It’s the note from school every parent in Hawaii dreads: There’s been an outbreak of uku, or head lice, in your child’s classroom.

Uku are no doubt an itchy nuisance, but upon the advice of the American Academy of Pediatrics and other health experts, more schools across the nation are saying that a case of head lice is no longer cause enough to send a student home from school.

In a reversal of long-held “nit-free” policies, a number of public schools in Hawaii are following suit based on recommendations by the state Department of Health and in response to concerns about chronic absenteeism.

“There were cases where students were spending too much time out of school because they weren’t allowed to return due to ukus,” said DOE spokeswoman Lindsay Chambers. “The department takes recommendations from DOH seriously and wants to keep kids in school as much as possible since chronic absenteeism is a major predictor of whether students succeed.”

Under nit-free policies, affected students are immediately sent home and kept out of class until a scalp check by a school health aide confirms the insect parasites and their eggs are no longer present.

Under the new protocol, when school health aides find evidence of uku on a student, parents will be notified and given the option of immediately picking up their child or leaving them in school until the end of the day. Parents will be advised to start treatment that evening, but the student will be allowed to return to school the next day.

Also, routine head lice screening will no longer be conducted because it has not been shown to decrease the presence of head lice at schools, according to the DOE.

Lindsay cited the Health Department’s position that “no healthy child should be excluded from or allowed to miss school time because of head lice.”

The statement echoes stands taken by the AAP, the U.S. Centers for Disease Control and Prevention and the National Association of School Nurses.

A letter to parents explaining the policy was distributed on Monday.

The facts of lice

Uku are spread by direct head-to-head contact and indirectly by the sharing of hats, combs, hair ties, scarves and headphones. A common misconception, according to the Health Department, is that the bugs jump or fly from one person to another. They do not; uku are crawlers.

Head lice have nothing to do with poor hygiene and occur across socioeconomic lines, according to Joan Takamori, chief of the DOH Public Health Nursing Branch. The insects feed on human blood and do not survive very long — usually less than one to two days — when not on a host. They do not spread disease.

“This is not a health condition that would warrant sending a child home,” said Takamori. “The key is education, not just with parents but with students.”

Neither the education nor health departments tracks the number of uku cases at schools or their impact on absenteeism. Students are considered chronically absent if they miss 15 or more days of instruction. Nearly one in five Hawaii public school students — more than 30,000 youngsters — were chronically absent in each of the last four years.

The updated uku policy is not sitting well with some parents who have lashed out against the new protocol on Facebook and other online forums.

Parents launch petition

After receiving the DOE letter in May, Joni Kamiya of Honolulu used the petition website change.org to launch her own petition titled, “Stop the spread of ukus in Hawaii public schools.”

Her petition has been signed by at least 1,200 supporters so far and is directed at DOE Superintendent Kathryn Matayoshi.

“As a parent of public school children, I am angered that my kids and the rest of our family can be potentially affected by this pest,” she writes in the petition. “As a family of five with kids from a 10 to a year old, we all can be affected by the spread of head lice.”

Kamiya could not be contacted to comment.

Naomi Perez, a mother of two who lives in North Kohala on the Big Island, signed the petition, saying she prefers the no-nit policy. Her daughter, a fifth-grader at Waikoloa Elementary, suffered uku in kindergarten and again in third grade. Perez remembers how much work it took to rid the child and their home of uku.

She said she spent at least three hours checking every strand of hair on her daughter’s head to remove eggs and crawlers. Then she washed all the linens and stuffed animals in the house in hot water and vacuumed the floors, furniture and car. After that, she did regular checks to make sure the uku did not come back.

Though uku are not life-threatening, they are a big nuisance, Perez said.

“It costs time, in cleaning and taking time off work, money and peace of mind thinking your child has ukus every time they scratch their head,” she said. “We don’t want our schools to be a welcome breeding ground for head lice. If anything, there should be tougher rules regarding head lice in school.”

Perez also said she did not see how students could focus in class while constantly scratching their head. The potential for bullying was another concern.

“Some kids can be cruel, and this opens a door for teasing and poor self-esteem,” she said.

Jenny Harris of Maui recalled the hassles when her third-grader came home itching three weeks after being notified of a classroom outbreak in May at Haiku Elementary School.

She found live uku in his hair and treated him, then washed all the sheets, thinking she was done with it. To her dismay, she found live uku on her son again the next day. Eventually she ended up shaving his hair off and checking him about 20 times. She, too, signed the change.org petition, saying she prefers students with uku be sent home.

It affects the whole family, including siblings, she said, as well as parents who have to take time off from work to deal with uku.

Nationwide trend

Hawaii schools adopting the more relaxed head lice protocols follow in the wake of others, including education departments in California, Washington and Texas, where resistant parents also launched change.org petitions.

In July 2010, the American Academy of Pediatrics updated its 2002 guidelines for the treatment of head lice infestation, citing many misdiagnoses of dandruff, hairspray droplets or other insects as lice.

“Based on what we know about head lice, kids are missing a lot of school and for reasons that are really not medically sound,” said Dr. Mike Hamilton, president of the group’s Hawaii chapter. “I think the misconception is they spread much easier in school classrooms than they really do. They are much more likely to be spread within the household.”

It can happen when kids play closely together, he said, but head lice is not commonly spread through contact with carpets or desks.

Hamilton usually recommends over-the-counter treatments like Rid or Nix to his patients first, with parents advised to carefully follow instructions. If that does not work, he will write a prescription. As for parents who prefer home remedies such as smothering lice with mayonnaise, the pediatrician recommended plain petroleum jelly but warned it may take seven to 10 days of shampooing to get the gunk out.

With treatment, he sees no good reason to keep kids home from school.

“They (head lice) don’t carry diseases, so there’s no public health risk to being around someone that has lice.”

WHAT ARE UKU?

Uku, or head lice, are six-legged, wingless insects about the size of a sesame seed. They live on the human scalp, feeding on blood. Adult lice can live for about 30 days. If not feeding, they die within a day or two.

Female lice lay eggs called nits, which they glue to the hair shafts near the scalp. Eggs are incubated by body heat and can hatch in seven to 12 days. Once hatched, the nymph goes through three stages before becoming an adult. If not treated, the cycle repeats itself about every three weeks.

Source: American Academy of Pediatrics

——-

CORRECTION: The new Health Department and Department of Education policy on ukus is in effect for all schools. An earlier version of this story and the story on page D1 of Thursday’s paper said the policy was in effect on a school by school basis.