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An itchy situation: Not all parents on board with DOE’s handling of head lice

Hawaii Tribune-Herald - 8/21/2017

KAILUA-KONA - With a new school year kicking off, some parents say they aren't fans of state guidelines, based on federal recommendations, that let kids found to have head lice, or ukus, return to school right after treatment has started.

The Department of Education doesn't have a specific policy about ukus, said DOE spokeswoman Lindsay Chambers, but the department's recommended procedure follows guidelines from the Centers for Disease Control and Prevention and the state Department of Health, both of which advise that students diagnosed with live lice don't need to be sent home early from schools.

Instead, students can go home at the end of the day and return to class once treatment begins.

The CDC cites the American Academy of Pediatrics and National Association of School Nurses, which advocate against "no-nit" policies, which prevent kids from returning to school until they are free of nits or eggs. The American Academy of Pediatrics has argued that such policies "are unjust and should be abandoned." The CDC grounds their position in the unlikelihood of transferring nits and the burden of absenteeism to students and families.

Chambers said with the positions of CDC and DOH in mind, public schools "have come up with a new procedure that doesn't exclude students from learning."

The guidelines for schools are a continuation from the previous year. Last August, the Department of Education and Department of Health partnered to release guidance that said ukus "should not be a reason for children to miss school or be shunned," and that ukus don't transmit disease.

That guidance also indicated that school health practices call for an inspection of a student who might have ukus and, if confirmed, the parent or guardian will be notified. The child will then return to class until the end of the school day unless the parent chooses to take the kid home early to begin treatment. Information on home treatment is also provided to the parent or guardian.

"We understand parents' concerns," Chambers said, "and our schools will continue to monitor students and custodians will be diligent and treat classrooms where there may be a case of head lice."

But not all parents are on board.

"I'm not in agreement with that," said Monika Stafford after hearing DOE's recommended procedure

Stafford said she thinks the treatment process should be entirely completed before children are able to return to school, likening it to other contagious infections like chicken pox.

"A parent could start something and not finish it," she said.

She said it's not just other students she'd be concerned about getting exposed to lice, but also teachers.

She wasn't the only parent concerned about the policy.

Mele Lopes, who has a son in high school, said she didn't know the DOE guidelines are what's actually in place.

She said she thought it was better to keep students home until they are treated.

"That would be a better solution, yeah?" she asked.

Chambers noted that under the DOH and CDC recommendations, parents will still be contacted if their child is found to have head lice, and will have the option to pick them up immediately for the start of treatment or when school lets out.

"We encourage parents to treat it," she said. "If they don't know how, they can reach out to their schools."

Treatment often uses a specific medicine aimed at killing lice, which may or may not also target the eggs, according to the CDC.

Retreatment is often recommended for medications that either weakly or don't affect eggs, the CDC said, while stronger medications only require retreatment if live lice are present several days after treatment.

Barrie Desmond, who owns a Lice Clinics of America clinic in Maui, said parents can run into the issue of ineffective over-the-counter treatments.

After her own daughter contracted ukus last year from summer camp, Desmond said she was seeing "tons of misinformation" about ukus and how they could be treated.

Chemical treatments, she explained, sometimes use insecticides like permethrin, which lice in many areas have developed resistance against.

Similar efforts to get rid of lice can be equally ineffective, she added, when parents don't follow the proper procedure for treating them.

Desmond said that in lieu of the chemical measures that might not be 100 percent effective, she "wanted to try and find something that would be guaranteed."

Her own clinic uses the AirAlle, a device that uses heated air to get rid of not only the lice, but also dehydrate the eggs with a 1-hour treatment.

The Department of Education also has some tips for managing ukus, such as checking kids' hair weekly and treating any ukus or nits found promptly. It also advises parents to consider keeping kids' hair slicked back or tied up to reduce the risk of transmission.

Desmond also made a note of emphasizing prevention.

"I think the first thing that we stress is education," she said.

Near the top of the list, Desmond said, is tying up long hair into a braid or a bun as a way to limit the opportunity for lice to spread.

She also stressed the importance of parents educating their children about refraining from sharing brushes or hats as well as not touching heads.


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