Introduction
The following is selected excerpts from the manual, Prevention,
Control and Treatment of Head Lice Infestations in Schools
published by the Wisconsin Division of Health, March, 1998. For
sections referred to but not included in this excerpt, see complete
manual. For a copy of the manual contact Linda Caldart-Olson, RN, School
Nursing/Health Services Consultant at (608) 266-8857 or (800)
441-4563.
PREVENTION AND CONTROL IN THE HOME
VII. PREVENTION AND CONTROL OF HEAD LICE IN THE HOME
The prevention and control of head lice begins in the home.
Remember, schools and daycare centers do not get head lice, people
do! After a member of the family is diagnosed with head lice,
the following recommendations may help prevent the spread of head
lice in the home.
A. When Head Lice are Confirmed on a Family Member
- Check every household member for lice and nits.
- Anyone with whom the infested person has recently had physical
contact or may have shared lice-carrying objects should be notified
that they may have been exposed to head lice.
- If the infested person is a student, their school should be
notified.
B. Who Should be Treated
- Treat only those persons with confirmed head lice or nits
with a pediculicide.
- It is generally not recommended to do a preventive treatment
of contacts of an infested person One possible exception may
be bedmates of an infested person.
- Following any treatment, nits should be removed manually following
the recommendations found in section III, part F.
- Persons treated for head lice or nits should be checked for
lice and nits every 1-2 days for at least two weeks even if a
second application of the treatment is planned.
C. Cleaning the Home Environment
- Floors, rugs, pillow and upholstered furniture should be thoroughly
vacuumed. There is no need to discard the vacuum bag after cleaning,
except for aesthetic purposes.
- Clothing, linen and cloth toys worn or handled by the infested
individual during the 2 days before diagnosis should be washed
in water hotter than 130 degrees F, or machine dried at the hottest setting
for at least 20 minutes.
- Other articles may be dry-cleaned or sealed in plastic bags
for at least 10 days to kill nits.
- Combs and brushes used on infested persons should be immersed
in water hotter than 130 degrees F, Lysol®, rubbing alcohol or a pediculicide
for one hour.
- It is not necessary to hire an exterminator to treat the home.
- Spraying or fogging homes with insecticides or pediculicides
is not recommended, and maybe harmful if used in a poorly ventilated
area.
PREVENTION AND CONTROL IN THE SCHOOL
VIII. PREVENTION AND CONTROL OF HEAD LICE IN THE SCHOOL SETTING
The proper education of students, parents, school and health care
personnel, along with the commitment and cooperation from school,
public health and human service officials is vital to the success
of a pediculosis screening program, It is important for nurses
to be up-to-date about the efficacy and risks of the available
head lice treatment options and available community resources
to assist families and enforce the communicable disease policies
in their district.
Newspapers, school newsletters, presentations at parent-teacher
organizations, community education classes and health fairs are
examples of opportunities to educate parents and other community
members about handling head lice, treatment options, environmental
cleanup and head lice prevention strategies.
It is important for school district personnel to clearly communicate
communicable policy issues re-garding the prevention and control
of head lice, to the community.
A. Preparation for Screening-
Staff from the school district should implement the following
recommendations prior to screening students:
- Review current literature on the spread, prevention and treatment
of head lice infestations.
- Prepare informational handouts for parents on the identification,
transmission and prevention of head lice. This information should
be written in a way that will be easily understood, and answer
frequently asked questions about head lice. For an example see
the attached fact sheet on pediculosis in Appendix A (head lice
infestation) prepared by the Wisconsin Division of Health.
- Review and, if necessary, revise the policy of the school
district regarding exclusion of students with head lice or nits
and when these students will be allowed to return to the classroom.
- Prepare a letter to notify parents that a classmate of their
child has been diagnosed with head lice. This letter should be
written in an informative way that will not result in unnecessary
anxiety for the parents.
- Provide proper training regarding the screening procedures
and record-keeping process for all school personnel or volunteers
who will conduct pediculosis screening.
B. Screening of Students
It is the decision of each school district to determine the need
for regular screening of students for head lice. Those school
districts that choose not to do regular screening of students
should be prepared to screen all close contacts or possibly all
classmates of an infested student. Those districts that choose
to establish a regular screening schedule should implement their
screenings after students return from scheduled breaks in the
school year, for example:
- After the start of the school year
- After winter break
- After spring break
C. When Head Lice are Confirmed on a Student
Promptly contact the parents to pick up the student at school.
