No Head Lice

1
No Head Lice!

• Facts About Head Lice
• Office of School Health
• Department of Education
• Department of Health and Mental Hygiene

2
Head Lice Policy Change

• Old DOE Policy No Nit
• New DOE Policy No Head Lice
• Why the change?
• Most nits will not develop into live lice
• Therefore
• No nit policies unnecessarily increase the number
  of student absences
  
• No nit policies unnecessarily increase missed
  days of work for parents
  

3
School Head Lice Policy

• Excludes stand alone pre-school daycare and
  sleep away camps
  
• Policy already adopted by other large school
  systems
  
• Supported by major health organizations
• National Association of School Nurses
• American Academy of Pediatrics
• American Public Health Association

DO NOT PANIC! Remember, others take their cues f
rom you. If you give the impression that head li
ce is dirty and gross you are
communicating incorrect information and contribu
ting to the stigma.
4
Head Lice

• Found mainly on children 3-12 years of age
• Do not transmit diseases
• Spread requires extended direct head to head
  contact.
  
• Cant swim, fly, hop or jump.

5
Head Lice

• Found in both clean and dirty hair
• Do not always cause itching
• Do not live on pets.
• Lice don't care about race and income - they just
  like humans!

6
Head Lice

• Eggs are laid close to scalp
• Hatch at 6-7 days
• Lice live for about 30 days spending their entire
  life on the human scalp
  
• When moving through hair they move quickly
  forwards and backwards
  

7
Nits (Eggs)

• Nits
• Are found firmly attached to the hair shaft.
• Are hard to remove.

Dandruff, dust or dirt that can be easily removed
is not a nit!
8
Nits (Eggs)

• Live Nits
• Are greyish-white eggs that look like swollen and
  shiny dandruff.
  
• Are found within 1cm of the scalp.
• Dead Nits
• Are whiter and dried out.
• Are mainly found more than 1cm from the scalp.

Very difficult to tell them apart!
9
Looking for Nits or Lice
Parent participation is essential in preventing
and controlling head lice!

• - Wash hair well and then dry it with
• a towel. The hair should be damp, not
• dripping.
• - Make sure there is good light.
• Daylight is best.
• - Comb the hair with an ordinary comb.
• - Start with the teeth of the fine tooth
• comb touching the skin of the scalp at
• the top of the head. Draw the comb
• carefully towards the edge of the hair.
• - Look carefully at the teeth of the
• comb in good light.
• - Do this over and over again working
• round the head.
• - It may take 10 to 15 minutes to do it
• properly for each head.

10
Minimizing spread of head lice

• Keep long hair tied back.
• Remind children
• To avoid head-to-head contact.
• Not to share hats, caps, scarves, combs, brushes,
  etc.
  
• Parents should check the childs head regularly
  and treat only when live lice are found.

11
Treatment Options

• Apply treatments ONLY if you see live lice
• Louse asphyxiation Vaseline applied to the head
  (not proven to be effective)
  
• Physical removal wet combing with fine tooth
  comb
  
• Chemical removal
• Malathion (0.5) (e.g Ovide) by prescription only
  for children older than 6 years of age
  
• Permethrin (1) (e.g. Nix) over-the-counter for
  children older than 2 years of age
  
• Generally recommended to apply twice 10 days apart

12
Treatment Issues

• No treatment is 100 effective
• At least 2 treatments 10 days apart are needed
• Fine tooth combing is essential
• Recommend consultation with healthcare provider
  if live lice remain after two treatments
  
• No preventive treatment exists
• Best prevention of spread is prompt treatment

13
No Head Lice Policy

• Students with head lice will be excluded when the
  head lice are identified along with parent
  notification
  
• Students with head lice will not be allowed to
  re-enter until they are lice free. They will be
  re-examined by the principals designee (NOT the
  school nurse) upon returning to school.
• Students that have been cleared of lice will be
  re-examined in 14 calendar days (or closest
  school day if 14th day falls on weekend or
  holiday) by principals designee.

14
No Head Lice Policy

• Students found to have head lice on
  re-examination will once again be excluded until
  they are lice free
  
• Student with nits and no evidence of head lice
  will NOT be excluded from school.
  
• No school-wide surveillance will be conducted for
  nits (studies have shown them to be ineffective)

15
How School Nurses Can Help

• Train personnel designated by the principal on
  how to properly identify live head lice
  
• Provide consultation on cases that do not resolve
  after two treatments.
  
• Confirm that parents are following treatment
  recommendations appropriately
  
• Initiate case management as needed
• Provide health education to staff and parents as
  needed.

16
THANK YOU!