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New lice advice has some scratching their heads


Head lice — the tiny critters that cause itchy scalps among school kids and strike fear in the hearts of parents — are relatively harmless and should not prevent students from attending school, a national pediatric advisory group now says.

The American Academy of Pediatrics advises that "no healthy child should be excluded or miss school because of head lice."

The group goes further to recommend that schools drop policies that prohibit students from coming to class until they are free of lice and lice eggs, called nits.

"It's a social nuisance more than a health risk and you don't want kids to miss school if they don't have to," said Dr. Mark Netherda, Sonoma County's deputy health officer. "Although people are concerned that lice spread disease and are dirty, they are really more of a social nuisance than a health nuisance."

While some doctors say the risk of spreading the bugs in a classroom setting are slight because lice can't fly or jump, others still urge caution, citing a nit's 6-9 day gestation period and the critters' ability to live away from a human host for about 48 hours.

"Lice is highly contagious," said Kaiser pediatrician Sharon Henderson. "Reinfestation is extremely common. Even if you have killed 99 percent of the lice, that one percent you leave can be a major reinfestation."

Even after treating an infected child, parents and school administrators should be encouraged to conduct frequent monitoring to make sure a reinfestation has not occurred.

"It's all controversial because if you do initiate treatment, it's not just a one time treatment, you have to do constant monitoring," Henderson said.

The California Department of Public Health recommends a no-lice policy but now tells schools to forgo the more stringent no-nit stance. No lice means a kid who has shampooed with a lice-killing treatment should be allowed to return to school the next day.

That is the rule in the Roseland School District.

A student with "active, adult head lice shall be excluded from attendance." That same student shall be allowed to return to class the next day, following treatment, according to the policy.

In Santa Rosa City Schools, director of special services Debra Sanders has scheduled a meeting with all district nurses to review and update health policies, including rules that cover lice.

Regulations used in the 2009-10 school year required that children be nit and lice free to return to school.

"The fear of lice is much worse than the infection," said Dr. Fred Brewer, a general pediatrician with Sutter Medical Group of the Redwoods. "They are not associated with human disease, they don't transfer disease. It doesn't mean you are dirty or filthy."

"It's not reasonable to exclude the kids until every last nit has been removed from their hair," he said.

"Zero tolerance just doesn't work and it's not necessary and kids need to be in school," said Dr. David Smith, a pediatrician with the Annadel Medical Group.

A more conservative approach might be appropriate in a day-care setting where young kids might share pillows or blankets during a nap, but for school age students whose desks abut or whose jackets hang on the same rack, send &‘em to school, Smith said.

"No one needs to stay home, that is the key thing," he said.