School Head Lice Policy

School head lice policy is a set of rules and guidelines designed to minimize transmission and incidence of head-louse infestation in school settings. Similar policies are implemented at summer camps, day care facilities, and other locations where large numbers of children come into close contact. The most well-known aspect of school head lice policy is the "no-nit policy". This policy bars children from attendance if they are found to have nits in their hair—a sign of head-louse infestation (pediculosis).

School head lice policy involves a number of issues:

• Circumstances under which children will be inspected
• Criteria to infer infestation
• Procedures for dealing with infested children upon discovery
• Criteria to permit previously infested children to return to school (e.g., the no-nit policy)

These issues are controversial. In particular, a number of health researchers and organizations object to the required removal of nits (i.e., the no-nit policy). Opponents to the no-nit policy point out that nits, being empty eggshells, have no clinical importance. Time-consuming nit removal, therefore, has no direct effect on transmission. This has led to the perception that the no-nit policy serves only to ease the workload of school nurses. Proponents of the no-nit policy counter that only a consistently nit-free child can be reliably shown to be infestation-free. That is, the presence of nits serves as a proxy for infestation status. Proponents argue that such a proxy is necessary because lice screening is prone to false negative conclusions (i.e., failure to find lice present on actively infested children).

Contributing to the controversial nature of school head lice policies is a lack of available data on their importance and efficacy. For example, as of 2008, the transmissibility of head lice in school settings is largely unknown. Further, control-matched studies of the effect of specific school policies on head lice incidence are also lacking.

Schools in developed countries such as the United States, Canada, and Australia commonly exclude infested students, and prevent return of those students until all lice, eggs, and nits are removed. Policies in the United Kingdom extend to legal action against parents of infested students. Attitudes in developing countries are often quite different. Many societies consider head louse infestation to be normal, if even remarked upon at all.