The Good Thing About Lice

The school year is back in swing and that means many of you will be discovering the joys of lice. I know, I know. How can there be anything good about lice? Here is how I turned it into a good thing for me.

1) My own children had it so many times in kindergarten and grade one that I decided to join the Lice Committee at their school.  It was the first way I got involved in my kids school and I liked meeting the other ladies that volunteered and the sense of community it gave me with the other moms.

2) Unlike other parent volunteer jobs in the school, this one really let me get to visit with kids. And a lot of them!  One by one, checking their heads (which is really rather personal and you feel a bit like a baboon going through another person’s heads with chop sticks), I got to have a little visit with the other kids in my children’s school. I knew kids by name and learned a little something about them so I could say “hello” on the school yard to so many of them.

3) I got very skilled at finding those little critters and their nits and differentiating them from hair casts and dandruff, so my own kids benefitted from my keen eye as I got better at “early detection.”  I got a reputation as being the “lice lady” and could offer my services to moms who wondered, “Is this a nit?” “Go ask Alyson to check your kids head!” Ah, nice to share my talents and help others. I was developing my “social interest,” as Adler calls it.

4) When my kids had to be treated and have their nits removed, it was a nice quiet time together, usually involving hot chocolate and watching a movie together and often missing a day of school. Any “exception to the normal day” was a bit of a treat for us both.  We made it an occasion.

5) When I was in the hallways doing the head checks, I could overhear the teachers in the classroom. This gave me a “peek” into various teaching styles that I never would have seen if I was “officially” visiting the class.  Who doesn’t act differently when there is a visitor in the class? So it was a good way to get to know the teachers of the school too. The good, the bad and ugly of that.

6) I learned a LOT about lice and could calm people’s fears. Lice like clean hair, not dirty hair, for example.  Yes, they are a hassle to deal with, but are they are not dangerous.  And yes indeed, the incident of infestation does drastically drop after about grade two.  I needed to see that for myself when it seemed a bit “perpetual” that first year.

So – if you get the note home saying, “Nits have been found in your child’s classroom,” don’t have a hissy fit.  Check their hair and don’t pass judgment on others. This is a part of the stuff of life and if you get a good attitude going, you can find the upside to anything.  Now shall we talk about pin worms? No – maybe not.

Brooklyn School Reports ‘Epidemic’ of Head Lice

The principal of an elementary school in the Sheepshead ‘Bay section of Brooklyn said ;yesterday that an outbreak of head lice and nits among the 'school's student body had reached “epidemic proportions” and was affecting school morale and instruction.

But City Health Department officials said the pediculosis at P.S. 255 at 1866 East 17th Street was not a serious problem.

“We, don't consider it a serious health problem,” said Dr. Alice Pitkin,director of school health. “It doesn't cause any functional health problem, doesn't incapacitate people or lower their health status.”

“Frankly I'm surprised,” said the principal, Saul Koren. “Parents are hysterical because they've never seen such thing.”

Attendance at the school has dropped from 90 percent. to 68 pereent, the principal said., There are 715 students in the school. At present 125 are released from classes because of lice infestation.

Some parents have kept students at home for fear they will become infected.

Mr. Koren said he had pleaded with Health Department officials for help in curbing the spread of the vermin after they were first discovered two weeks ago. "But my own boss, Chancellor Irving Anker, has not supported me,” he added.,

Mr. Koren said he had requested Health Department nurses to visit the school to check the heads of children sent home to cleanse themselves of lice.

“We had parents and teachers trying to check them initially.. but we were not trained to detect them because they come in different sizes,” said Mr. Koren. Sometimes, he added, youngsters with lice were readmitted to classes because they hai: notes from family physicians that said they were free of tile lice when, in fact, they were not.

Dr. Pitkin said the Health department had sent staff workers to the school with literature and instructions for parents. Parents have been told to use Quell and other prescription soaps.

In addition the school has been fumigated on two weekends—all 36 rooms on three floors, Mr. Koren said.

Though parents and the principal discussed closing the school on one occasion, they decided against it, Mr. Koren said. Mrs. Lenoir Rabinow, president of the school's Parent ‐ Teacher Association, said a parisitologist would be hired at parents’ expense.

Punish the Louse, Not the Child

A few years ago, I got a call from the children’s school. “I’m so sorry,” said the voice on the other end of the phone, “but we’ve found a live louse on [child].”

“Oh, no,” I responded. The school knew we’d been treating for lice — I’d alerted it earlier in the month. “Just one?” Yes, just one. The caller had looked for more but seen nothing. “We’ll have to treat her again tonight! Thanks.”

