An Outbreak of Scabies in a Teaching Hospital Lessons Learned

Abstract

HCWs with the most patient contact are at highest risk of acquiring scabies. Because HCWs who used traditionally accepted barriers while caring for patients with Norwegian scabies continued to develop scabies, we found additional measures were required in the acute-care hospital. HCWs with skin exposure to patients with scabies should receive prophylactic treatment. We recommend (1) using heightened barrier precautions for care of patients with scabies and (2) extending the isolation period for 8 days or 24 hours after the second treatment with a scabicide for those patients with Norwegian scabies. Oral ivermectin was well tolerated for treating patients and HCWs who failed conventional treatment. Finally, we developed a surveillance system that provides a "barometric measure" of the infection rate in the community. If scabies increases in the community, a tiered triage system is activated to protect against transmission among HCWs or hospital patients.

Mass scabies management in an orphanage of rural community: An experience

“…11 Introduction of a single case of scabies into crowded living conditions can result in an epidemic. 12,13 The population at risk is the underprivileged, alcoholics, drug addicts, homeless persons, refugees, serving soldiers, small children in day care centres, handicapped persons as well as aged people in nursing homes. In a study conducted in inmates of prison, scabies accounted for 57.6% of skin conditions and had significant association between infection and the duration of stay of inmates in the prison.…”

Infection Prevention and Control in Residential Facilities for Pediatric Patients and Their Families

“…Crusted or Norwegian scabies is a severe form of scabies that affects primarily the elderly and those who are immune compromised. Outbreaks of scabies, especially crusted scabies, have occurred in hospitals, 81 nursing homes, 82 and other residential facilities, sometimes lasting for several months. Scabies is usually transmitted by prolonged skin-to-skin contact with an infected person.…”

A scabies outbreak in a diabetic and collagen disease ward: Management and prevention

“…Although there is less information about mortality, deaths frequently occur due to secondary sepsis (2). There are numerous medical staff who have not experienced scabies, and there are previous reports that have misdiagnosed it as eczema and senile dermal pruritus, leading to an outbreak because of its highly contagious nature (3)(4)(5)(6). Scabies is relatively common in tropical areas and in developing countries because of poor hygiene practices, and war and poverty can be causes of large epidemics (7).…”