The great lice debate is heating up this fall, with talk of so-called “super lice” and more school districts scrapping the old practice of sending children home until there’s no trace of the parasite.

Many school districts in Minnesota and elsewhere now let stricken students stay in class instead of missing school for days on end.

“It’s not causing disease. It’s not causing health complications,” Cindy Hiltz, a nurse and health services coordinator for the Anoka-Hennepin School District, said of the itchy bug that strikes an estimated 6 million to 12 million children nationwide every year.

Fall is prime lice season, with students returning to school after a summer of sleepovers, camping and other close-quarters activities with friends, cousins and siblings. As if regular lice weren’t enough to make your skin crawl, a recent study presented at the American Chemical Society found that 25 states — including Minnesota — have lice bugs resistant to over-the-counter chemical treatments.

That has some people wondering whether schools have backed off too much.

“Now kids aren’t being checked the way they used to be,” said Gonne Asser, who runs a lice-removal service and is known as the “Minnesota Lice Lady.” “Because the resistance rate has gone up, perhaps the pendulum has swung a little too far.”

No more no-nit

Schools have been gradually moving away from the old ways of dealing with head lice and the accompanying parental anxiety.

Before, when head lice were discovered on a child, the child was brought to the school nurse, who would call the parent to come and take the child home. Then, the nurse would check the head of every other child in that classroom.

Now, not only is the student staying in school, but the classroom checks also have largely disappeared, said Beth Mattey, president of the National Association of School Nurses.

“It doesn’t yield much information, and it took up class time and the nurse’s time and the teacher’s time,” she said. It also could be traumatic for the afflicted student.

“What was the most harmful was that it would identify a child … with head lice. I think about that [stigmatizing experience for the child] and I just cringe.” she said.

There’s still a stigma associated with having lice, even though the American Academy of Pediatrics notes that lice are not a sign of poor hygiene.

Anoka-Hennepin, the state’s largest school system, stopped excluding students with lice from class a few years ago. The decision followed advice from the American Academy of Pediatrics that schools should nix the practice of banning students from school until they are free of lice and nits (lice eggs).

At first, there was a backlash from parents.

“Oh, boy, that was a can of worms,” Hiltz recalled. “People get really anxious about head lice. There were some parents that were angry with us.”

But the results are reassuring, she said. “Since we’ve changed this policy, we have tracked the first two years [to see] whether we were seeing more outbreaks. We weren’t. What we did see was more kids in school.”

Cutting down on unnecessary absences also was an aim for St. Paul Public Schools, which has changed its ways of handling lice cases.

“We want to notify the parents when lice have been identified. The parents can choose to come and pick the child up and begin to treat them right away, or we can work with the student to tie hair back and help them get through the day, and the parent can then treat the head lice at home,” explained Mary Yackley, supervisor of student health and wellness for St. Paul Public Schools.

The district made the decision about 10 years ago.

“Kids can’t learn if they’re at home,” she said. “Head lice are a nuisance, but they are not a vector that spreads serious disease, like vaccine-preventable diseases.”

But not everyone agrees with the new protocols when it comes to lice. “I’ve had phone calls from unhappy parents,” Yackley said.

‘Lice notes’

Forest Lake is among the remaining Twin Cities area school districts that don’t allow students back in class until every nit is gone. Those districts also send out “lice notes” to notify all parents with children in an affected classroom when a child has lice.

Other districts, such as Edina, excludes students from school until they have been treated at home.

Parents should be notified, said Deborah Altschuler, the president and co-founder of the National Pediculosis Association, a nonprofit with a website touting the benefits of no-nit policies. “We recommend that screenings take place at the end of the day when parents are picking up their kids anyway,” she said, adding that she doesn’t think it does any good to send a child home in the middle of the day.

But at the same time, she took issue with the argument that lice are not a health hazard.

“They want to say it’s a nuisance,” she said. “But it’s still a communicable disease.”