I hung up and went back to work. About 45 minutes later, the phone rang again. “Excuse me,” said the same voice, politely. “Are you going to come get [child]?”

Well, no, I wasn’t. It hadn’t occurred to me that one louse removed by the school was grounds for removing the child from the school. I was wrong, of course, very wrong (and any of my fellow parents will recognize immediately that I must have been a fairly young parent myself at the time). But the school in question had a firm, and common, policy: at any sign of head lice, the child is out.

Because policies vary, even in different schools within the same district, I can’t find hard numbers on how many schools will send home a student for the presence of lice or nits (lice eggs). Anecdotally, and based on a purely unscientific survey of friends, acquaintances and a few pediatricians, many (if not most) schools, like mine, ignore the recommendations of both the C.D.C. and the American Academy of Pediatrics. According to the C.D.C:

“Students diagnosed with live head lice do not need to be sent home early from school; they can go home at the end of the day, be treated, and return to class after appropriate treatment has begun. Nits may persist after treatment, but successful treatment should kill crawling lice. Head lice can be a nuisance but they have not been shown to spread disease. “

“But that’s a hard sell,” says Dr. Kenneth Wible, director of the pediatric care center at Children’s Mercy Hospitals in Kansas City, Mo. “I’ve had school nurses tell me that they don’t care what the research says. Their 30 years on the job tells them that if they leave children in the classroom with lice, they’re going to get more children with lice.”

Our lice odyssey lasted that entire school year; for a variety of reasons (inconsistency of treatment, the use of treatments to which many lice are now resistant, attempts to spread expensive treatments among several family members, and the sheer number of people infested in our household), we just couldn’t get rid of them.

It’s possible we were simply reinfected. It’s more likely that I missed a nit on my own head or that of my long-haired son, failed to do a timely retreatment, and the whole cycle slowly, inexorably, started again.

Over the course of that year, I learned firsthand what schools don’t tell you about those no-lice-no-nit policies: they incentivize parents to lie, or at least to sin by omission. What working parent would own up to lice when the result will be vigilant school officials ready to send a child home at the first sign of dandruff? In our case, those vigilant officials left one of my children in tears at the thought of school; every morning, before allowing her into the classroom, someone would part and search through her hair, and every teacher she came in contact with repeated the search throughout the day, leaving her miserable and self-conscious.

As the recalcitrant, failed parent, I have some feeling that I (although not my daughter) deserved all of that: how could I let the lice get such a hold, and how could we fail so consistently to get rid of them? I never knowingly sent a child to school or to a friend’s house with lice. But I stopped telling the school when we had found and treated them yet again, and I told the children to volunteer nothing. It’s fair to say that I should not have done either. A better person would have both been able to more quickly defeat the problem, and would have owned up every time in order to allow other parents (somewhere out there lay the source of our lice; I cannot be blamed for everything) to check their children’s heads.

After reaping the harvest of that first honest report, I kept quiet. We learned to comb better, we learned to treat the children at least twice, and we learned to braid the girls’ hair very tightly before sending them off to school. Dr. Wible agreed with me that the best response is a treatment immediately and one in just over a week to kill any newly hatched lice. (No treatment has been proved to completely kill or remove the nits that hatch in about that amount of time.) As for products designed to prevent lice from settling on your child? I admit it, I bought some. An expert I spoke with in reporting last year laughed, and offered to sell me a magic spell that he guaranteed would be just as effective.

The Art and Science of Nit-Picking

Back in the early 1980s, I was delighted when the elementary school in my town let me know that I had been hired as the school nurse. Not only would I have a new challenge, but after many years of working as a registered nurse in hospitals, I would no longer have to work evenings and nights.

I loved my new job at the school. My charges were, for the most part, healthy, active youngsters who came to me with scraped knees, bloody noses, tummy aches, poison ivy and the like. Soon I had won their hearts with my pain-free technique of splinter removal.

Of course, there were trying days. In our small, enclosed world, colds and viruses spread quickly. During the winter months my tiny office would be inundated with coughing and sneezing children, and I became very busy checking throats, taking temperatures and wiping small noses.

But cold season was nothing compared with the moment when a teacher would stop me in the hall and say, “Susie’s been scratching her head all morning.” At once I would investigate Susie’s dark brown curls to find tiny, silvery nits, soon to become dark brown six-legged creatures.

School policy dictated that I call Susie’s mother to take her home lest she infect her classmates, which she already had. Soon I had a list of more calls to make, my least favorite chore in the world.

