CUSD’s head lice policy is not supported by science

Recently, our family has had the opportunity to experience first-hand the Cabrillo Unified School District’s "no-nits" policy toward head lice.

The policy is broken.  Not only does it impose needless misery and expense on district families, it’s unsupported by scientific, medical or public health evidence.

Under the policy, no child will be admitted to school if there are nits (head lice eggs) present in the child’s hair. While no-nits policies are common among school districts, they are universally opposed by the very public health and medical organizations cited in the district’s policy: the Centers for Disease Control and Prevention, the California Department of Public Health, American Academy of Pediatrics, National Association of School Nurses, and California School Nurses Association.

The life cycle of a louse

The good news is that a couple of weekly treatments will kill any lice that hatch before they are mature enough (eight days old) to lay more eggs.

But there are no medications that can remove nits. Nor can hours of combing remove all the nits. Nits have evolved to stay cemented to a person’s hair. They can be tediously removed if they can be found, but only if you inspect every side of every single hair on the child’s head. There is a reason why nit-picking has become a metaphor for the futile pursuit of trivial outcomes.

That is why a no-lice policy is effective and a no-nits policy is no improvement.

The district’s cure is worse than the disease

The district’s no-nits policy causes unnecessarily lost school days. But most of the misery happens at home, away from the school.

The policy almost certainly results lost income and increased expenses for many Coastside families that work two jobs and cannot afford to pay for childcare.

Even more hidden is the unnecessary misery the district’s policy creates for parents and children.

I’ve seen parents discussing ineffective folk remedies, and futilely coming their childrens hair for hours in a vain attempt to remove nits. We have no idea how many have been driven out of desperation to overuse anti-lice medications.

Only the CUSD board can solve this problem

Because the no-nits policy was adopted by the district board last December, only the board can reverse the policy. I spoke to the board meeting Thursday night about why it must reverse the policy and I’m trying to get the board to put this on the agenda of its next meeting. 

Because the board only meets once a month, it’s critical for the board to strike down this prejudicial, punitive, and unscientific policy at its next meeting.

I know that the board is dealing with much weightier matters right now. But this is an opportunity for them to solve a serious district problem quickly and simply.

Follow the link for quotes from the CDC, California Department of Public Health, California School Nurses Association, and American Academy of Pediatrics saying why they oppose this policy.

Centers for Disease Control and Prevention

"No-nits" policies that require a child to be free of nits before they can return to school are not recommended. Children should be permitted to return to school or child care after appropriate treatment is started. Head lice can be a nuisance but they have not been shown to spread disease.

California Department of Public Health

There is no evidence that a no-nit policy prevents or shortens lengths of outbreaks (Pollack et al., 2000, Williams et al., 2001). The American Academy of Pediatrics, the National Association of School Nurses, and the Centers for Disease Control and Prevention are all opponents of classical no-nit policies (Frankowski and Weiner, 2002; Schoessler, 2004). In light of current research, CDPH now recommends a no-lice policy.

California School Nurses Association

Research and the literature do not support school exclusion for pediculosis. Because no disease process is associated with pediculosis, schools are advised to not exclude students when nits remain after appropriate lice treatment. However, further monitoring for signs of re-infestation is appropriate and recommended. Presence of nits does not indicate active infestation and there is no evidence that presence of nits correlates with any disease process. Other studies show that lice are not highly transferable in the school setting and no increase in outbreaks of lice resulted from allowing children with nits to remain in class. The California Department of Health Services does not support "No Nit" policies.

American Academy of Pediatrics

A child should be allowed to return to school after proper treatment. Some schools have had "no nit" policies under which a child was not allowed to return to school until all nits were removed. The American Academy of Pediatrics and the National Association of School Nurses (www.nasn.org/positions/nitfree.htm) discourage such policies.