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The etiology of minimal lesion nephrosis (MLN), the most common cause of nephrotic syndrome in children, is unknown. The only incidence data on MLN have been extrapolated from population surveys of nephrotic syndrome in childhood performed over 20 years ago. These studies estimated the incidence of MLN at 1.5 cases per year per 100,000 children, ages 1-9. New cases of MLN occurring during the years 1970-1979 were identified by survey of area pediatricians and by medical record review of 9 hospitals in the area most likely to care for children. Total population of the study area in 1974 was 1.1 million with 187,000 children, ages 1-9. Thirty-five cases of MLN were identified with onset after first and before tenth birthday. Criteria for identification were initial response to daily steroids (33 pts) with complete clearing of proteinuria in <1 month or initial non-response (2 pts) with both renal biopsy and subsequent clinical course compatible with MLN. Incidence of MLN in the study area was 1.9 cases per year per 100,000 children, ages 1-9. However, in one rural 5-county area the incidence was 4.7 cases per year per 100,000. Whether this cluster of cases is epidemiologically meaningful or a statistical artifact is uncertain. Further refinement of the distribution and demographics of cases in the high rate area may provide clues to the etiology of MLN and continuing surveillance of area will enable us to assess the reliability of the finding. NOSOCQ\lIAL SCABIES INFECTIONS: EPIDEMIOLOGY IN THE 502 OUTPATIENT CLINIC. T. Yamauchi K. Eisenach, and S. Furr, Departments 07 P-; GdPediatric PatFol-o w , Universityof AGkansas Medical Sciences and Arkansas Child-ren's ~ospital; Little Rock, Arkansas. Scabies infestation appears to be increasing over the past few years. Nosocomial spread of this disease has been rarely reported. In October of 1978, 2 nurses and a medical student developed pruritic, papular eruptions on wrists, shoulders, neck and axil-lary areas. Scabies was diagnosed in each case by clinical and microscopic findings. Since all 3 of these individuals were assigned to the general pediatric outpatient clinic, an epidemio-logic investigation was initiated. Both nurses and the medical student remembered prolonged close contact (during lumbar puncture procedure) with a 6-year-old child with aseptic meningitis and scabies. Thls index child had been diagnosed infested with scabies 24 hours previously, but had not received the prescribed treatment. A total of 41 persons who had both direct and indirect contact with the scabietic child were identified and examined. Scabies was diagnosed in 12 cases: 6 family members of the index child, 5 family members of the nurses, and a single child visiting one of the infested children. Topical application of 1% gamma benzene hexachloride was initiated for all diagnosed individuals and persons sharing living facilities were simultaneously treated to avoid reinfection. A re-education of staff, stressing the importance of proper handling of infected and suspected patients was ini...