I braced myself for the reactions. Some parents were angry, and it would turn into a shoot-the-messenger kind of day. Others felt guilty and were embarrassed — even horrified. I knew how they felt. I had three children myself and had vivid memories of long, dreary nights fine-combing their hair.

When the parents arrived, I had to hand them a long, green form with the grim title: “Instructions to the Parent of a Child Sent Home With Pediculosis.” The steps included washing the child’s hair with a special shampoo, removing all nits with a fine-tooth comb, cleaning all sheets and pillowcases, airing out toys and mattresses, and so on. The list ended with a stern warning: “The school has a nit-free policy — all nits must be gone before the child can return to class.”

As the grim-faced parents arrived, the principal barricaded himself in his office, his sensible reaction to a public relations disaster. Only the children were unperturbed. “I have head lice,” they announced proudly to their classmates as they packed up to go home.

Every September as children returned from summer camps and sleepovers, our school would have an outbreak of lice. I tried to get a head start on the problem. I studied the literature, which was voluminous and overwhelming. There were reams of advice from dermatologists, school nurses, infectious-disease experts: “Be proactive,” “Prevention is the key,” “Screen all the children in the school.” Even the psychologists weighed in. “Avoid alarming the parents,” they warned. I read and read until my head ached.

So on the first days of school, magnifying glass in hand, I scrutinized 300 small heads. I lectured the children: Never share combs, brushes, hats, hair, ribbons, bike helmets. I sent memos to the parents. “You are the first line of defense,” I wrote. “Check your child’s head vigilantly. Be alert to symptoms — investigate at once if your child starts scratching her head.” What I wanted to write but could not was, “Please, please, never send your child to school with full-grown creatures romping through her head,” as one mother once did.

Despite all my efforts, the outbreaks continued unabated. In my own small way I had confirmed the findings of researchers at the American Academy of Pediatrics, who concluded that screening programs do not have a significant impact on the incidence of head lice. Each year the lice grew bolder and more robust, breaking my heart and even confounding Big Pharma as they became resistant to the killer shampoos.

I’m retired now, but I keep a professional eye on what’s happening with the pediculosis establishment. “No-nit policies for return to school should be abandoned,” said the American Academy of Pediatrics in a groundbreaking statement in 2010. The National Pediculosis Societyfired back, militant in its faith in no-nit policies. What’s a parent to do?

 I’ll still be watching the head lice battles from the sidelines, silently cheering all the parents who search in vain through shining tresses for the one that got away.

The Bugs Sharing Your Home (Get Out a Calculator)

Humans share their homes with hundreds of species of flies, spiders, beetles, lice and other arthropods, a new study reports.

Researchers visited 50 houses within 30 miles of Raleigh, N.C., and collected all of the arthropods they could find. They found 579 different morphospecies — meaning they were all physically different — from 304 different families.

The study, which appears in the journal PeerJ, found there were more than 100 species per house.

One arthropod found in all homes was the gall midge, a fly just four-one hundredths of an inch long. Although gall midges live only outdoors, they are probably blown often into homes, said Michelle Trautwein, an entomologist at the California Academy of Sciences and one of the study’s authors.

She and her colleagues also found many booklice, harmless cousins of head lice. “Basically, we are all are living with lice,” Dr. Trautwein said.

Although many different arthropods were found, most were benign.

“The vast majority of the arthropods we live with are not pest species,” Dr. Trautwein said. “They are not going to suck your blood, eat your food or destroy your house.”

To do their study, the researchers crawled around homes wearing kneepads and head lamps, and used forceps as well as an aspirator to suck up samples that they later studied under microscopes.

The scientists are now expanding their study to include homes on all seven continents.

“We’re aiming to find out more about arthropods in different kinds of houses and in different climates,” Dr. Trautwein said.

The Meaning of Lice

Here we are, my husband, daughter and I, sitting in beauty parlor chairs, our heads slathered in fluffy blobs of hair conditioner mixed with baking soda while a stalwart woman unflinchingly scrapes our scalps with tiny combs. After eight hours of this, we’re getting hungry, and begin looking through a stack of delivery menus. We’re thinking Mexican or Thai.

We call this the Lice Place, and we have come here because a gang of the tiny insects was found on the head of a child in my daughter’s second-grade class. A respectable head disinfecting establishment, the Lice Place is nonetheless understandably hidden behind a storefront cheerfully disguised with a flowery-decal-laden door. Lice are notoriously hard to spot and even harder to remove, so we are here, rather than home, for an expert examination — and really because I am insect phobic. It’s true that a fear of something most people find disgusting invites very little sympathy or understanding — unlike say a fear of the color yellow, bookcases or cheese — but I understand the severity of my own issue perfectly. So I outsourced the solution.

