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Related Experiment Video

Updated: Jul 9, 2026

Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 2. General Practices

Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 2. General Practices

Published on: October 3, 2016

Lice, nits, and school policy.

L K Williams¹, A Reichert, W R MacKenzie

¹Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

|May 23, 2001

Summary

This summary is machine-generated.

Most children with head lice nits but no active lice do not become infested. School policies excluding children with only nits may be excessive, suggesting repeated checks for active lice instead.

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Area of Science:

Pediatrics
Epidemiology
Public Health

Background:

Head lice infestation epidemiology is not well understood.
Current school policies often exclude children with nits, even without active lice.
This practice impacts children, families, and school attendance.

Purpose of the Study:

To determine the likelihood of children with only head lice nits developing an active infestation.
To inform school policies regarding children with nits.

Main Methods:

Prospective cohort study conducted in two elementary schools in metropolitan Atlanta.
1729 children were screened; 63 had nits without lice.
Follow-up was conducted on 50 children with nits alone to assess conversion to active lice infestation within 14 days.

Main Results:

18% of children with nits alone converted to active lice infestation within 14 days.
Having 5 or more nits within one-fourth inch of the scalp significantly increased the risk of conversion (RR: 4.45).
Nits near the scalp were a risk factor, even after controlling for sex, recent treatment, and total nit count.

Conclusions:

While nits near the scalp indicate a higher risk, most children with nits alone do not develop active lice infestations.
School exclusion and treatment policies for all children with nits alone may be overly strict.
Repeated examinations for active lice are recommended for children identified with nits.