RCS Head Lice Protocol
No student shall be denied an education solely by reason of head lice infestation and his/her educational program shall be restricted only to the extent necessary to minimize the risk of transmitting the infestation.
It shall be the responsibility of the principal/his designee to notify the parents in the event a child has pediculosis (head lice).
Students found with live head lice shall remain in class, but shall be discouraged from close direct head contact with others.
A letter shall be sent home by the child to explain the condition and the requirements for readmission.
Prior to readmission, satisfactory evidence must be provided to school personnel that the student has been treated for pediculosis (head lice).
This evidence shall include determination (after examination) by a school official that there has been improvement (meaning reduction/elimination of lice and nits) since the parent/guardian was notified.
A student shall be expected to return to school no later than the day following notification of the condition.
Failure to meet these requirements shall result in the student’s exclusion until criteria are met for readmission. These absences will not be excused.
Treatment and prevention procedures shall be developed by the director of schools in consultation with the school nurse and distributed to all classroom teachers. These procedures shall also be distributed to the parent/guardian of any child that has pediculosis.
Head Lice General Information
Lice spread from direct head-to-head contact or from indirect contact through the sharing of personal items such as combs, brushes, scarves, hats, headphones, sleeping bags, and stuffed animals. Stray lice that fall off a head are either injured or dying and incapable of causing a new infestation, but it is possible for them to survive for about 24-48 hours without a human host. Daily vacuuming and proper disposal of vacuum bags will help to prevent further infestation.
Nits (eggs) are laid at the junction of the hair shaft and the scalp and are firmly attached to the hair shaft by a cement-like substance. They hatch in 7-10 days. Nits seen within ½ inch of the scalp show an active infestation. The presence of any lice or nits on a person with no documented treatment should be treated as an active infestation. Nits can be light, tan, or dark, depending on color of the host's hair. When the eggs hatch, the louse is then in the nymph form. They are about the size of a piece of pepper. It takes them 8-9 days to develop to adulthood and sexual maturity.
Mating occurs shortly after adulthood and continues till death. A female adult louse lays 2-5 nits a day during her 30-day lifespan. The adult head louse is the size of a small ant; it varies in color depending on the host's hair color. The louse holds onto hairs with hook-like claws, located at the end of its six legs. To feed, the louse stabs an opening through the skin and sucks blood into its digestive tract. They feed mostly at night and are very sensitive to light. Louse bites cause tiny red spots on the scalp and cause intense itching. Lice are found most often behind the ears and at the nape of the neck, although they can be anywhere on the scalp. Lice can only live 24-48 hours off the host, and they need a blood meal every 3-6 hours or they become quickly weakened.
Slide Presentation from LiceWorld 2012
The following slide presentation was made by Dr. Richard Pollack at the 2012 Liceworld conference in Copenhagen Denmark as part of his discussion on Head Louse Biology, Myths & Lousy Policies.
Head Lice Treatment Checklist
• Check everybody in the family for lice and/or nits. Do this slowly and carefully using a strong light. The insects are harder to see in dark hair, but the nits are harder to see in light hair.
• Pediculocide products are most effective when applied to DRY hair. It is important that you follow the directions exactly in order to have the best results.
• Remove all nits, which are the eggs of the louse. These will hatch in 7 to 10 days if not removed. Use a fine-toothed lice comb to get the nits off the hair shaft (a metal one does the best job). The nits are “glued” onto the hair where the adult louse lays the eggs. This is the most important step because if only one nit hatches, it can begin a whole new “crop” of lice . The nits are difficult to remove, and you may need to scrape the nits off the hair with your fingernail.
• Wash all bedding and clothing in the hottest water possible and dry on HOT dry. If an article cannot be washed, it should be dry cleaned. Don't forget backpacks, hats, or other personal items.
• Vacuum carpets, furniture, and car upholstery.
• Notify parents of other children who have had contact with your child so they can begin treatment also. This will help prevent re-infection of your child.
• Retreat all household members and close contacts if live lice are noted 7-10 days after the first treatment.
• If live lice are noted 7-10 days after second treatment , retreat using a different pediculocide shampoo, as Rid, following package instructions. Do not use Rid if allergic to ragweed, if scalp is raw or inflamed, or if allergic to this product.
• Check all family members every other day for the next two weeks. Remove any nits that you might find. After that, inspect everyone's hair at least once a week during lice season or “lice alerts”.
Handling the Environment
Wash clothes, bedlinens, and towels in hot water (130 degrees), then dry on the HOT cycle for at least 20 minutes. Items such as stuffed animals, headphones, and hats that are not machine washable must be dry-cleaned or stored at room temperature in a tightly sealed plastic bag for at least 2 weeks.
Vacuum all rugs, carpets, upholstery, cars, carseats, mattresses and pillows. After vacuuming, take the vacuum outside to remove the vacuum bag, seal it in a plastic bag and discard in the trash.
Fumigation of classrooms, school buses, and homes has not proven to be effective.
Common Problems with Treatments
Not following package directions exactly . Product may not work if directions are not precisely followed.
Retreating the head because nits are still present after initial treatment . There is no head lice medication that gets rid of the nits. They must be removed by nit comb and fingernails immediately after treatment. Retreat only if live bugs are seen in 7 days or if recommended by product.
Treating the head repeatedly to prevent head lice . When there is not an active case of lice, repeated treatments can lead to scalp irritation, systemic toxicity (with some products) and possible drug resistance.
The child continues to scratch head after treatment and is retreated without evidence of lice or nits. All head lice medications cause drying and irritation of the scalp, which can lead to itching and flaking of the scalp.
Misidentifying head lice. Hairspray and dry scalp can be mistaken for nits. Dry scalp will move when touched. Recommend washing out hairspray thoroughly and re-inspecting head.
Common Myths about Head Lice and Treatments
Do head lice transmit disease?
Will a hair “perm” get rid of head lice?
Do commercial hair dryers get hot enough to kill lice?
No. If temperatures hot enough to kill head lice were produced, extreme discomfort or burns would result.
Will hairspray or hairdressings (Vaseline, baby oil, etc.) prevent you from getting head lice or nit attachment?
Do vinegar rinses control head lice?
Do home remedies (i.e. bleach, kerosene, coal oil) work just as well as head lice treatments?
No. These products are not safe to use and are not approved for head lice treatment.
Should hair be kept short to prevent getting head lice?
No. Studies have indicated that long hair is not more likely to be infested than short hair, but long hair should be kept tied back to keep it from coming in contact with other children.
Should hair be cut to get rid of head lice?
No. Most eggs are within ½ inch of scalp.
Is head lice infestation related to uncleanliness?
No. Head lice can occur at all social and economic levels.
Can lice hop, jump, or fly?
No . They have claws to cling to the hairshaft.
Should a home or school be sprayed, dusted, or otherwise treated with insecticides when a person has head lice?
No. Lice do not hide in wall crevices and floor cracks like cockroaches or other household pests. Head lice need fibers to grasp onto; therefore, smooth surfaces on items such as desks, non-upholstered furniture, non-carpeted floors, and tables would not transmit head lice. Vacuuming is adequate.
Can pets give head lice to humans?
Can I use a pet shampoo for head lice treatment?
Adapted from: Harvard Public Health web page, 1999.
PHN Protocol, August, 1999.
School Health Alert , 1997.