St. Louis School Lice Policy

St. Louis, LaDue, Kirkland, and Clayton Missouri Public School Districts have all adopted the current policy of the Missouri Department of Health and Senior Services and guidelines from the Centers for Disease Control (CDC) that “children should not be excluded or sent home early from school because of head lice or nits." Following are statistics related to schools and head lice checks in Missouri:

• 91% screen regularly
• 60% screen beginning of school year
• 81% screen according to situation

Read more at health.mo.gov. According to the Missouri state government web site: "National recommendations for school policy are The American Academy of Pediatrics recommends that no healthy child be excluded from or allowed to miss school because of head lice and that ‘no nit’ policies for return to school are to be discouraged. The National Association of School Nurses states that nit-free policies disrupt the education process and should not be viewed as an essential strategy in the management of head lice. Health and Health Care in Schools Children with nits do not pose an immediate threat to the health of others, therefore, excluding these children from school and requiring them to be treated with a pesticidal product is probably excessive. Recommendations for schools

• Reconsider “no nit” policies as they are not supported in the literature;
• Check symptomatic students. Routine head checks of healthy students are not recommended.
• Do not exclude a student from school when nits 1⁄4 inch or closer to the scalp or live lice are discovered, but notify the student’s parent that day and provide instructions on how to treat and eliminate the lice.
• Offer extra help (from the school nurse) to families with chronic infestations.
• Provide community-based education."

Read more at health.mo.gov.

Webster Groves Schools School Lice Policy

Webster schoolsThe Webster Groves School District created new guidelines for handling head lice in the schools following a report issued by the American Association of Pediatrics (AAP) in 2009 stated above. The report was endorsed by the Center for Disease Control and Prevention and the School Nurses Association. "Currently, children in Webster Groves are sent to the school nurse to be checked if they are suspected to have lice. Parents are called if live lice are found and can decide to pick up their student immediately or wait until after school. Treatment is required and nurses re-check the student upon their return to school to make sure that they have been properly treated. 'We quit doing schoolwide head checks after the AAP's recommendations came out,' "stated a school official, 'We wasted a lot of academic time with those, and we have not seen an increase in cases since we stopped.' Read more: at websterkirkwoodtimes.com

Ladue Schools Lice Guidelines

According to the Ladue  School District web site, "school guidelines serve to outline the roles and responsibilities of the Ladue School District in community efforts to control head lice (pediculus capitis). These guidelines draw on information obtained from the Missouri Department of Health, the American Academy of Pediatrics, the National Association of School Nurses and the Harvard School of Public Health.

The Ladue School District will use best practices in pediculous management:

• A child with an active head lice infestation who most likely has had the infestation for a month or more poses little risk to others and will remain in class until the end of the day but discouraged from close direct contact with others. If there are complications or other health problems as a result of the presence of lice, the school nurse will use her professional judgment in determining whether the child will remain in school for the remainder of the day. The age and development of the child will be a determinant if the child cannot refrain from direct contact with others (as in the preschool and early elementary years).
• The school nurse will notify the parents either with a phone call or a note that the child has lice and that prompt proper treatment of the child is required before returning to school.
• To prevent embarrassment or social stigmatisms, the child ‘s infestation will be kept confidential.
• The parent or guardian will be given written information on head lice and encouraged to contact their pediatrician for treatment advice.

