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School Policies on Head Lice May Be Overkill

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"Our study confirms that few children (18%) with nits became infested over the follow-up period," says Williams. "Based on these findings we suggest that children with nits and no crawling lice be followed and examined regularly, rather than be excluded from school. Additionally, in the absence of signs of crawling lice, we suggest that children with nits alone not be treated with medication, but rather followed and nit removal encouraged."

At the time he performed the study, Williams was with the Epidemic Intelligence Service in the Division of Applied Public Health Training at the CDC, as well as with the Georgia Division of Public Health, both in Atlanta. He is now a lecturer in Internal Medicine at the University of Michigan in Ann Arbor.

Two experts, Richard J. Pollack, PhD, and Anthony E. Kiszewski, DSc, tell WebMD that there are some problems with the study, notably that it's not clear whether the children with nits went on to develop lice because of an ongoing infestation or because they caught a new set of lice from contact with friends of siblings.

However, they do agree with the conclusions of the study regarding how to handle head lice in schools. Pollack is an instructor in immunology and infectious diseases and Kiszewski is a research associate in the department of immunology and infectious diseases, both at the Harvard School of Public Health in Boston.

Pollack's recommendations for getting rid of head lice are the following:

  1. Be sure your child has live lice in his/her hair. Do not treat a child unless you see bugs walking around on the head. Children with only nits should be reinspected a week or so later.
  2. Use a fine tooth louse comb combined with an over-the-counter medicated shampoo to get rid of live lice. If you still see live lice a few days later, treat again.
  3. If you still see live lice after these two treatments, visit your doctor, who can prescribe a stronger remedy.
  4. There is no need to clean your house if someone in the household has lice. The most you need to do is throw the pillowcases and stuffed animals of the affected person in the dryer.

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