Screening

Screening by parents of children who have been exposed

Parents of school-aged children are often asked to screen their asymptomatic children for head lice infestation if their child has been exposed or had close contact with someone with an infestation. The circumstances could be an exposure in a school classroom, camp, or sleepover party in the preceding month. The parent should receive instructions on how to effectively look for live lice. Alternatively, parents of young school-aged children could assume exposure could take place at any time, and screen their children for live lice on a weekly basis, using the same effective technique (wet combing).[10]​​[30]

Screening in the school setting

Screening large groups of asymptomatic children in the school setting is time consuming, disruptive to the learning environment, and has never been shown to be effective, although many feel this is a necessary duty of the school nurse.[38]

If screening does take place, it should be conducted by individuals who are formally trained, have the necessary equipment (a suitable magnifying device), and be legally qualified (an MD or appropriate nursing credential) to make a diagnosis. Teachers, custodians, and parent volunteers should not screen children and make diagnoses of head lice infestations.[33][38]

School nurses should be able to diagnose head lice infestation in a symptomatic child referred for a head-check. In circumstances where there are an unusually high number of children with infestations, school nurses could assist by evaluating the environment for high-risk exposure situations, provide accurate information to staff, students, and parents, and aid in screening affected children and close contacts.[38]

Routine classroom or school-wide screenings have not shown to be helpful and should be discouraged.[10] These mass screenings either give a false sense of security (because wet combing is rarely used, and casual observation could miss many cases) or result in many more children being recommended for treatment than is necessary (when eggs or nits alone are used as the diagnostic criteria).​[28][29][33]​

School nurses can play a valuable role by instructing parents in proper diagnostic technique, and offering their expertise to families having difficulty with diagnosis or treatment.[6][13][33][36][38]

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