Lice

Sandi Cranny uses a NitFree Terminator, a type of metal comb, as she looks for nits on the hair of a 4-year-old girl during a head check in Glen Ellyn. No nits were found. Shiny Strands is a business that caters mainly to children with head lice. Co-owners Cranny and Suzanne Comella use the strand-by-strand removal method once lice nits are found in the hair. (Chuck Berman/Chicago Tribune)

School reaction to lice outbreaks has relaxed in recent years –– in sharp contrast to previous generations when students were subjected to mass inspections every fall, forced to stand in line to have their scalps checked for the tiny parasites and their eggs.

These days, both the National Association of School Nurses and the American Academy of Pediatrics discourage schools from sending home children with head lice, arguing such policies punish parents and kids alike and do little to prevent infestations.

But that message can be lost on many parents, who panic during lice outbreaks, according to local school and health officials. Some parents still have misconceptions that lice are caused by poor hygiene or they just get grossed out by them.

"I freaked out a little," Karen Crotty, 41, said, adding that she examined her daughter's scalp after learning about a recent outbreak in her daughter's fourth-grade class in Lombard. "There were bugs living on my daughter's head.

"I thought, 'OK, we can take care of this,' and I tried my best to remain calm."

Cathy Rigali, a health services coordinator at Romeoville-based Valley View School District 365U, has seen her share of lice infestations over the years.

"Many parents often accuse the school of being the source," Rigali said. "By the time parents find the lice, the child has usually had it for three to four months, and maybe picked it up at a summer camp or a sleepover."

The early fall is usually the worst season for outbreaks since children often pick them up during summer activities before school starts. A few sporadic outbreaks have been reported this fall in District 365U's 20-plus schools, but Rigali said large outbreaks in the past were a nightmare for the school nurse.

"The parents become very frustrated," Rigali said. "The stigma is also tough on people. Some feel like they are second-class citizens and are unclean, but lice is something anyone can get."

Even with the advancements of modern medicine, head lice each year infect 6 million to 12 million American kids ages 3 to 11, according to the Centers for Disease Control and Prevention.

This year is no exception, say Chicago-area school nurses and lice experts, who have noticed recent outbreaks of the resilient critters at schools from Joliet to Lombard to Evanston.

Outbreaks aren't carefully recorded so comprehensive data are hard to come by, public health officials said. Because lice do not spread disease or cause serious health problems, Illinois and area health departments do not track local outbreaks.

But Illinois is No. 9 on the list of states that have the most cases of head lice this year, with more than 35,000 prescriptions written for head lice medications, according to prescription data from Wolters Kluwer Pharma Solutions.

"(Researchers) have gone into schools, which many thought were lice-free, and have still found children with lice," said Barbara Frankowski, the former chairwoman of the council on school health for the academy of pediatrics. "Some believe that every school in the United States almost always has at least one active case of lice, if not more."

School district policies on lice vary, and some still send home children with lice. Valley View officials usually send children with lice infestations home but usually allow them to return to class after washing their head with a medicated shampoo, Rigali said. She also teaches parents on how to pick out the egg nits and recommends over-the-counter shampoos like Rid or Nix.

"I sent home kids in the morning and they were back in class by afternoon," Rigali said, adding that no-nit policies at most schools have become more relaxed and even eliminated over the years. "If children come back to school after a shampooing and only have five nits in the hair, we'll pick them out and send them back to class."

At St. Paul the Apostle School in Joliet, some students showed up in September with head lice. "We had a couple of families who went to summer camp and the kids picked it up there," said Principal Mary Kay Robbins.

After more cases came up, Robbins said she decided to check all the students' heads. In addition to the earlier cases, she sent home a couple more students who were found to have lice. Their parents were asked to treat their children, who were then allowed to return to class.

She also downplayed any stigma attached to having lice, reminding kids that lice like clean heads. Students and parents were encouraged to check for lice every day.

The school was lice-free by the end of September. "It's one of those things that you want to deal with upfront," Robbins said.

The school nurses association recommends that children with lice remain in class, but be discouraged from close head-to-head contact with others.

The small parasitic insects, which feed on blood on the scalp, are mostly found around the ears and back of the neck. Children in preschool and grade school are most commonly affected because lice spread by direct contact with the hair of an infected person, according to the CDC. Kids are more likely to share combs and brushes and come in close contact during sleepovers and camp.

The most common symptom of head lice infestation is itching, and though the parasites don't make people ill, intense scratching may lead to a secondary bacterial infection, experts say.

Glen Ellyn resident Barbara Eichin, 47, said she and her three children –– an 8-year-old daughter and two sons, ages 11 and 13 –– contracted lice over the summer and still are trying to get rid of it.

"We were itching our heads but didn't know what it was," Eichin said. "I couldn't find anything in their hair."

A friend suggested it could be lice, so she did some research on the Internet. "We finally found the bugs. I guess I didn't know what I was looking for," Eichin said. An inspection at her children's school found that no other students were infected.

The methods of treating lice can be controversial, with some advocating "natural" shampoos. The CDC recommends shampooing with over-the-counter or prescription treatments and combing out the bugs and nits. Officials of the manufacturer of Natroba, a new treatment approved for lice this year, say the medication is one of the first that kills both lice and nits.

Pillowcases, pillows, sheets, blankets, hats, scarves and other items that may have come into contact with an infected person should be cleaned or discarded.

Suzanne Comella, co-owner of Shiny Strands salon in Glen Ellyn, uses the "Shepherd Method" for removing lice, based on Katie Shepherd's advice book. Comella removes the bugs using her hands and uses a special comb to remove egg nits. The method can take up to two hours at a cost of $90 per hour.

"Most of the time it works," Comella said, "but because we rely on our eyes, we can always miss something."

Eichin has been using a lice shampoo to kill the bugs and spends hours a week combing out the nits.

"We got it under control, but (we're) still picking out the nits," Eichin said. "The hardest thing is that it's time-consuming and is just an annoyance."

Freelancer Alicia Fabbre contributed.