The child may be allowed to return after treatment. The school nurse will check the child before reentering the classroom and again between 9-12 days after treatment, if requested to do so by the parent. Students will be allowed to return if nits are found; however the nurse will encourage nit removal for the following reasons:

• Nit removal may decrease diagnostic confusion
• Nit removal may decrease the possibility of unnecessary retreatment
• Some experts recommend removal of nits within 1 cm of the scalp to decrease the small risk of self-infestation
• Some lice are resistant to commonly used pediculocides.
• In preschool and elementary school, the nurse will notify the parents or guardians of all children in the index child’s classroom by letter and provide educational information on head lice. Parents and guardians will be encouraged to check their children at home and treat appropriately before returning to school the next day.
• The school nurse will provide the families with advice on current practices for treatment of lice, how to identify lice and nits, home interventions for the family and ways to prevent head lice. Parent education is crucial to any successful pediculois management.
• The school nurse may direct the maintenance staff in the school on interventions in the classroom with 2 or more infested students; vacuuming, washing of blankets, pillows; bagging up items in plastic that cannot be washed (stuffed animals, costumes or hats) for up to two weeks.
• Head lice screening will not occur on a regular basis because screening programs have not been proven to have a significant effect on the incidence of head lice in the school setting. However, the school nurse will check for lice on symptomatic children who are itching or complaining of pruritis. Screening an entire classroom of children will only be done if there are more than 2 confirmed cases in a particular classroom.
• For the rare student that has continuing reinfestations, the school may refer the case to public health personnel for a home visit to ensure that treatment is conducted effectively.
• The school and the school district will remain calm and educate the community on the fears and myths of head lice. A student with head lice will be confidentially managed on individual case basis with the goal being for the student’s attendance to be unaffected due to a diagnosis of head lice.

Kirkwood Public Schools Lice Policy

Kirkwood's policy is very similar to Ladue's. "In keeping with the Kirkwood R-VII School District's policy of avoiding the unnecessary exclusion of students from school, the district will not exclude otherwise healthy students from school due to nit infestations. Students with head lice infestations will be excluded from school only to the minimum extent necessary for treatment. To avoid the unnecessary exclusion of students from school, the administration provides the following procedure: 1. Schools will not perform routine school wide head lice screening. However, should multiple cases be reported, the nurse will identify the population of students most likely to have been exposed and arrange to have that population of students examined. 2. If the school nurse or teacher discovers head lice or nits on a student, the parent/guardian of that student will be notified, and other students who reside with the infected student will also be checked. 3. The school nurse will instruct the parent/guardian concerning various shampoos, sprays and other appropriate treatments that can be purchased to eliminate head lice or nits and will also give information concerning necessary procedures to be taken in the home to ensure that the head lice are eliminated. 4. If the student was infected with live head lice, the student may be permitted to return to school after appropriate treatment has been started. 5. When a student who had a live head lice infestation returns to school, the student will be examined by the school nurse. If live head lice are found at that time, the parent/guardian will again be called and reinstructed concerning treatment. This process will continue until the student is free of head lice. 6. The school nurse will keep accurate and confidential records of students infected with head lice or nits. 7. If it appears the parent/guardian of an infested student is failing to secure timely treatment for the infestation after having been given notice of the existence of head lice or nits in accordance with these procedures, the nurse will notify the school principal, who may report the matter to the Children's Division (CD) of the Department of Social Services. The school nurse will develop education programs regarding the diagnosis, treatment and prevention of head lice for staff, students, parents and the community. Students are sent home immediately if live lice are found and can return to class as soon as they have been treated — even as quickly as the same day — as long as there are no more live lice present or nits closer than a half inch from the scalp. "We check the student again 10 days after they first presented because that is the life cycle of lice. If there are no more live lice or nits close to the scalp, we can be absolutely sure that there will be no more viable lice," Kirkwood lead nurse Linda McKeon said. Read more at www.websterkirkwoodtimes.com and policy.msbanet.org.

Clayton Schools Lice Policy

Schools in Clayton, Missouri tend to have a more conservative approach to lice management than the aforementioned districts. The district lice policy is stated as: "PEDICULUS HUMANUS CAPITUS/HEAD LICE: The school must be informed if your child has head lice. Treatment and removal of all eggs is required before returning to school. The student must be ""checked in" by the school nurse before returning to class." Read more at www.clayton.k12.mo.us LiceDoctors encourages all parents to check with their school nurse to be sure that you are aware of the most up to date head lice policy.