notify classmate’s parents that a case
of head lice is suspected, asking them to check all of their children.
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Provide information sheet on head lice infestation and treatment.
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http://www.michigan.gov/documents/Final_Michigan_Head_Lice_Manual_103750_7.pdf
Who recommends No-Nit Policies and
exclusion of children from school?
• National Pediculosis Association –
www.headlice.org
• Sells the LiceMeister™ comb.
• Mission statement equates lice and nit control to
“responsible personal health behaviors” and “a commitment
to health and wellness.”
• Contradicts CDC, AAP, NASN guidelines.
• No clinical relevance.
• No data to support the claims.
Conclusions
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Although Glen Ridge is among many school districts and day care
centers that enforce a “no-nit” policy, this policy is not supported by
scientific evidence or research. Nor is it supported by:
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US Centers for Disease Control
American Academy of Pediatrics
National Association of School Nurses
Furthermore, a “no-nit” policy is not in the best interests of the
borough’s children, as it can lead to:
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Excessive school days missed.
Unnecessary stigmatization and anxiety.
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Therefore, the Glen Ridge Board of Health recommends that the Glen
Ridge Board of Education change its current policy, to allow children
back to school once treatment has been initiated.
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The Glen Ridge Board of Health proposes the formation of a joint
subcommittee between the BOH and BOE to implement a changed
policy in order to allow children back to school once treatment has been
initiated.