Background: Summer camps, attended by over 11 million children yearly, represent an ideal setting for head lice (Pediculus humanus capitis) infestation from close quarters and opportunities for direct camper-to-camper contact. Lice infestations in summer camps, although non-life threatening, have substantial social, economic, and medical consequences for campers who are unnecessarily excluded and can cause more significant logistical problems for camp programs and parents compared to infections in school environments. Although the American Camp Association (ACA) and Association of Camp Nurses (ACN) recommend lice screening procedures and policies, current national camp practices for lice detection, management, and training are not well characterized. Objectives: To assess via web-based survey, current summer camp policies regarding detection and management of head lice from a national sampling of summer camps in the United States. Methods: We partnered with CampDoc.com, a national, web-based health records system, to send camp leadership representing 500 camps a 12-question online survey on lice policy, management, and training. Data were summarized using descriptive statistics. Results: 255 responses were received. Respondents were mostly camp directors (36%) and camp nurses (36%). Over 30% of camps were either unaware of or had no formal lice policy, while nearly 35% reported a “No-Nit Policy”, defined as exclusion of a camper with presence of nits only. More than half of the camps (55%) screen for lice when campers arrived, with the screening conducted mainly by camp nurses (71%). Only 20% of respondents reported that a camper could remain at camp and receive treatment if nits and live lice were detected. Of the 150 respondents who said their camps would provide lice treatment, only 40% said they would repeat a second application if needed ∼7 days later. Over 63% of respondents stated that manual removal of nits (after treatment) was necessary to prevent the spread of lice. Camps reported lice infections were a substantial logistical burden for staff (60%) and the child’s family (56%). Nearly 35% of camps said no formal training on head lice was available while most would favor hands-on or web-based lice training (70%). Conclusions: While many camps have formal head lice policies in place, a substantial proportion of camps continue to have practice variations that differ from national American Academy of Pediatrics (AAP) lice recommendations, including “No Nit policies” and treatments that require complete nit removal. These practice variations may contribute to the logistic and financial burden experienced by camps and families and should be addressed by AAP lice policies tailored specifically towards summer camps and the creation of web-based lice training materials for camp staff to disseminate best practice guidelines for the diagnosis and management of head lice.
Scratching Our Heads: A Survey of Current Practices for Head Lice Detection and Management in United States Summer Camps
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Ashley DeHudy, Andrew N. Hashikawa, Michael Ambrose; Scratching Our Heads: A Survey of Current Practices for Head Lice Detection and Management in United States Summer Camps. Pediatrics January 2018; 141 (1_MeetingAbstract): 190. 10.1542/peds.141.1MA2.190a
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