Rethinking Lice

09/12/2006

Be honorable yourself if you wish to associate with honorable people.
Welsh Proverb

Researchers from the Department of Parasitology at the Hebrew University-Hadassah Medical School in Jerusalem, Israel, from Global Health Associates of Miami, Florida, and from the Department of Medicine, Medical College of Ohio in Toledo suggest, in a provocative new article, that we rethink our practices in early childhood programs in regard to excluding children.

Health authorities in the U.S.A., Canada, and Australia recommend a "no nit" policy, i.e., the immediate dismissal of all children who have head lice, eggs, and/or nits on their hair from school, camp, or child care settings. These children would be readmitted to the institution only when all head lice, eggs, and nits have been removed. The "no nit" policy assumes that all nits seen when examining the scalp are viable and therefore the infested individual should be treated for lice, and all nits must be removed from the scalp.

However, according to the authors' abstract, "it has been repeatedly shown that only a small number of children who have nits on their scalp are also infested with living lice. Accordingly, in the U.S.A. alone 4-8 million children are treated unnecessarily for head lice annually, which amounts to 64% of all lice treatments. In addition, 12-24 million school days are lost annually. The annual economic loss owing to missed workdays by parents who have to stay home with their children adds US$4-8 billion to the country's economy. The policy also results in serious psychological problems for children and their parents. Therefore, the "no nit" policy should be abandoned and alternative ways of examination and treatment for head lice should be found."

Mumcuoglu, K., Meinking, T., Burkhart, C., and Burkhart, C. (2006, August). "Head louse infestations: the "no nit" policy and its
consequences." International Journal of Dermatology, 45 (8), 891-896.

Contributed by Michael Kalinowski

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