Authority to send a student home is found in Wisconsin Administrative
Code HSS 145. 06 (1) Schools:
"Any teacher, principal or nurse serving the school may
send home, for the purpose of diagnosis and treatment,
any pupil suspected of having a communicable or of having any
other disease or condition having the potential
to affect the health of other students and staff including
but not limited to pediculosis or scabies."
- In a sensitive manner, separate the infested student from
other students while s/he waits to go home, being careful to avoid
public isolation.
- Be prepared to spend time talking with the parent about treatment
options and school district policy for returning, the student
to school.
- Make current literature available to the parent. Emphasize
that other family members should be screened, and demonstrate
how that is done.
- If the infested student has siblings in the same school, have
them screened for head lice. Alert the sibling's teacher, as
appropriate.
- Classmates of identified elementary school aged students should
be screened. In middle and high school grades, screening may only
be necessary for locker-mates or close friends, unless the infested
student is involved 'in a team activity where head gear may be
shared (e.g., baseball or wrestling team).
- To convince parents that their child is infested with head
lice, show them the lice and/or nits found on their child's head.
This will enable the parents to identify lice and nits when checking
their child's hair.
- Reassessment is a crucial component of the screening process
as students return to school. An infested student should report
to the health room upon return to school with a note describing
treatment. If the school district has a "No nit" policy,
and nits are found on the child's hair shafts, the child should
be returned home until s/he is completely nit-free.
D. Return to School
It is the decision of each school district to determine when a
student who was infested with head lice or nits can return to
school. "No lice" and "no nit" policies are
addressed below.
"No nit" policy
- All head lice and nits (eggs) must be removed from the head
before the student returns to the classroom, regardless of the
treatment used to kill live lice.
- Staff from the school, either the school nurse or a trained
volunteer, must check infested students before they are
allowed to return to the classroom.
- The National Pediculosis Association strongly recommends that
schools adopt a "No nit" policy, although this policy
has not been demonstrated to be effective in controlling head
lice transmission.
- Because of the difficulty in determining if a nit is viable
or has been killed by a lice killing treatment, a "No nit"
policy can lessen the diagnostic confusion that may lead to inappropriate
retreatment.
- Because nits can often be confused with hair care residue
or dandruff on the head, a "No nit" policy may lead
to unnecessary student absenteeism from school. It is important
that each person who examines students' heads for head lice infestation
and nits are properly trained to identify nits (see section I).
- It is important that staff and volunteers who reassess returning
students who have been diagnosed with head lice fully comply with
the policy of their school district regarding, the return of these
students to the classroom.
- It is important to educate parents to insure they understand
their responsibility under the "No nit" policy.
"No lice policy"
- Head lice must be treated with an effective lice killing treatment
and removed from the hair before the student returns to the classroom.
Under this policy, it is assumed that any nits that may remain
on the head have been killed by the treatment or will be killed
during the second treatment.
- A "No lice" policy allows students to return to
the classroom the day after being treated with an effective lice
killing treatment.
- Staff from the school, either the school nurse or a trained
volunteer, must check infested students before they are allowed
to return to the classroom.
E. Cleaning the School Environment
- Floors, rugs, pillow and upholstered furniture should be thoroughly
vacuumed. There is no need to discard the vacuum bag after cleaning,
except for aesthetic purposes.
- Combs and brushes used on infested persons should be immersed
in water hotter than 130 degrees F, Lysoll®, rubbing alcohol or a pediculicide
for one hour.
- Clothing, linen and cloth toys worn or handled by the infested
individual within 2 days before diagnosis should be washed in
water hotter than 130 degrees F, or machine dried at the hottest setting
for at least 20 minutes.
- Other articles may be dry-cleaned, or sealed in plastic bags
for at least 10 days.
- It is not necessary to hire an exterminator to treat
the school.
- Spraying or fogging schools with insecticides or pediculicides
is not recommended, and may be harmful if used in a poorly ventilated
area.
F. Preventing the Spread of Head Lice in Schools
School nurses in conjunction with administration and custodial
staff may wish to initiate facility inspection and prevention
procedures at school, which may include:
- Storing each child's possessions in individual cubbies, lockers
or even individual plastic bags;
- Teaching children to hang coats separately--placing hats/gloves
in sleeves of coats/jackets;
- Teaching children not to share clothing, hats/caps, helmets,
headsets or personal grooming articles; individual combs should
be distributed on picture day;
- Storing towels, smocks and gym clothing brought from home
in separate cubbies and encouraging students to bring these articles
home frequently for washing;
- Shared headgear should be cleaned and disinfected with Lysol
or rubbing alcohol before being used by other students.
For questions about this information, contact Rachel Gallagher (608) 266-8857
Last updated on 2/22/2008 8:00:28 AM
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