Statewide policy in Missouri no longer requires school nurses to check every student for lice and children with nits or lice are not sent home from school. The state government policy on its web site follows the guidance of the American Academy of Pediatrics and is stated as, “Head lice infestations are common in school settings. Transmission occurs by direct contact with the head of another infested individual. Indirect spread through contact with combs, brushes or hats is unlikely.
Head lice are often diagnosed in schools, but transmission usually occurs at home or in the community. The presence of nits reflects an infestation of weeks to months. Classroom and school-wide routine screenings are not shown to be cost-effective or effective in reducing head lice infestations over time. Head lice do not carry disease, and therefore otherwise healthy students should not be excluded from school attendance because of nits or lice. (American Academy of Pediatrics, School Health Policy and Practice, 2004)
Local district procedures should include:
- Description of school and community education regarding diagnosis, treatment, and prevention of head lice. This should include information sheets in different languages, and the availability of visual aids for families with limited language skills.
- Procedure for screening selected groups of students when there is evidence of more than a few cases in a classroom.
- Procedure for notifying parent(s)/guardian(s) of the presence of nits and/or live lice. Parent(s)/Guardian(s) should be notified, but students should not be excluded from school or from bus transportation. Students with live lice should be asked not to return to school the next day until treated..”
For the complete Missouri Manual on School Health, visit www.health.mo.gov
St. Joseph School District School Lice Policy
In St. Joseph County, schools follow the Missouri state recommendations and do not have a “no nit” policy. The policy is stated, “In keeping with the Lexington R-V School District’s policy of avoiding the unnecessary exclusion of students from school, the district will not exclude otherwise healthy students from school due to nit infestations. Students with head lice infestations will be excluded from school only to the minimum extent necessary for treatment. To avoid the unnecessary exclusion of students from school, the administration provides the following procedure:
- Schools will not perform routine school-wide head lice screening. However, should multiple cases be reported, the nurse will identify the population of students most likely to have been exposed and arrange to have that population of students examined.
- If the school nurse or teacher discovers head lice or nits on a student, the parent/guardian of that student will be notified, and other students who reside with the infected student will also be checked.
- The school nurse will instruct the parent/guardian concerning various shampoos, sprays and other appropriate treatments that can be purchased to eliminate head lice or nits and will also give information concerning necessary procedures to be taken in the home to ensure that the head lice are eliminated.
- If the student was infected with live head lice, the student should not return to school for 24 hours after the discovery of the head lice to allow for treatment.
- When a student who had a live head lice infestation returns to school, the student will be examined by the school nurse. If live head lice are found at that time, the parent/guardian will again be called and reinstructed concerning treatment. The student will be excluded from school for 24 hours to allow for additional treatment. This process will continue until the student is free of head lice.
- A student who was identified as having nits but not a live head lice infestation will be re-examined within five (5) calendar days of the initial identification. If this examination reveals nits are still present, the parent/guardian will again be instructed on treatment options. This process will repeat until the student is free of nits.
- The school nurse will keep accurate and confidential records of students infected with head lice or nits.
- If it appears the parent/guardian of an infested student is failing to secure timely treatment for the infestation after having been given notice of the existence of head lice or nits in accordance with these procedures, the nurse will notify the school principal, who may report the matter to the Children’s Division (CD) of the Department of Social Services.
The school nurse will develop education programs regarding the diagnosis, treatment and prevention of head lice for staff, students, parents and the community.
St. Joseph school district head lice procedures official documentation can be found here: www.sjsd.k12.mo.us
Lee’s Summit Schools Lice Policy
If the school nurse or designee should identify a student with an active case of head lice (which is defined as live lice or nits within a quarter inch of the scalp). The parent/guardian will be notified that student needs to be removed from school.
The policy continues:
“All siblings of the affected student will also be screened, including siblings at other buildings within the district. The school nurse or designee will discuss the need for notification of parents/guardians of other close contacts to be made by the affected student’s parent/guardian…To be readmitted to school, students in grades preK-6th must be accompanied to school by a parent/guardian or relative and must be examined by the school nurse or designee. It is permissible for secondary students to check in with the health room for readmission on their own, prior to attending class. The student will be readmitted if there are no live lice, no nits within ¼ inch of the scalp and there is visible progress that treatment has been initiated. Within 6-10 days after being readmitted to school, the student will be screened again by the school nurse or designee.
If live lice or viable nits are found within a quarter inch of the scalp at that time, the parent/guardian will be notified and student will be removed from the school nurse or designee will maintain accurate records of student’s identified with headlice/nits for communicable disease reporting and monitoring effectiveness of treatment. Classroom screening will not be done when a case of head lice is identified. The decision to send home communication to parents/guardians regarding head lice in a specific classroom, grade level, or school, will be at the discretion of the building nurse in collaboration with the health services coordinator.
If it appears the parent/guardian of an infested student is failing to secure timely treatment for the infestation after having been given notice of the existence of head lice or nits in accordance with these procedures, the nurse will notify the school principal, who may report the matter to the Children’s Division (CD) of the Department of Social Services.”
According to Amy Wald, Health Services Coordinator for the district, the policy is far more lenient that it was 2 years ago when a change was made away from the former “no nit” policy. Too many children were missing too much school. Now that the district allows students with some nits to remain in school, there has not been an increase in the incidence of head lice according to Ms. Wald.
Lee’s Summit schools revised head lice policy can be viewed at www.leesummit.k12.mo.us
Not all schools in the Kansas City area follow the state’s recommendations!
Blue Springs School District
Blue Springs schools retain a “no nit” policy. According to the district web site, “Students who have an active head lice infestation will be excluded from school. Parents will be notified immediately when an infestation is confirmed and treatment options will be discussed at that time. Students may be allowed to return to school after it has been determined by school health personnel that proper treatment has been completed and no further evidence of active lice infestation exists.”
While there is a variation in policies in the Kansas City area, school districts tend to be revising policies toward the more lenient bias that is stated on the Missouri state government web site. It is important for you to check your school district’s policy to be sure you are familiar with the criteria.Learn About Our Kansas City Lice Removal Service