Head lice: notes and guidance for head teachers

General

Please read this Statement carefully. You may worsen the problem in your school if you are under the same misapprehensions as many of your parents.

Head louse infection is not primarily a problem of schools but of the wider community. It cannot be solved by the school, but the school can help the local community to deal with it.

Head lice are only transmitted by direct, prolonged, head-to-head contact.

Transmission of lice within the classroom is relatively rare. When it does occur, it is usually from a "best friend".

Head lice will not be eradicated in the foreseeable future, but a sensible, informed approach, based on fact not mythology, will help to limit the problem.

At any one time, most schools will have a few children who have active infection with head lice. This is often between 0% and 5%, rarely more.

The perception by parents and staff, however, is often that there is a serious "outbreak" with many of the children infected. This is hardly ever the case.

The "outbreak" is often an outbreak of agitation and alarm, not of louse infection; a societal problem not a public health problem.

Specific

Do have a written protocol on the management of the head louse problem, based on the Statement and this Appendix. If possible, agree a protocol for your area in consultation with the Local Education Authority, the local Consultant in Communicable Disease Control, Infection Control Nurses, the School Nurses, and, if appropriate, your colleagues in other schools.

Do make sure that your school nurse is informed in confidence of cases of head louse infection. The school nurse will assess the individual report and may decide to make confidential contact with the parents to offer information, advice and support.

Do keep individual reports confidential, and encourage your staff to do likewise.

Do collaborate with your school nurse in providing educational information to your parents and children about head lice, but do not wait until there is a perceived "outbreak". Send out information on a regular basis, preferably as part of a package dealing with other issues.

Do consider asking your school nurse to arrange a talk to parents at the school if they are very concerned. Be present yourself and encourage your staff to attend; they are just as likely to be misinformed about head lice as the parents. You may prefer to arrange a separate talk for the staff.

Do ensure, with the school nurse, that your parents are given regular reliable information, including instructions on proper diagnosis by detection combing, the avoidance of unnecessary or inappropriate treatments, and the thorough and adequate treatment of definitely confirmed infections and their contacts using an insecticidal lotion.

Do advise concerned parents to seek the professional advice of the school nurse, the family practice, or the local pharmacist.

-- o 0 o—

Do not send out an "alert letter" to other parents.

Do not exclude children who have, or are thought to have, head lice.

Do not recommend or support any mass action, including wet combing campaigns.

Do not agree with angry parents that routine head inspections should be reintroduced. They were never effective.

Do not refer parents directly to the Consultant in Communicable Disease Control. The appropriate clinical advisors are the school nurse, the local pharmacist, the health visitor, and the general practitioner.

Do not take, or support, actions simply "to be seen to be doing something" (such as sending out "alert letters").

(This document was originally appendix 4 of Head Lice: a report for Consultants in Communicable Disease Control (CCDCs).)

	Please read this Statement carefully. You may worsen the problem in your school if you are under the same misapprehensions as many of your parents.
	Head louse infection is not primarily a problem of schools but of the wider community. It cannot be solved by the school, but the school can help the local community to deal with it.
	Head lice are only transmitted by direct, prolonged, head-to-head contact.
	Transmission of lice within the classroom is relatively rare. When it does occur, it is usually from a "best friend".
	Head lice will not be eradicated in the foreseeable future, but a sensible, informed approach, based on fact not mythology, will help to limit the problem.
	At any one time, most schools will have a few children who have active infection with head lice. This is often between 0% and 5%, rarely more.
	The perception by parents and staff, however, is often that there is a serious "outbreak" with many of the children infected. This is hardly ever the case.
	The "outbreak" is often an outbreak of agitation and alarm, not of louse infection; a societal problem not a public health problem.

	Do have a written protocol on the management of the head louse problem, based on the Statement and this Appendix. If possible, agree a protocol for your area in consultation with the Local Education Authority, the local Consultant in Communicable Disease Control, Infection Control Nurses, the School Nurses, and, if appropriate, your colleagues in other schools.
	Do make sure that your school nurse is informed in confidence of cases of head louse infection. The school nurse will assess the individual report and may decide to make confidential contact with the parents to offer information, advice and support.
	Do keep individual reports confidential, and encourage your staff to do likewise.
	Do collaborate with your school nurse in providing educational information to your parents and children about head lice, but do not wait until there is a perceived "outbreak". Send out information on a regular basis, preferably as part of a package dealing with other issues.
	Do consider asking your school nurse to arrange a talk to parents at the school if they are very concerned. Be present yourself and encourage your staff to attend; they are just as likely to be misinformed about head lice as the parents. You may prefer to arrange a separate talk for the staff.
	Do ensure, with the school nurse, that your parents are given regular reliable information, including instructions on proper diagnosis by detection combing, the avoidance of unnecessary or inappropriate treatments, and the thorough and adequate treatment of definitely confirmed infections and their contacts using an insecticidal lotion.
	Do advise concerned parents to seek the professional advice of the school nurse, the family practice, or the local pharmacist.

	Do not send out an "alert letter" to other parents.
	Do not exclude children who have, or are thought to have, head lice.
	Do not recommend or support any mass action, including wet combing campaigns.
	Do not agree with angry parents that routine head inspections should be reintroduced. They were never effective.
	Do not refer parents directly to the Consultant in Communicable Disease Control. The appropriate clinical advisors are the school nurse, the local pharmacist, the health visitor, and the general practitioner.
	Do not take, or support, actions simply "to be seen to be doing something" (such as sending out "alert letters").