"While
absence from school or
child care is a loss of educational opportunity and an encumbrance to
working parents,
readmitting an infested child
is not the solution."
Schools
maintain a “no nit policy”. This means that once your
child has been found to be infested they can not return to school
until all bugs and nits and bugs have been removed. This policy
is intended to keep schools and children lice free.
LICE FORCE supports the standards recommended
by the National Pediculosis Association.
The spirit of the No Nit Policy is to minimize head lice infestations.
Early
intervention provides the needed assurance for those who have successfully
eliminated an infestation that everything possible is being done
to prevent new outbreaks when children return to groups where close
contact is inevitable. Repeated exposures to pesticidal products
put children at risk. Parents need to be informed that chemical
treatments may also be dangerous for children with certain pre-existing
medical conditions and/or medication regimens. Families with pregnant
or nursing mothers should be given advance notice that early detection
with manual removal of lice and nits can serve as a safe alternative
to pesticidal lice treatment products.
Opponents of the No Nit Policy say that "overzealous"
enforcement can lead to inappropriate exclusion of children with
residual nits, but whose infestation has otherwise been "treated."
Those who judge enforcement to be "overzealous" may not
consider the broader public health values and preferences of the
community. Few who oppose the No Nit Policy would accept infestations
for themselves or for their own children. Without the No Nit Policy,
communities are left with a hit-or-miss approach. Indifference about
adopting a standardized management protocol permeates the attitudes
of health professionals at every level. This in turn gives way to
a maze of conflicting opinions and directives that are counterproductive.
Public health policies for head lice cannot be based solely on the
use of chemical remedies.
The Food and Drug Administration recommends repeating chemical treatments
in 7-10 days because none of the available treatment products are
100% effective against lice eggs and that remaining viable nits
will hatch lice. Unfortunately, the FDA’s directive does not
take into consideration the endemic nature of head lice. Children
being managed in this manner can infest others or become reinfested
in the interim. Mechanical removal of head lice and nits is less
noxious and more likely to be successful than repeated chemical
treatments
Manual Removal of All Lice and Nits:
There are no safe pesticides, "natural" or otherwise, scientifically
proven to be 100% effective against head lice, nits or nit glue. Reliance
on head lice treatment products that are ineffective promotes repeated
use of potentially harmful chemicals and contributes to ongoing infestations,
outbreaks, and resistant strains of head lice.
Parents should be discouraged from spending unnecessary time and money
on "concoctions" for which there is no scientific basis
for claims or evidence of efficacy and human safety. A wide variety
of such "lice remedies" are vigorously marketed to consumers
especially via the Internet. The result is more confusion for families
already deluged with conflicting treatment recommendations. Manual
removal is the safe alternative and necessary component to any head
lice treatment regimen.
Temporary Dismissal of Children with Head Lice and/or Nits: Administrators
and health personnel must take all reasonable measures to help ensure
that infested children do not join the group setting. It is more than
fair to expect that uninfested children will be safeguarded while
infested children will be cared for with sensitivity.
LICE FORCE offers a non-toxic solution to
head lice infestation by manually removing all the bugs and nits,
screening the household members and making our clients knowledgeable
on the prevention of head lice and future infestations.
School Nurses cited non-removal of nits as one of the primary causes
of treatment failure. With nit removal absent from school policy,
children with hatching nits are readmitted to the group setting. Still
there are many, perhaps more distant from the front lines, who dispute
the value of removing nits. This opposition is based on a reliance
on chemical agents rather than a preventive approach, a belief in
second and even third pesticide treatments as "mop-up" operations
and the notion that pediculosis is not a significant disease.
In 1990, the NPA published a warning to the public that resistant
strains of head lice were inevitable based on the way the products
were being vigorously marketed and inappropriately used. Again in
1995, the NPA notified leading manufacturers of both permethrin and
pyrethrin-based pediculicides that the NPA was receiving increased
numbers of treatment failure reports from parents and health professionals
alike, indicating possible lice resistance to some of these products.
In 1996, the NPA sponsored independent scientific evaluations of head
lice sensitivity which documented permethrin-resistant head lice from
children in Massachusetts, Iowa, and Washington. In 1997, the World
Health Organization review of treatments for pediculosis noted the
issue of lice resistance to almost all of the commercially available
pesticide treatments including permethrin-based products. As recently
as February 1999, the Journal of Parasitology reported lice resistance
in England, following in the footsteps of journal reports from Israel,
Czechoslovakia, France and the U.S. Resistance issues alone warrant
that people be reminded in advance that products may not provide the
positive outcome they seek. Repeated use of these products will not
change product performance and may risk children's health and contribute
to more strains of resistant lice. While absence from school or child
care is a loss of educational opportunity and an encumbrance to working
parents, readmitting an infested child is not the solution.
A
policy for head lice must consider not only the infested child,
but also his or her peers who have already been successfully deloused
or who have not yet been infested.
All this considered, the No Nit Policy remains a sensible approach
that sets the standard to serve and protect all the children in
the group.