'Super Lice' Shouldn't Keep Students Out of School, Experts Say
Recent headlines about the discovery of head lice that are resistant to over-the-counter treatments have stirred up fears in many parents that the tedious task of ridding their children’s hair of the tiny pests may now be even more difficult.
Perhaps intensifying their concerns, many news media outlets have dubbed the new strain of insects “super lice,” conjuring up visions of biblical plagues.
At the same time, on the recommendations of organizations like the American Academy of Pediatrics, many school districts have been abandoning their so-called “no-nit” policies in recent years, keeping children in class even if lice or their eggs, known as “nits,” are discovered in their hair and urging parents to treat them when they return home from school. Districts have also shifted away from mass screenings for lice, opting to educate parents on checking their children’s scalps instead.
New strains of lice aren’t a reason to return to old policies, which often led to long absences for some students as their families treated the condition, said Beth Mattey, a school nurse in Wilmington, Del., and the president of the National Association of School Nurses, an organization that has advocated ending no-nit policies.
“We always get pushback from that,” she said. “But the evidence shows that no-nit policies are not necessary, that they keep kids out of school unnecessarily. That’s what we keep trying to get across to parents.”
The infestation of super lice stories started when researchers presented findings at an August meeting of the American Chemistry Society that in at least half the states, the dreaded insects that feed on blood from the human scalp have developed resistance to over-the-counter treatments that doctors and schools frequently recommend.
After testing samples of lice collected by public-health workers in 30 states, Southern Illinois University Edwardsville researcher Kyong Yoon concluded that 25 states have some lice strains that are resistant to the treatments. That’s because they have a combination of genetic mutations that allow their nervous systems to withstand exposure to permethrin, the active ingredient in many head-lice treatments sold in drug stores.
Lice with the mutations can still be eliminated with prescription medications, which contain a different active ingredient, and with the use of special combs, Yoon said at a press conference last month in Boston.
While Yoon’s research provides greater insights into the scope of the problem, doctors around the country have been aware of resistant lice populations in their areas for years; the first discovery of the mutation in the United States happened in 2000, Yoon said. So chances are good that some parents who are fretting about super lice have already dealt with them.
Mattey recommends that parents consult with a pediatrician to determine the best course of treatment.
“We have things to treat it,” she said. “It may be a concern in your community, but we can take care of that.”
Nuisance, Not Health Concern
Whether discussing super lice or those without the mutations, some parents have criticized districts’ decisions to change their approaches to dealing with the pests in recent years.
The school board in Wilson County, N.C., recently voted down a proposal to keep students in class after lice are discovered, citing parent concerns that young children work in close proximity to each other and often sit three-to-a-seat on school buses, increasing the likelihood of transmission.
But school health experts say concerns about transmission at school are often based on myths.
Although lice are a nuisance, they don’t spread disease, the American Academy of Pediatrics noted in revised treatment guidelines released in May. Lice can’t jump or fly, and they are unlikely to leave a healthy scalp to make their home on another child’s head except in cases of heavy infestations, those guidelines say.
“Because a child with an active head-lice infestation likely has had the infestation for one month or more by the time it is discovered and poses little risk to others from the infestation, he or she should remain in class but be discouraged from close direct head contact with others,” the organization said in an updated position paper released in 2010.
The position paper recommends that school officials notify parents if lice are discovered so they can be quickly treated, and that children should not be restricted from returning to the classroom during those treatments, which can go on for days or even weeks.
And policies that keep students out of class until their heads are free of all lice eggs should also be abandoned, the organization said. That’s because nits are often misidentified in screenings and because the presence of nits is not necessarily a sign that insects are actively living on a child’s scalp.
Mattey said the school nurses association has worked to acknowledge parents’ concerns while also educating them that lice are not any more likely to be spread at schools than in any other environment.
“We want to be very proactive” she said, “and educate people.”
Vol. 35, Issue 03, Page 8