SIKESTON -- Just the mention of head lice can often make a person's head begin to itch, but every year when school begins, there's always students who end up contracting the condition.
Already a month into the new school year, most area school nurses say head lice isn't a large problem amidst the student population, but it is an ongoing issue throughout the year.
"We don't have a problem here, but head lice is always going to be a problem in schools," said Sikeston R-6 nurse coordinator Nikki Vaught.
At Sikeston R-6 elementary schools, students are checked for head lice the first full week of school, and then again after each long holiday weekend, Vaught said.
Like most schools, Sikeston has in place a "no-nit policy," which means if found with a nit or live louse, students must go home and be treated.
"It can become educational neglect if kids are out of school very long," Vaught noted.
New Madrid Elementary school nurse Lura Jones said she sends out memos to teachers at the beginning of the school year, reminding them to watch for warning signs of head lice throughout the school year. New Madrid also has a no-nit policy in place.
"If they see any excess scratching from children, they'll send the child to me immediately, and I'll check and recheck to make sure that it doesn't get out of hand," Jones said.
The condition is contracted from scalp to scalp by using someone else's brush or comb, wearing hat or helmet, from coats, chairs or bed linens, Vaught said.
And there's really no specific time or reason it occurs, Vaught said.
"It's just a matter of being in the wrong place at the wrong time," Jones agreed. "It has nothing to do with how dirty or clean a person is, how they fix their hair or whether they take a bath everyday."
In 2002, the American Academy of Pediatrics made recommendations for dealing with head lice in schools. The AAP says no healthy child should be excluded from or allowed to miss school because of head lice, and that "no-nit" policies for return to school should be discouraged.
According to the AAP, because a child with an active head lice infestation has likely had the infestation for a month or more, by the time it is discovered and because the child poses little risk to others and does not have a resulting health problem, he or she should remain in class, but be discouraged from close direct head contact with others.
However, most schools still follow the no-nit policy.
"The thing is it's not a problem to get it -- the problem is having to get rid of it," Jones pointed out. "It's a major expense, and that's not counting the time it takes to remove the nits. You have to comb through an inch of hair at a time and go through each section."
When checking students, Jones uses a gooseneck lamp -- and it works, she said.
"When I walk into the classroom with gooseneck lamp, the kids say 'it's that time again," Jones said.
Normally Jones checks the very back of the scalp next to hairline behind each ear because that's where they seem to like to lay the eggs, she said. The eggs are tiny, round, silvery things stuck to the hair shaft, and when they lay eggs, they do it right on the scalp, she explained. As the hair grows out, the egg will move out with it. As the child combs hair, it can move out a little, too, Jones said. When a child is found with nits or lice, nurses try to be really careful when notifying students to prevent embarrassment, Vaught said.
"We don't want to pull them out of class because we think about their self esteem. It really is detrimental and if they get it over and over, it can hurt their self esteem (if they're called out of class all of the time). And sometimes it's not the kid's fault."
Head lice are most common in children ages 3 to 12, the AAP reports. Symptoms of lice include excessive head scratching and continuous itching, Jones said. Medicated shampoo should be used in treating lice, and it's very important to follow directions, she advised. The AAP recommends Permethrin 1 as a treatment for the condition.
Overall, Vaught said she thinks Sikeston's nurses do a good job of detecting and preventing lice.
"We check for it often and notify people," Vaught said. "If it's found in an elementary student, we'll notify siblings at other buildings if needed, and the whole family gets treated."
Jones, who's been the school nurse at New Madrid Elementary for 31 years, said she's seen tons of head lice over the years, and it doesn't really bother her. She hasn't even contracted it from the students.
"I take a shower every day," she laughed. "I guess I've just been lucky."