Our diagnosis: mother and child both had those little critters in their hair. Apparently they had been merrily mating and giving birth on our heads as we bobbed around town focused on our thoughts and not the community taking shape above them.

All this makes me think of Jane Goodall. She was a heroine of every schoolgirl I know from my generation — a passionate scientist who followed her heart to study primates in the jungle, and the star of several grainy science films of my youth. I remember my friends and I watching these films, our mouths open, smug teenagers begrudgingly awed, as she hid behind a tree or a rock, whispered provocatively off-camera, and in turn watched her beloved chimpanzees picking at each other’s fur, looking for tiny insects and then eating them. These were beautiful scenes of calm companionship, the image of communal living at its best.

So why didn’t this feel as lovely?

Another family comes into the Lice Place. The father looks at us, looks away, then looks at us again with an expression of embarrassed, grossed-out friendship. We strike up a conversation. We learn that his daughters go to a fancy girls’ prep school and I can’t help feeling pretty great about this. Clearly this is not a scourge of low lives. In fact, it is a point oft-mentioned, lice are especially drawn to clean hair. We cling to this fact as stickily as those lousy eggs cling to our locks. We talk about soccer and how to suffocate a nit, while his girls read Shakespeare.

As I sit in my beauty chair, I consider an article I read recently in The Times. The headline asked: Should Americans Fear Their Furniture? What followed was an interview with documentarians who had just finished a film on all the toxic chemicals contained in pretty much every piece of upholstered furniture made since 1975.

I suppose this should not be shocking to me. All the old familiar comforts of American life have been found to be deadly. Apples bathed in pesticides. Chickens fed a steady diet of chemicals. Wheaties and Cheerios laden with G.M.O.s. A mother and daughter leaning their heads together over “Charlotte’s Web” may have always imparted a faint stirring of agita. But now that copy of “Charlotte’s Web”? The one from the library? It could totally have bedbugs.

My daughter suffers the indignities of head lice removal with a stoic silence. My husband and I suffer the indignities of the bill a little less bravely. It turns out that the cost of eight hours of vigilant attention to every strand on an entire family’s collective head could get you a studio apartment in Williamsburg for about two weeks.

We ditch the delivery menus and decide to go out to dinner instead, maybe get a little air. The Lice Place had not covered us in the cloaks that are a staple at a normal hair salon (I think we were all too chastened to ask), so we walk stiffly down the street, covered in the blotches and splotches left by those soft clouds of hair cream and baking soda that flew around us like we were in some really unappealing snow globe.

We knew it was a short break because there was much more work to do. The bagging of pillows. The dry cleaning of duvet covers. More time and money to spend on getting back to normal. Not to mention the moral duty to tell your child’s close friends’ mothers that they are at risk.

And ah, the dilemma — with whom can I laugh about this? The friends who get to find out are in the small, precious category of close enough to get it, nice enough not to judge, sturdy enough not to feel threatened. Those to whom I don’t need to mention that lice are especially drawn to clean hair.

We sit quietly at the restaurant, reminded that no matter how well ordered our lives, havoc can break loose. No matter how much we think we are embracing the natural world (munching on organic kale, suffering under unflattering environmentally friendly light bulbs), that world can turn against us. No matter how good the school, how well read the parents, things can get primal. And no matter how sweet the tendril of hair gently curled on your daughter’s neck on a warm spring day, the fact remains — that tendril can turn quickly icky.

It is only lice. So blessedly minor. But it all highlights nonetheless the randomness of misfortune, the fragility of life, how nature can still turn overly intellectualizing and technologically shielded humans into vulnerable, helpless creatures. It reminds me of death.

It reminds me to feel joyous while I can.

We eat.

Your Child Has Lice? Spread the Word.

Prepare yourself. Starts with L. Makes your head itch. … Lice. The mere word sends tingles up the scalps of parents across the country. It should. Because in the battle of exhausted parents versus lice, it feels as if the lice are winning.

Treating lice is an unpleasant, time-consuming job. Sadly, it’s a job many parents are forced to add to their already busy schedules. The Centers for Disease Control and Prevention estimates that 6 to 12 million infestations occur each year in the United States among children 3 to 11 years of age.

