A Note from Nurse Fiore

Dear Parent or Guardian:

Welcome back!  I am looking forward to a productive and enriching new school year.

As you may know, head lice cases have been on the rise.  An estimated 6-12 million infestations occur each year in the United States, most commonly among children ages 3-11. So, I am writing to you to help you learn how to identify lice and provide information on what you can do if lice hit your home.

What are head lice?

Head lice are tiny, wingless insects that live close to the human scalp.  They feed on blood.  The eggs, also called nits, are tiny, tear-drop shaped eggs that attach to the hair shaft.  Nits often appear yellowish or white, and can look like dandruff but cannot be removed or brushed off. The nymph, or baby louse, is smaller and grow to adult size in one to two weeks. The adult louse is the size of a sesame seed and appears tan to grayish-white.  An itchy and inflamed scalp is a common symptom of lice.  Although not common, persistent scratching may lead to skin irritation and even infection.

Who is affected by head lice?

Head lice are not related to cleanliness.  In fact, head lice often infest people with good hygiene and grooming habits.  Infestations can occur at home, school or in the community.  Head lice are most spread by direct head to head contact- for example, during play at home or school, slumber parties, sports activities, or camp.  Less often lice are spread via objects that have been in recent contact with a person with head lice, such as hats, scarves, hair ribbons, combs, brushes, stuffed animals or bedding.

What to do if an infestation occurs?

If you think your child has head lice, it’s important to talk to a healthcare provider to discuss the best treatment approach for your family. Resistance to some over-the-counter head lice treatments has been reported, but the prevalence of resistance is not known.  There are new prescription treatment options available that are safe.

As your school nurse, I want to provide you with the information you need to safeguard your children’s health and pave the way for a healthy school year.  Please refer to the lice policy listed in our school handbook.  During the school year we strongly encourage parents to notify the school nurse if they find head lice on their child.   I have included the Policy on Head Lice for you below. I hope you find this information helpful.


Cindy Fiore

Lice Policy

School Head Lice Policy:

The Academy of Pediatric states “children with 5 nits 1 cm away from scalp

were significantly more likely to develop infestation”. On finding live lice

or untreated nits within 1 cm of the scalp, we recommend pick up and

treatment. Students may return to school after treatment. Nit removal will

be encouraged according to the Academy of Pediatrics “to decrease diagnostic

confusion, decrease the possibility of unnecessary re-treatment and some

experts recommend removal of nits within 1 cm to the scalp to decrease the

small risk of re-infestation.”

According to the MA DPH School Health Manual and the Academy of

Pediatrics, “Close contacts should be checked to determine if there are other

cases.” Preschool through third grade students will be checked, when a case

is discovered in a particular classroom, for head lice because students work

in close cooperative groupings and often sit in larger numbers in smaller rug

areas for frequent, daily group activities. In addition some grade levels

share lockers. Also according to the MA DPH the student found to have head

lice should be rechecked in 10-14 days after treatment.

Parents/Guardians of students found with lice infestation are responsible for

following directions of treatment product and checking their child daily for

10-14 days. (Recommended by the MA MPH School Health). Parent/Guardian may

request that the School Nurse recheck the student’s head at any time for

signs of nits 1 cm. close to the scalp.

Any parent/ Guardian who does not want their child screened for lice if a

case is found in their immediate classroom or other activity based program

(extended day program or after school program) may write a letter at the

beginning of the school year opting out. This is the same as for BMI, vision

and hearing screening. Parent/Guardians are responsible for checking their

child’s head at home and reporting back to the School Nurse if an infestation

is found.

The MA Dept of Public Health Head Lice Letter, along with the Parent Fact

Sheet, will be sent home to notify all parents of more than 2 cases of head

lice, which are not sibling related.

The NASA power point and Parent Fact Sheet will be placed on the website for

ease of accessibility to parents.

A custodian and the classroom teacher will be notified. In addition play

clothes and stuffed animals will be bagged, rugs and furniture will be