The outbreak of scabies in schools and a home for the elderly has led to panic among some parents, but health authorities assure there is no cause for alarm. Ariadne Massa gets the lowdown on this pesky mite.
News of the re-emergence of scabies was travelling nearly as fast as the tiny mite was infecting people, driving some parents to urge the temporary closure of affected schools.
We have had parents who were overly anxious and didn’t even want to send their children to school
“We have had parents who were overly anxious and didn’t even want to send their children to school, but we did our utmost to allay their fears,” Health Promotion and Disease Prevention Department director Charmaine Gauci said.
To nip this frenzied fear in the bud, health authorities swiftly descended on the schools where children contracted the skin infection, and provided treatment to all those who had come into close contact with them.
Dr Gauci said in some cases parents whose children had not come into any contact with those infected also wanted the treatment, but “we tried to explain that this is not a vaccination, that provides you with immunity against it”.
Information meetings were held for parents of students from infected classes, but in the case of a primary school in Paola the concern was so great it was decided to brief the entire school and bring it up-to-date on the situation.
Since the first week of October, a total of 64 cases have been identified across Malta: 35 residents from an old people’s home, 14 staff members from this same home, and five children related to the staff.
This figure includes a separate cluster of five children and five of their adult relatives.
Dr Gauci said the current outbreak was more widespread than usual since it originated in an institution where it was bound to spread.
Last year eight cases of scabies had been reported at Mount Carmel Hospital and in 2007 about 12 cases were identified in a Floriana school.
Many tend to associate this condition with the war and poverty, but this is not a disease of poverty, neglect or poor hygiene.
A parasitic condition that is caused by tiny mites that burrow into the skin, scabies is spread through direct, prolonged skin-to-skin contact.
It is frequently acquired through sexual contact.
The most common signs and symptoms are severe itching due to an allergic reaction against the mite and its eggs and faeces, a pimple-like rash, itchy or pus-filled bumps, and blisters.
Paediatrician Victor Grech said when contacted that a quick handshake or a hug does not usually spread scabies, and, for example, in the case of children it could be easily spread through play.
The elderly could have passed it to each other by sitting very closely to one another, possibly sharing clothes and resting on the same bed sheets.
Prof. Grech said it was difficult to establish the origin of scabies this time round since this parasiticcondition had never been fullyeradicated.
A number of cases have been also reported worldwide – it affects people of all races and social classes and spreads rapidly in crowded conditions where there is close body and skin contact.
“Scabies is just there and occasionally we get sporadic outbreaks,” he said, adding that people could contract this condition more than once.
Scabies has an incubation period of about two to six weeks, and the infested person can still transmit this disease to others even if they do not have symptoms.
Affected areas include the finger webs, wrists and elbows, the forward part of the armpits, the belt line, abdomen, thighs, external genitalia and buttocks. In women, nipples and breasts may also be involved. The effects are more likely to be evident in the head, neck and palms and soles of feet in the case of infants, Prof. Grech said.
Despite the notoriety of scabies, it is easily treated by applying a special lotion from the neck down and allowing it to act for 24 hours. There is also oral treatment for the more serious cases.
Infested people should not go to school or work until the day after treatment, he advised. However, Prof. Grech does not believe closing schools is necessary and assures there is no cause for alarm.
People who come into contact with an infected person are treated once. Infested individuals need to repeat treatment after a week.
All clothes and underwear, towels and bed linen prior to treatment should to be washed with a hot cycle.
The mites can only live in human skin and die within hours of leaving the body, so there is no need to replace mattresses or fumigate houses or furniture. Parents would do well, for example, to set aside the soft toys of their infected child in a plastic bag for two to three days to allow the mites to die.
“My advice is if you or anyone you know develops a nasty itch or rash, seek medical help,” Prof. Grech said.