Scabies is a parasitic disease of the skin that disproportionately affects disadvantaged populations. Scabies causes considerable morbidity and leads to severe bacterial infection and immune-mediated disease. Recent scientific advances suggest that scabies is amenable to population-level control, particularly through mass drug administration. In recognition of these issues, WHO added scabies to the list of neglected tropical diseases (NTDs) in 2017. In order to develop a global control program, key operational research questions must now be addressed. Standardised approaches to diagnosis and methods for mapping are required to further understand the burden of disease. The safety of treatments for young children, including with ivermectin and moxidectin, should be investigated. Studies are needed to inform optimum implementation of mass treatment, including the threshold for intervention, target, dosing, and frequency. Frameworks for surveillance, monitoring and evaluation of control strategies are also necessary.
This report adds 16 cases, including one from the Mississippi investigation, of chronic T. cruzi infection presumably acquired via vector-borne transmission in the United States to the previously reported seven cases. The estimated prevalence of autochthonous infections based on this study is 1 in 354,000 donors. Determining US foci of vector-borne transmission is needed to better assess risk for infection.
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