Montgomery County (MD) School Lice Policy

Montgomery County schools retain a “no nit” policy for all nits located closer than ½ from the scalp. If a student has nits (eggs) that are near the scalp and/or live bugs, that student is sent home and not permitted to return to school until he or she has been treated and there are no visible nits (within a half inch from the scalp) remaining in the hair. According to the Montgomery County schools web site, “Head lice are common among children. Lice can be readily transmitted in schools, homes, camps, backyards, and playgrounds. According to the Center for Disease Control (CDC) and other health authorities, head lice are not a health hazard or sign of uncleanliness and are not responsible for the spread of any disease. Nits (lice eggs) that are not viable (1⁄2 inch or more from the scalp) do not cause the spread of head lice. The spread of lice is best prevented by providing parents/guardians with accurate information about the identification and treatment of head lice and nits. A student is considered to have infestation with head lice if live lice and/or viable nits (those that are closer than 1⁄2 inch from the scalp) are observed. Students with infestation are excluded from school to obtain treatment with a pediculocide in order to prevent spreading lice to other students. Health care providers are a resource for treatment. Removal of nits located 1⁄2 inch or more from the scalp is recommended to avoid identification confusion. Every effort should be made to minimize time away from school and to expedite treatment for students who are excluded due to head lice infestation. Head lice screening programs are not recommended by the American Academy of Pediatrics because the screenings have not proven to have a significant effect on the incidences of head lice in a school community.

IV. PROCEDURES A. At the beginning of each school year and as needed, the principal, working with the School Community Health Nurse (SCHN), should— Send the Lice Education Letter and Lice Fact Sheet to parents/guardians. These documents provide information about identification, treatment, and prevention of head lice. Recommend parents/guardians inspect their children’s heads upon return to school in the fall and every few weeks thereafter. Request that parents/guardians treat an infestation according to the recommendations provided in the Fact Sheet and notify the SCHN or School Health Room Aide (SHRA).

B. If a student in a school is suspected of having head lice - The person suspecting the lice infestation should contact the SCHN or SHRA or, if unavailable, a school-based administrator. The health staff will look closely through the hair and scalp of the student to determine if there are live lice and/or nits that are located 1⁄2 inch or closer to the scalp. If all observed nits are located 1⁄2 inch or more from the scalp, no further action is necessary. If live lice or nits located less than 1⁄2 inch from the scalp are identified, the SCHN or SHRA will call the student’s parent/guardian to inform him or her that lice infestation has been identified and to request that he or she pick up the student to obtain treatment. The health staff will review information contained in the Lice Treatment Letter with the parent, which includes information from the CDC on treatment, nit removal, and environmental precautions. If the parent/guardian is not available, the emergency contact person should be called and requested to pick up the student and should receive the Lice Treatment Letter to give to the parent/guardian.

C. Upon Return to School - - The student should report to the health room accompanied by the parent/guardian. - The SHRA or SCHN should inspect the student’s head to assure the absence of live lice and nits located within 1⁄2 inch of the scalp before the student may return to class. Offer informational/educational programs about head lice identification, treatment, and prevention that are consistent with current research to school staff, parents/guardians, students and/or volunteers; - Contact the families of students with repeated infestations, and/or make home visits if necessary, to discuss health information, treatment procedures, nit removal, environmental control, and possible reservoirs of infestation including the student’s after-school friends; For recurrent lice infestations, visit the child's classroom to identify any environmental factors that may account for the spread of lice in the school environment (i.e., sharing of hats, storage of coats, etc.); and Monitor the students who are excluded to assure that they obtain proper treatment and that their parents/guardians respond to the information provided in the follow-up letter to try to prevent their re-infestation." Reference:  www.montgomeryschoolsmd.org

The Wall Street Journal On Head Lice

According to an article in the Wall Street Journal, “Cynthia Devore, the chairwoman-elect of the Council on School Health for the American Academy of Pediatrics, said parents usually bear the brunt of the task of ridding children of head lice. But, she said, pediatricians may need to get more involved, particularly as head lice increasingly grow resistant to traditional treatments. It's not clear how widespread the resistance problem is, she said. ‘The risk of transmission within a school is actually pretty low," Dr. Devore said. ‘Head lice are part of raising children,’ said Deborah Altschuler, president of the National Pediculosis Association, a nonprofit parents group that advocates nonchemical solutions to curing infestations. ‘We teach our kids to brush their teeth twice a day to prevent cavities’ so parents should check for lice, perhaps once or twice a week after washing children's hair, she said.” Reference: online.wsj.com