The health authorities are dealing with an outbreak of scabies in the community and are taking all the necessary measures and precautions to control and prevent further spread. This includes contact tracing and preventative treatment.
Scabies is a parasitic condition that affects the skin and is caused by the mite sarcoptes scabiei. Scabies comes from the Latin scabere, “to scratch”, and is also known as “the seven-year itch”.
The mite is tiny and not visible to the naked eye. It burrows into the skin and causes a raised rash that may also contain fluid-filled vesicles. As the mites burrow under the skin, they may also produce tiny linear burrows that can be seen by the naked eye.
Scabies is highly infectious, especially among close contacts, and is not related to poor hygiene. It is a condition that only affects humans.
Affected sites include the finger webs, the wrists and elbows, the forward part of the armpits, the belt line and abdomen, the thighs and the external genitalia and buttocks. In women, nipples and breasts may also be involved. The feet can be affected in more severe cases. The effects are more likely to be evident in the head, neck and palms and soles of feet in the case of infants.
The condition causes severe itching due to an allergic reaction against the mite and its eggs and faeces, especially at night, with scratching that could lead to excoriation of the skin, obscuring the underlying rash and burrows. In senile individuals or those with immunodeficiency, the parasite could only cause a severe and generalised dermatitis with extensive scaling and crusting, with little or no associated itch.
The mites are passed from one individual to another after prolonged direct contact and during sexual encounters.
Crusted scabies is highly contagious and contagion has also been documented through undergarments and bed linen if these have been contaminated by infested persons immediately before contact.
The incubation period is two to six weeks with an average of four weeks.
Scabies can be found worldwide and outbreaks in several other European countries have occurred in the past years.
The diagnosis is made clinically and can be confirmed by the microscopic identification of mites, eggs or mite faeces.
Treatment is via a whole body application of one per cent malathion skin lotion or five per cent permethrin for cases and their contacts. Contacts are treated once but infested individuals need to repeat treatment after a week and it is essential to coordinate such treatments in households and institutions to simultaneously eliminate the parasite at all locations in the household/institution. All clothes and underwear, towels and bed linen prior to treatment need to be washed with a hot cycle.
Infested individuals should not go to school or work until the day after treatment. The symptoms may persist for some time after the treatment because they are caused by an allergic reaction to the mite and this does not mean that the treatment has failed.
The mite can only live in human skin and dies within a few hours of leaving the human body. There is, therefore, no need to replace the mattresses or fumigate houses or furniture.
Doctors, nurses and paramedics are being encouraged by the Health Department to notify the Infectious Disease Prevention and Control Unit of any suspected or confirmed cases that they may encounter in their practice in order to prevent any further spread of scabies.
Thus, it is evident the health authorities are on top of things, meaning there is no room for panic but cooperation.