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Helmut Schmidt, Published December 01 2012

Most area schools remain nitpicky on head lice

FARGO – Most area school districts apparently aren’t itching to change their “No nits!” policies on head lice, despite national and state recommendations to the contrary.

If a student is found to have live head lice, nearly every area school pulls them out of class and sends them home until they are treated and lice free.

Desi Fleming, director of nursing at Fargo Cass Public Health, said the tiny beasties are a lousy problem to have, but they are not disease carriers and they don’t spread easily in schools.

Still, it’s not a head-scratcher to understand why many schools are reluctant to follow relatively new national and state guidelines that call for letting kids stay in class, Fleming said.

After all, the only thing more persistent than the scalp skitterers is the stigma attached to having them, she said. That ick factor is tough to overcome.

“It’s definitely an emotionally charged issue,” Fleming said.

Head lice are tiny, about one-tenth to one-eighth of an inch long. They live in human hair and feed on blood. They multiply rapidly, laying small oval eggs called nits, which lice glue to the base of hair, close to the scalp.

The North Dakota Department of Health changed its policy last spring on how to deal with head lice found on students. The new policy says children shouldn’t be pulled out of class, but treatment should be started as soon as possible.

That protocol was first suggested by the American Academy of Pediatrics in 2010 because it was felt that the loss of time in school was more damaging to children than the remote possibility of other children getting lice. Also, pulling children out of school can disclose to others that they are infected.

Fargo Cass Public Health changed its policy in August to match the state, the Centers for Disease Control and Prevention and other national groups which agree with the AAP.

The Minnesota Department of Health and Clay County Public Health policies follow the new guidelines, too.

To date, two Cass County public school districts are letting students stay in class once head lice are found – Northern Cass and Kindred. Parents are informed and children must be treated.

All the rest – Fargo, West Fargo, Central Cass, Page, May-Port CG, Enderlin, Central Cass and Mapleton – inform parents and send children home as soon as its practical, with the admonition that they must be treated and lice free – and in some cases nit-free – to return to class.

“It certainly is in the school’s right to do what they feel was effective in the past,” Fleming said.

On the Minnesota side of the Red River, Moorhead public schools don’t have a no-nit policy, but the policy calls for removing children from classes once lice are found. They can’t return until they are free of live lice.

Dilworth-Glyndon-Felton, Barnesville and Hawley schools also send children home for treatment if live lice are found.

Ulen-Hitterdal has had a couple of students with head lice this year, but they were found while the children were at home. The district is mulling whether to change its policy to reflect the new guidelines.

Nancy Leith, the nursing manager for Fargo Cass Public Health, said school nurses screen the students. The schools may also screen the siblings of a child found to have head lice. And in some cases, all of the kids in a classroom may be screened.

This year hasn’t seen any unusual outbreaks of head lice in schools, Leith said.

Generally, head lice are found when children return to school in the fall and after vacations. That’s because lice are more likely to be transmitted between family members and close friends, Leith said.

Things to keep in mind:

• Head lice are spread usually by head-to-head contact. That’s followed by contaminated pillows, hairbrushes or sheets. It is rare for lice to transfer via hats or coats.

• Head lice are harder to get than a cold, the flu, ear infections, pink eye, strep throat or impetigo (a bacterial skin infection that causes blisters and sores).

E Head lice aren’t attracted by poor hygiene. They are not affected by cleanliness or lack thereof. They don’t care whether you’re rich or poor. They are simply opportunistic critters that live on human blood.

• You won’t get them from the family dog or cat.

• They crawl. They don’t hop, jump or fly.

• Most people don’t have symptoms. When symptoms occur, it’s usually itching on the scalp or neck where lice feed. Nits are commonly found behind the ears or nape of the neck. Scratching can lead to sores or infections.

A person may also experience sleeplessness or be irritable.

• There are over-the-counter and prescription shampoos that will kill live lice. A nit comb to remove the eggs is part of a lice-removal kit.

Local experts remind parents not to treat children who don’t have head lice, because the medications that kill lice have some toxicity.

Also, there is a worry that overtreatment could lead to some head lice developing a resistance to the chemicals now used to kill them.

• The child’s environment must be cleaned and vacuumed the same day as treatment. Bedding should be washing and hair tools soaked in hot water. Items that can’t be washed can be bagged for a couple of weeks. Without a blood meal, lice die, Fleming said.

Readers can reach Forum reporter Helmut Schmidt at (701) 241-5583