The Bainbridge Island School District policy regarding head lice (Pediculosis capitis) is based on recommended guidelines by the Centers of Disease Control (CDC), American Academy of Pediatrics, National Association of School Nurses and the Harvard School of Public Health.

If live lice are observed, then parents will be asked to pick up their student and begin treatment. Once treatment has been verified (signing of document sent home with child), the child will be allowed to return to school.  Upon return, school staff will re-examine the student before the child returns to the classroom.  The student will be examined again in 7-10 days by school staff to confirm the absence of lice and nits.

If only nits (lice eggs) are observed, the student may remain in school for the balance of the day, parents will be notified and information will be sent home advising how to address the condition. Once treatment has been verified (signing of document sent home with child), the child will be allowed to return to school.  Upon return, school staff will re-examine the student before the child returns to the classroom.  The student will be examined again in 7-10 days by school staff to confirm the absence of lice and nits.

Treatment of head lice for many years has been based on old wives tales, misconceptions and marketing departments for companies who make products for profit from head lice hysteria.  Head lice are small parasitic insects that are host specific to the human head.  Lice likely co-evolved with people, their claws are well adapted to grasping only the human hair shaft.  In fact head lice have even been recovered from prehistoric mummies.  Head lice are equal opportunity parasites, they do not recognize socio-economic class distinctions or lack of hygiene.  They are primarily spread from head to head contact.  In North America and Europe, children are more frequently infested than are adults, and Caucasians more frequently than other ethnic groups.   Head lice are not known to transmit infectious agents from person to person.  They are not considered a vector for illness.

Facts About Head Lice:

• Head lice are human specific, they do not live on other animals.
• Head lice do not jump or fly.
• A louse lives on the human scalp and feeds only on human blood.
• If they are unable to feed they die within 24 hours of separation from the human host.
• Head lice hatch from small eggs or nits that are attached with a cement like substance to the base of a hair shaft.
• Eggs more than an inch away from the base of the scalp are nearly always hatched.  
• The eggs mature in about 10 days, the louse then matures in less than 2 weeks.
• Female lice may survive for as long as a month, however after 2 weeks they tend to produce fewer and less viable eggs. 
• If nits are present head lice have already been infested for a month or more. 
• Head lice are a pest and are not known to transmit microbes that cause disease. 
• Rarely more than 12 live lice live on the head at one time.

Signs and Symptoms:

• Itching of the scalp caused by an allergic reaction to the bites.
• Tickling or feeling like something is moving on the scalp.
• Sores on the scalp resulting from intensive scratching.
• The most common places for head lice include behind the ears, the back of the head at the neck line.

Mode of Transmission:

• The MOST common mode of transmission for head lice is head to head contact. 
• Less common transmission may occur through indirect transmission such as shared combs, brushes, hats, hair accessories and rarely through helmets. 
• Schools are NOT a common source of transmission, even though schools have been blamed in the past. 
• Sleep-overs among friends and relatives are thought to be a common way they are passed home to home.
• Check family members, that would also include adults who have head to head contact with the infested child.

Treatment:

• Treatment of head lice is a multi-faceted approach.  
• Nit and lice removal is a tedious process. 
• Head lice shampoo uses pesticide treatment and should be used only when active lice are present. 
• If the insecticide shampoo is used follow the directions precisely! 
• Never use lice shampoo as a preventative measure,these chemicals can be harmful if not used properly.
• The MOST effective way to get rid of nits (eggs) is to pick them off the hair shaft, thus a new definition for “being nit picky”.
• Nits DO NOT wash out of hair.  They are cemented onto the hair shaft.
• Some believe these products might help loosen the “cement” that the nits use to attach to the hair shaft: vinegar, real mayonnaise, olive oil, tea tree shampoo.

Combing the hair in the opposite direction of normal brushing will help you find more eggs:

• Nit picking can also be done by hand, using your fingernails or tweezers.
• Get rid of eggs in the sink, toilet, or garbage.
• Vacuum around the area where you were combing out eggs.
• Both people should change their clothes.

Continue checking for lice and eggs for two weeks using the nit comb daily, until you no longer find any more lice or eggs. This process takes the most time, energy, and patience. Combing is the most important step!

What Needs to be Cleaned:

• Vacuum car seats, upholstered furniture anywhere the child has frequented within 48 hours of diagnosis, survival of the lice past this time would be unlikely. 
• Wash and dry with heat the pillowcases, sheets, night clothes, towels and stuffed animals that may have come in contact with a child’s head. 
• Combs, brushes, hats and other hair accessories that have been in contact with the infested person should be washed in hot water each day to dislodge any lice or nits. 
• Items that cannot be washed should be placed in a plastic bag for 2 weeks.

Prevention: 

• Once the nits and lice are gone, check your child’s hair every couple of weeks to see if nits or lice are present. 
• Challenges occur in communicating to other parents when head lice is found.  It can be difficult to make calls to friends but a  necessary step to prevention of head lice spreading.
• Educate children when playing with other children to avoid activities that may spread head lice.

Resources:

• American Academy of Pediatrics (PDF)
• Centers for Disease Control
• Pictures of Head Lice
• National Association of School Nurses
• IdentifyUS - Head Lice FAQs