An Undiagnosed Index Case Leading to a Nosocomial Scabies Outbreak: How Mass Single-Dose Ivermectin Treatment Can Help Control a Nosocomial Epidemic

Boyer, Pierre; Deboscker, Stéphanie; Hernandez, C.; Ramsheyi, Morgane; Schneider, Pauline; Foeglé, J.; Lavigne, Thierry

doi:10.1017/ice.2018.31

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…Similar to other reported scabies outbreaks where elderly or immunocompromised patients were the source of infestation, diagnostic investigation for scabies was only initiated after development of pruritus in healthcare workers in our study 12,14‐17 . In one outbreak reported by Boyer et al, 17 similar to our observations, the outbreak could be identified only after the onset of scabies symptoms among healthcare workers and the source of infection was an index patient who presented with a cutaneous disorder that could obscure the diagnosis of scabies (ie, graft vs host disease) and who died 9 days after admission. Although a total of 35 secondary cases consisting of patients and healthcare workers were diagnosed during the 9‐week course of the outbreak, rapid implementation of precautionary measures together with extensive mass prophylaxis of the contacts (single dose ivermectin) resulted in the resolution of the outbreak.…”

Section: Discussionsupporting

confidence: 87%

“…Similar to other reported scabies outbreaks where elderly or immunocompromised patients were the source of infestation, diagnostic investigation for scabies was only initiated after development of pruritus in healthcare workers in our study. 12,[14][15][16][17] In one outbreak reported by Boyer et al, 17 In one study, fomite-implicated transmission contributing to an outbreak was recorded when a crusted scabies patient shared a communal lounge chair, supportive of the possibility that our patient might have also shed skin crusts for a while in the ward. 19 Several studies recommended that carpets and furniture should be vacuumed or items that cannot be washed should be treated with insecticidal powder such as chloramine 5%, and stored in plastic bags for 10 days or in a freezer at −20°C for 72 hours.…”

Section: Discussionmentioning

confidence: 99%

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A nosocomial scabies outbreak originating from immunocompromised transplant patients in Turkey: Upholstery as a possible cause

Özdamar

Türkoğlu

2020

Transplant Infectious Dis

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Background Inpatients with crusted scabies represent an important source of nosocomial transmission with consequent outbreaks among patients and healthcare workers. This study aimed to report the course of an institutional scabies outbreak, which progressed with infestation of immunosuppressed transplant patients, health care workers, and caregivers. Methods Patients diagnosed with scabies in a nosocomial outbreak in a 200‐bed, tertiary hospital were included. Following a diagnosis of scabies in the index patient, strict contact isolation measures were implemented. During the outbreak, a root cause analysis (RCA) was carried out by an infection prevention and control team. Results Forty‐two individuals were affected (7 patients, 25 health care workers, and 10 family members of the patients) during the outbreak consisting of three attacks. Index case was a multiple myeloma patient who received hematopoietic stem cell transplantation and presented with crusted scabies. A RCA suggested that upholstery could serve as a means of reservoir. All upholstery of the sofa and armchairs in patient rooms as well as in lounge areas were replaced by wipeable leather material. After the 19‐week course of the outbreak, no additional cases of scabies have been observed until now. Conclusion A high index of suspicion should be maintained, particularly in immunocompromised patients, in order to achieve rapid diagnosis of scabies and to implement institutional infection control measures. It should also be borne in mind that the transmission may occur through direct contact as well as fomites, such as upholstery.

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Section: Discussionsupporting

confidence: 87%

“…Similar to other reported scabies outbreaks where elderly or immunocompromised patients were the source of infestation, diagnostic investigation for scabies was only initiated after development of pruritus in healthcare workers in our study. 12,[14][15][16][17] In one outbreak reported by Boyer et al, 17 In one study, fomite-implicated transmission contributing to an outbreak was recorded when a crusted scabies patient shared a communal lounge chair, supportive of the possibility that our patient might have also shed skin crusts for a while in the ward. 19 Several studies recommended that carpets and furniture should be vacuumed or items that cannot be washed should be treated with insecticidal powder such as chloramine 5%, and stored in plastic bags for 10 days or in a freezer at −20°C for 72 hours.…”

Section: Discussionmentioning

confidence: 99%

A nosocomial scabies outbreak originating from immunocompromised transplant patients in Turkey: Upholstery as a possible cause

