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Head lice: Separating facts from fiction as kids get ready to head back to school  1 Week ago

Source:   USA Today  

It's almost time for books, backpacks, homework – and head lice?

As younger students in pre-K, kindergarten and elementary school return to tight quarters with increased head-to-head contact, experts are warning parents and teachers that head lice cases are likely to spread.

“When the kids have close physical contact in school, the incidents do clearly go up,” said Bernard Cohen, a Johns Hopkins pediatrician and head lice expert. 

Here's how head lice experts separate fact from the fiction on the pesky bugs. 

There's no evidence that head lice carry disease of any kind, said Laurie Combe, the president of the National Association of School Nurses.  

“It is a nuisance and certainly causes anxiety, but it is not a known health problem,” Combe said.

Getting head lice is not an indication of poor hygiene, she said. Lice also can't propel themselves from head to head without close physical contact, or if people share a brush, hat or other item that touches the hair.

"People believe that head lice jump and they don't – they crawl," Combe said. 

No-nit policies, where students are banned from school if they have nits – baby shells of lice – in their hair, are an issue at the heart of prevention efforts. But experts say they are ineffective.

“No-nit policies have never been demonstrated in the evidence to reduce the incidence of head lice,” Combe said. “They result in unnecessary school absences and we know that seat time is critical for children’s learning.”

Half of lice cases are overidentified and children could be exposed to unnecessary treatment, Combe said. For low-income parents, she said missing a day of work to care for a child could result in a loss of wages or even firing.

And the kids themselves could be subject to stigma and shaming, Combe said.

Cohen said the real concerns are the live crawlers, not the nits. As long as students can show they have been treated and are rid of live crawlers, Cohen said there's no reason for schools to restrict kids from attending.

The Centers for Disease Control and Prevention reports that while head lice infects around 6 to 12 million people in the United States yearly, "African Americans have fewer reported infestations compared with other ethnic groups, which may be due to differences in hair thickness and curl.”

Cohen agrees. Fifteen years ago, he attempted to study head lice in Baltimore City Public Schools but ran into a problem.

“The nurses in Baltimore City told me that they don't see head lice in Baltimore City Public Schools,” Cohen said. "We couldn't do the studies here in the (predominantly) African American school districts. We had to go to the counties, where there were more white kids in the school districts.”

Lice have a hard time attaching to the hair shafts of African American children, Cohen said, possibly because of their cork-screwed shape.

The best way to avoid lice is to instruct kids to avoid head-to-head contact with peers and to never share personal care items such as combs, brushes and hats, according to Combe and Cohen.

“Don't share jackets and hats and hoods, use your own stuff, and let everybody else use their stuff,” Cohen said.

“Parents can proactively, periodically check their children's scalp or hair, and if they think their child has a problem, they can ask their school nurse to take a look," Combe said.

Cohen said lice thrive on close, physical, head-to-head contact and need blood meals to survive. But lice spreading through inanimate objects is not usually a major cause for concern.

“The adult organisms may survive for a little while off the scalp, but the new ones that have just hatched need to have a meal pretty quickly, and if they're not on your head or a place where they can get a meal, they're not going to be viable for very long,” Cohen said. “You don't need to tear up the house, for sure.”

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