Director of Infectious Disease Epidemiology and Response The Facts of Lice! Sheri Tubach Director of Infectious Disease Epidemiology and Response

Objective The objective of this presentation is to provide current research and recommendations about head lice in the school setting

Acknowledge that when most of us hear the word “lice” we immediately have an “icky reaction” Parents and potentially staff have a tendency to react with great fear and panic In the past children with lice have been banished from school and advised not to return until they are “nit free” The Fear Factor

Kansas Administrative Regulations Prior to 2007 No Nit Policy 2007 – 2018 Students with live lice excluded until treatment Initiation 2018 – Present No regulation Recommendation is for students to remain at school

All About Lice Lice have been our companions since ancient times and have so befriended us, that they can’t live without us Lice are host specific parasites so human lice don’t live on other animals Lice must feed on human blood Lice die within 24 hours of separation from human hosts Head Lice are a common nuisance, do not spread disease, and are not considered a health hazard

Transmission Direct head to head contact Lice CANNOT jump or fly Lice crawl quickly from head to head when in close contact Nits (eggs) do not transmit lice Indirect transmission can occur Schools are not a common source of transmission

Centers for Disease Control and Prevention Students diagnosed with head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after treatment has begun Personal hygiene or cleanliness in the home has nothing to do with getting head lice The burden of unnecessary absenteeism to the students, families, and communities far outweighs the risks associated with head lice

American Academy of Pediatrics No healthy child should be excluded from or allowed to miss school time because of head lice No-nit policies for return to school should be abandoned School personnel should be appropriately trained to correctly diagnosis active head lice infestation Head lice screening programs in the school setting does reduce incidence of lice infestation and are not cost-effective

National Association of School Nurses The management of lice infestation should not disrupt the educational process No disease is associated with head lice In-school transmission is considered rare Children with live head lice should remain in class

No-nit Polices: What is wrong with them? Children are often excluded due to misidentification of nits or the presence of nonviable nits Assumes nits are viable and / or transmissible Not justified for medical or public health purposes No other minor medical condition excludes children (upper respiratory infections) which are often more contagious Exclusion may hinder academic performance and increase social stigma Burdensome to children, school personnel, and parents

Recommended Lice Policy Parent Education Educating and supporting the child and parent with factual, nonjudgmental information Training for school personnel Child with active head lice infestation Remain in class Notify the parent or guardian Provide parent or guardian with information on the safe and effective treatment of lice Maintain confidentiality Return to school After treatment has begun Don’t check for nits Recommended Lice Policy

Unnecessary Responses to Lice Notification of classmates parents Classroom or schoolwide screenings Insecticide treatments to the school environment Reporting to Social Services in the absence of other indicators

Challenges Myth and fear Personal experiences No-Nit organizations Industry Products Nit-picking services

Conclusion Head lice is not an emergency nor a threat to your school community Head lice is a nuisance for your students and their families Children and parents dealing with head lice may feel stigmatized Education of students, families based on fact and not fear Head lice should not interfere with a student’s opportunity to learn

Resources http://www.kdheks.gov/c-f/head_lice.htm https://www.nasn.org/nasn/programs/edu cational-initiatives/lice-lessons https://www.cdc.gov/parasites/lice/head/s chools.html https://pediatrics.aappublications.org/cont ent/135/5/e1355

Thank you! Kansas Department of Health and Environment KDHE Epidemiology Hotline: 877-427-7317