We can give one another a fighting chance at defeating (or better yet, avoiding) the enemy if we not only treat lice, but destigmatize them. Unfortunately, in addition to their own excellent hiding and reproductive skills, lice are frequently accompanied by a cloud of shame and secrecy. And while that’s good for lice, it’s not good for us. We have to talk about lice, a whole lot more than we currently do.

I’ll start. My name is Kristin, and I’m a lice survivor. Our first time we went nuts — donned our hazmat suits, washed every sheet daily for two weeks and kept quiet. I was embarrassed. That’s all I knew to do, until one mom shared her family’s lice story on the school Listserv. She not only built awareness about lice in our school, but she also showed us that information was power. Because the more we talked about lice, the fewer cases there seemed to be.

I’ve been yapping about lice ever since. My suggestions for communities battling lice:

1) To the parent whose child has lice: 

We feel your pain. Now, please do the following: Treat it, and talk about it. Tell your kids that anyone can get lice; it’s nothing to be ashamed of. Let friends’ parents know so they check their children. And please, talk to teachers and school nurses, so they can be aware that a lice infestation is present in the school.

Schools with strict “no nits” policies unintentionally discourage this: Parents who fear missing work or their kids missing school treat as best as they can and hope no school official’s eyes are sharper than theirs. But here’s the problem: If you indeed missed some lice/nits, you put an entire classroom at risk of getting lice. And then your kid might cycle back through in a few months. Report the lice, please. It’s in the interest of all kids, including yours.

2) To the schools that have at least one case of lice: 

Tell us. Please. Some parents say their schools won’t notify parents of lice infestations until a certain threshold of multiple lice cases is reached. Schools that share detailed information on how to both prevent and treat lice — beginning with the first known case — may prevent many future cases. Educate us; don’t wait. And please, be proactive in helping repeat cases find the extra help they need to get rid of lice.

3) To the parents who get the lice note from school or the call from a friend’s parent: 

Say thank you, then get to work. Yes, it’s natural to want to groan. But remember, you’ve been given useful information. Knowing about lice leads to both prevention (have girls wear long hair pulled back; don’t share hats) and early intervention. Immediate and thorough comb-outs can mean catching the one and only louse. That’s far preferable to meeting her entire extended family a week later.

I think we can all agree that no one is pro-lice, though school and health organizations disagree on school lice policies. Strict “no nits” policies are opposed by the C.D.C. and the National Association of School Nurses and supported by the National Pediculosis Association and some school districts, including mine (for the record, we still have plenty of lice). But whichever school policy you support, the fact that our country has up to 12 million cases a year says we need to do more in our battle against lice. 

Here’s what doesn’t work: advocating secrecy and treating lice infestations as though they’re shameful. If we want to prevent the spread of lice, we need open and frequent communication from parents and schools. Because the less we talk about lice, the less likely we are to rid ourselves of a really annoying bug. 

Dealing With Lice Is Political Hot Potato For School Officials

No nit and no lice policies are imprudent, as they are based on misinformation, hysteria and intolerance rather than on science. The discovery of lice or their eggs on students should not cause them to miss school.

Exclusionary policies for lice were adopted early in the last century when body lice and infections they transmitted caused global epidemics. More recently, body lice and head lice were recognized as distinct in their biology, epidemiology, medical and public health significance. Body lice can spread disease but are restricted mainly to indigent adults. Head lice, which do not spread disease, are relatively trivial and serve as occasional nuisances that mainly affect young children. They do not cause epidemics.

Exclusionary policies are so entrenched that most folks believe they must be necessary and effective. Inertia is a strong force, and any effort to even suggest changing the policies is met with vigorous resistance by a misinformed, aggressive and highly vocal minority. The result is a political hot potato that causes angst among school administrators. Those who seek to pursue policies based on science and evidence-based practice tend to relent to the intense pressure and venom hurled by dissenting parents. 

Louse exclusion policies are discouraged by the American Academy of Pediatrics, the National Association of School Nurses and by the Centers for Disease Control and Prevention. Many school systems have consequently eliminated or modified their procedures. Instead of the feared epidemics, the change has resulted in relative calm, greater emphasis on education, fewer unnecessary absences and treatments, and cost savings for parents and schools. Kids will continue to have lice regardless of a school's policy, be it no nit, no live lice or one that says "all kids are welcome." 

The New York City Department of Education and Department of Mental Health and Hygiene were leaders in 2007 when they replaced their no-nit policy with a no-live-lice strategy. The next step, allowing children even with live lice to stay in the classroom, is long overdue.