Kids with head lice should stay in school: New guidance

According to new guidelines from the American Academy of Pediatrics (AAP), children with head lice do not have to be sent home from school.

In the United States, head lice are most common in preschool and elementary school-age children and their household members. According to the Centers for Disease Control and Prevention (CDC), between 6 and 12 million infections occur in children ages 3 to 11 each year.

The AAP’s recommendation to keep children with head lice in school was issued September 26, updating its previous 2015 guidance spread disease.

Despite this, a significant stigma has developed around head lice in high-income countries, resulting in “children and young people being excluded from their schools, friends and other social gatherings,” the group said. As a result, head lice can be “mentally stressful” for those affected.

Check children for head lice
Here parents examine children’s hair to see if they have head lice at a school in Scheveningen, the Netherlands, August 31, 2016. There’s no need to send children with head lice home from school, according to new guidance from the American Academy of Pediatrics (AAP).

Missing school because of head lice or nits can be an academic disadvantage even for healthy students. Along with the CDC and the National Association of School Nurses (NASN), the AAP has recommended abandoning the “no-nits” guidelines, which require a child to be free of nits before returning to school.

“Such a policy would adversely affect a child’s or adolescent’s academic progress, could violate their civil rights, and stigmatize head lice as a public health hazard,” the AAP said.

It’s very unlikely that many nits will hatch and become lice, or they may actually just be empty shells — misdiagnosis is very common with nit checks performed by non-medical personnel, according to the CDC. Also, nits are unlikely to be transmitted to other people as they cling to hair shafts.

Meanwhile, school head lice screening programs are not cost-effective and have not been shown to significantly affect the incidence of lice in schools, according to the AAP. A student found to have an active infestation has likely had it for four to six weeks, as this is the usual time it takes for itching to begin due to an allergic reaction to lice saliva.

“Given this length of exposure and the fact that the child or young person poses little risk to others from the infestation, he or she should remain in class but be restrained from close direct head contact with others,” the AAP said.

If a student is diagnosed, school staff should maintain confidentiality to minimize social stigma, the association added. Staff should notify their carers through a phone call or a note sent home with the student and exercise “common sense and calm” if they determine how “contagious” they might be.

news week turned to the American Academy of Pediatrics for comment. Kids with head lice should stay in school: New guidance

Rick Schindler

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