Apple Icon  HEAD LICE (PEDICULOSIS) PROTOCOL

Winchester Public Schools is committed to providing a healthy environment for all students and employees. WPS protocol for lice management in our schools is guided by current recommendations from the Virginia Department of Health (VDH), Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), Harvard School of Public Health, and the National Association for School Nurses (NASN). It is the position of these organizations that the management of Pediculosis (infestation by head lice) should not disrupt the educational process and no disease is associated with head lice. Using these recommendations WPS has established the following guidelines:

    When a student is identified with live lice at school, the family will be notified.

    The student will be sent home at the end of the day. Families may choose to pick up their child earlier if desired.

    A student with live lice should receive an appropriate lice treatment prior to returning to school. Students will not be excluded from school attendance. However families will be notified if live lice are still present upon their return to school requiring further treatment.

    The student will be examined upon returning to school for treatment and absence of live lice.

    Educational materials will be shared with the family for proper treatment of the student, other family members, and the home.

    The standard lice information letter may be sent to families of students in any grade level in which lice has been discovered.

Current evidence does not support the efficacy and cost effectiveness of classroom or school-wide screening for decreasing the incidence of head lice among school children. Families provide the most effective screening by checking their children regularly at home, using appropriate treatments and removing nits.

  • INFORMATION FOR FAMILIES
  • HEAD LICE FACTS
  • TREATMENT
  • RECURRING CASES 
  • OTHER RESOURCES

Checklist for Families

Steps to take when your child is identified with live lice at school. Click HERE for a printable copy.

  • Speak with your school nurse.
  • Choose and use an appropriate treatment. In addition to your school nurse you may wish to consult with your pharmacist, pediatrician, or family physician.
  • Treat your child prior to their return to school the next day. Carefully follow all treatment instructions.
  • All household members and other close contacts should be checked, and those with live lice should also be treated at the same time.
  • Have your child avoid head to head contact with others.
  • Discourage your child from sharing personal items such as hats, scarves, headbands, helmets, brushes, combs, or pillows to decrease the likelihood of spread from one person to another.
  • All recently worn clothing, hats, bedding, and towels used by anyone having lice or thought to be exposed to lice should be washed in hot water or dry cleaned.
  • Personal care items such as combs, brushes, and hair clips should also be washed in hot water or thrown away.
  • Toys such as stuffed animals can be placed in a hot dryer for 30 minutes or placed in a plastic bag for two weeks.
  • Check your child following treatment. If live lice remain consider consultation with your school nurse, pediatrician, or family physician.

Facts About Head Lice

Head lice are not dangerous and do not transmit disease. They cause no medical harm and can be effectively treated. Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice.

Life cycle of head lice: eggs or nits are cemented to the base of the hair shaft, eggs hatch into nymphs, in 7 days adult lice have matured. Lice can live 30 days on an infected head. Lice will die in 1 – 2 days off the host.

Head lice are spread by direct contact only. They cannot jump or fly.

All people are susceptible to head lice although some groups are more vulnerable than others.

Most students with head lice are symptom free although some may experience itching.

Nits visible farther than 6 mm (1/4 in) from the scalp are generally not viable and an indication of past infestation.

Current infestation is confirmed by inspection of scalp and hair for the presence of nits, nymphs or adult lice. Lice are often difficult to spot because there are few and they move quickly.

Treatment of Head Lice

Treatment options for head lice include over-the-counter (OTC) products purchased in a store or medications prescribed by a health care provider. These products are applied to the hair and scalp. Alternative treatments, such as herbal or home remedies, are available but are not regulated by the United States Food and Drug Administration in the way that medicines are. Whatever product you use, be sure to follow the directions carefully.

Over-the-counter (OTC) products – plant-based insecticides (pyrethins) and synthetic chemical insecticides (pyrethroids) – are popular choices. These products are available at pharmacies. Both types of OTC pediculicides are recommended for use by the American Academy of Pediatrics (AAP).

Prescription medications for the treatment of head lice include 3 pediculicides approved by the FDA since 2009 and 2 older products, which have been around for decades. Application times on the hair and scalp vary from several minutes to several hours. Treatment may be indicated for 1 time only or may need to be repeated a week or so after initial use.

Other treatment approaches - Home remedies include occlusive agents such as petroleum jelly, mayonnaise, and tub margarine, and “natural” products such as essential oils. Although widely used, these products are not approved by the FDA for the treatment of head lice and do not have to meet safety and efficacy standards comparable to those established for pharmaceutical products.

Manual removal of lice or nits, with or without a nit comb, is a lengthy and tedious process that is usually not completely effective at eliminating infestations alone or when done by someone other than a trained professional. However, manual removal is often mentioned as part of the treatment protocol in the product instructions for head lice pharmaceuticals. You may want to remove nits to improve appearance and to help in determining if treatment was effective.

You can help prevent your child from getting head lice by teaching them to avoid head-to-head contact with others, not to share clothing or personal items such as combs, brushes, or towels, and not to lie in beds, couches, pillows, carpets, car seats, or stuffed animals that have recently been in contact with someone with head lice.

Recurring Cases of Head Lice

A recurring case is defined as a student found repeatedly with live head lice for 3 consecutive weeks or 3 separate months during a school year. For these cases school staff will continue to follow the stated intervention protocol. Additionally other school personnel may be consulted for help in determining the best approach to identifying and resolving the problems that impact the student’s recurring head lice condition. These personnel may include the school nurse, student support staff, guidance counselor, and other appropriate individuals able to provide assistance, resources, and recommendations. Actions to address a recurring case may include:

  • Consultation with the family to review the student’s history and treatment approaches to identify problems and needs.
    • The failure of a head lice treatment is a common and frustrating problem. Possible reasons for this include:
    • Re-infestations from another person or from contaminated clothes, hats, etc.
    • Resistance of lice to insecticides or an improperly applied treatment by failure to follow product directions. If a course of one kind of treatment fails, a different treatment may be selected for the next course.
    • Misdiagnosis of an inactive case. It is important to look for active lice not just nits.
  • The student should be seen by a pediatrician or family doctor.
  • Provide consultation and additional information regarding treatment options. Including specific review of the Centers for Disease Control and Prevention guidelines for treatment, prevention and control, and additional measures to prevent re-infestation.
  • Assist the family in developing and implementing consistent actions regarding screening, treatment, and prevention.
  • Refer the family for assistance, resources, and/or recommendations to appropriate community agencies.
  • Assist the family in identifying necessary resources. For example students or families identified as homeless under the McKinney-Vento Act are eligible for financial and other assistance through the WPS homeless liaison.

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