WASHINGTON — Some schools are letting kids with live lice in their hair back in the classroom, a less restrictive policy that has parents scratching their heads.
"Lice is icky, but it's not dangerous," says Deborah Pontius, the school nurse for the Pershing County School District in Lovelock, Nev. "It's not infectious, and it's fairly easy to treat."
Previously, most schools have required children with lice to be sent home, in an attempt to prevent the spread to other children. Children haven't been allowed to return to the classroom until all the lice and nits, or lice eggs, are removed.
Also, schools customarily send notes home to let parents know that a child in class had lice so that they could be on the lookout for lice on their own children. Pontius has stopped doing that, as well.
The policy shift is designed to help keep children from missing class, shield children with lice from embarrassment and protect their privacy.
Schools in Tennessee, California, Florida, Nebraska, New Mexico and South Carolina also are adopting the more lenient lice policy.
Some questions and answers about head lice and the new policies.
Q: What are lice and who gets them?
Answer: Lice are tiny grayish-white bugs that infest a scalp, sucking bits of blood every few hours. Lice don't jump or fly. They crawl. They are not a sign of poor hygiene.
The Centers for Disease Control and Prevention estimate that there are 6 million to 12 million head lice infestations each year in the United States among children 3 to 11 years old. While itchy and unpleasant, health experts say lice don't spread disease and are not a health hazard.
Q: If they’re not a real health hazard, why are kids sent home?
Answer: Schools and parents feared that children in close quarters would spread lice to one another.
Q: Why the change in policy?
Answer: Itchy children probably had lice for three weeks to two months by the time they're sent to the nurse, Pontius says.
Classmates already would have been exposed. There's little additional risk of transmission, she says, if the student returns to class for a few hours until the end of the day, when a parent would pick up the child and treat for lice at home.
Pontius also doesn't send lice notes. "It gets out who had lice," she says, and there's no need to panic parents. Parents with elementary school-aged kids should check their children's hair for lice once a week anyway, she says. If they are doing that, then there's really no need for the notes.
Q: What do experts say?
Answer: The American Academy of Pediatrics updated its guidelines in 2010 to adopt a "do not exclude" infested students recommendation for schools dealing with head lice. It has long encouraged schools to discontinue "no-nit" policies. The itty-bitty nits — which can often be confused with dandruff — cement themselves to the hair shaft, making removal difficult.
The National Association of School Nurses revised its position the following year. In its guidance, the association said children found with live head lice should remain in class but be discouraged from close direct head contact with others and said the school nurse should contact the parent to discuss treatment.
The association doesn't have figures on how many schools have adopted less restrictive policies. Policies vary by state and often by school district.
Q: How do parents feel?
Answer: Letting kids with untreated lice remain in class doesn't sit well with some parents.
"I'm appalled. I am just so disgusted," says Theresa Rice, whose 8-year-old daughter, Jenna, has come home from her Hamilton County, Tenn., school with lice three times since August.
"It's just a terrible headache to have to deal with lice," says Rice. To pick out the tiny nits and lice from Jenna's long blond hair is a four-hour process. Add to that all the laundry and cleaning — it's exhausting, she says. Rice had to bag up her daughter's treasured stuffed animals, which remained sealed for weeks even after Jenna was lice-free.
Jenna's school implemented a new policy in the past year that allows children with untreated lice to go home at the end of the day, be treated and then return to school. The policy, the district said, complies with the guidelines of both the Tennessee Department of Education and the CDC.
Q: What do others think?
Answer: The National Pediculosis Association in Massachusetts opposes relaxing bans on lice and says the updated policies spread the bugs. Pediculosis means infestation of lice.
The association says lice treatment shampoos are pesticides that are not safe for children and not 100 percent effective. The group instead urges parents to screen regularly and use a special comb to manually remove lice and nits from a child's hair.
The CDC says the nits are "very unlikely to be transferred successfully to other people" — and many schools have dropped their no-nit policies. But supporters of no-nit rules, such as the National Pediculosis Association, say the eggs will hatch new lice and need to be removed before a child is considered lice-free.
Forsyth County’s policy
If a student has a visible infestation of lice, which means that more than 10 live lice are present on the student's scalp or that the student has had more than two infestations during the academic quarter, the student will wait in the office until a parent or guardian can pick him or her up, Theo Helm, the director of marketing and communication for Winston-Salem/Forsyth County Schools, said recently.
If a student does not have a visible infestation, he or she may stay in class for the rest of the day. If a student has nits, but not live lice, the student should stay in the classroom.
Students with nits should be re-screened daily to check for the presence of live lice.
The student’s parents are notified after the discovery of lice or nits and are given information about treatment options.
If two or more children in a classroom have lice, the school sends a letter home to parents letting them know.
The school system requires parents to provide proof that the lice have been treated when the student returns to school, such as a doctor's note, a receipt for the purchase of lice medication, or the top of a lice medication box. Students are also checked by the school to make sure there are no more lice or nits.
Students who have lice or nits are not identified.