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Friday, June 12, 1998 Published at 06:48 GMT 07:48 UK

Education: Features

The demise of the 'nit nurse'

Checks by school nurses are becoming less common - head lice are not

They were a regular part of school life for generations of children in the UK, but health professionals now take a dim view of regular head lice checks.

Dundee Healthcare Trust is the latest in a long line of health agencies to abandon what it describes as the "embarrassing and humiliating" practice of subjecting pupils to hair examinations by school nurses.

The decision has provoked an outcry in the area, with dire predictions being made about an "epidemic" of head lice, but it is merely the latest instalment of a trend which has seen the responsibility for diagnosing and treating head lice shift from schools to parents.

Many health officials believe that mass head examinations by school nurses are not clinically effective and represent a waste of resources.

[ image: Parents are expected to check their children for head lice]
Parents are expected to check their children for head lice
Public health organisations prefer to employ a strategy of public education; a popular tool is a leaflet for parents explaining all about the human head louse (pediculus humanus capitis), its eggs (popularly known as "nits"), and how to get rid of both.

Anne Hanning, a nurse taking part in one such education campaign at a Dundee supermarket, said: "It is not a school problem, it is a community problem - but it is the school that always gets the blame."

For those parents who take a laissez-faire attitude towards the health and hygiene of their offspring, the 1996 Education Act contains a range of sanctions.

A school medical officer can remove a child from school "where the person or clothing of a pupil is suspected to be infected" until remedial action is taken.

The Act makes it clear that the pupil's parents are guilty of an offence if repeated infection occurs as a result of their neglect.

Such situations are rare, but some schools are still automatically sending home children who have head lice.

Last resort

Guidelines for schools on head lice, often agreed by the local health authority, regard the exclusion of pupils as a last resort, but they are only guidelines. The final decision rests with the headteacher.

Carol Keys-Shaw, a senior nurse in the community health directorate of Richmond, Twickenham and Roehampton Healthcare Trust, said: "We don't recommend a policy of sending them home, but schools often over-react."

The transmission of head lice in a classroom situation is relatively rare, she said.

"If it does happen, it's often best friends who are affected, and this scenario is as likely to take place outside the school gates when children are playing together."

Ms Keys-Shaw has sympathy with fears that a blanket policy of sending children home could adversely affect their studies.

"No-one dies of head lice - their education is far more important."

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Features Contents

Mike Baker
Internet Links

Newcastle City Health Trust School Nursing Service

National Pharmaceutical Association advice on head lice

Royal College of General Practitioners head lice factsheet

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