Özdamar

Türkoğlu

2020

Transplant Infectious Dis

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“…Na Tabela 4 estão resumidas as características dos surtos de escabiose publicados mais recentemente. 5,[7][8][9][10][11][12][13][14] Nas visitas às instituições de origem dos CI, foi constatado que havia história de escabiose em vários institucionalizados, com tratamento tópico (benzoato de benzilo) efetuado em tempos diferentes. Verificámos as dificuldades em cumprir as medidas ambientais de evicção e rastreio de conviventes e visitas.…”

Section: Resultsunclassified

Dois Surtos de Escabiose num Hospital Terciário em Portugal

et al. 2020

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Introduction: Scabies outbreaks in healthcare institutions are an emerging problem. To determine the best management strategy is a topical matter. We analyzed two hospital scabies outbreaks and reviewed the management strategy of institutional scabies outbreaks.Material and Methods: We performed an observational retrospective study of two independent scabies outbreaks that occurred in a Portuguese tertiary hospital in 2018. Following the identification of the index cases, scabies cases and exposed individuals, we calculated the attack rate in patients and professionals. We also evaluated the treatment and infection control measures, as well as the global cost of each outbreak.Results: The hospital outbreaks of scabies occurred in two wards of Internal Medicine. Both had as index cases institutionalized patients with dermatosis at the time of admission. In the Ward 1, there have been identified 409 exposed individuals, 14 cases of scabies and the attack rate was 3.4%. In the Ward 2, there have been identified 254 exposed individuals, 17 cases and the attack rate was 6.7%. Topical treatment was prescribed to the cases and environmental measures were implemented.Discussion: In our analysis, both outbreaks had as index cases institutionalized patients and had a significant impact, with hundreds of exposed individuals and considerable costs. The analysis of hospital scabies outbreaks is mostly retrospective and represents an opportunity to review its best management strategy.Conclusion: Implementation of guidelines on tackling scabies outbreaks in institutional settings is urgent.

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“…Continuing education is also implemented on the Home of Infection Control platform, so staff can bring themselves up-to-date with the latest knowledge about hospital infection as well as communicating with their peers anytime and anywhere. Meanwhile, a competitive incentive mechanism has been introduced to enhance their learning ability 14 and cultivate their sense of participation as a hospital employee through a three-level network working model of infection control at both the hospital and departmental level. [15][16][17] So, for example, the selection of advanced infection management individuals and departments in Changzhou Hospital is carried out every three years to increase the sense of personal value of both full-time and part-time infection control personnel.…”

Section: Discussionmentioning

confidence: 99%

The Use of a Three-in-One Practice-Management-Innovation Training Model in the Construction of an Infection Control Team

Min

Yang

Gong

2021

RMHP

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Objective: This study aims to explore the role of a three-in-one practice, management, and innovation training model (also called as three-in-one practice-management-innovation training model) in the construction of an infection control team. Methods: This study retrospectively analyzed the position structure, mastery of professional knowledge, and working methods of the full-time and part-time personnel of the Changzhou Cancer Hospital, compared the training content of Jiangsu Hospital Infection Control Center with the actual situation of the hospital, and formulated and implemented a three-in-one practicemanagement-innovation training model. First, the team members were selected for the construction and management of the Hospital Infection Management Department according to the relevant responsibility and management requirements, and their learning and mastery of the basic knowledge and skills concerning infection control were completed based on their professional roles. In line with the regulations of the hospital and department, full-time personnel were ensured of having the opportunity to participate in provincial-and municipal-level academic exchanges and then learn from each other, through collaboration between doctors and nurses, how to exercise basic management skills. At the same time, a fair competitive incentive mechanism was established through the three-level network of the hospital infection committee, the hospital infection management department, and nosocomial infection management department to implement innovative projectbased management and cultivate an awareness of hospital infection control in all employees. Results: The professional structure of the full-time infection control personnel has been optimized, the awareness of the infection control team concerning active participation in practice has gradually increased, and infection control management and innovation has been significantly improved. Conclusion:After the selection of an infection control management team and the delivery of well-planned training, the quality of infection control management has improved.

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An Undiagnosed Index Case Leading to a Nosocomial Scabies Outbreak: How Mass Single-Dose Ivermectin Treatment Can Help Control a Nosocomial Epidemic

Cited by 7 publications

References 5 publications

A nosocomial scabies outbreak originating from immunocompromised transplant patients in Turkey: Upholstery as a possible cause

A nosocomial scabies outbreak originating from immunocompromised transplant patients in Turkey: Upholstery as a possible cause

Dois Surtos de Escabiose num Hospital Terciário em Portugal

The Use of a Three-in-One Practice-Management-Innovation Training Model in the Construction of an Infection Control Team

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