Scabies

Scabies Control

Scabies Description
Contagious infestation of the skin
Caused by human mites (Sarcoptes scabiei subsp. hominis)
Distributed worldwide
Reported incidence increasing in US since 1970’s
Humans are the reservoir

Scabies Transmission

Direct, prolonged, skin–to-skin contact
Sexual contact
Household contact
Indirect transfer from clothing, towels and bedding, only if contaminated immediately before contact
Communicable
while infested and untreated
during incubation period


Scabies Symptoms
Symptoms caused by reaction to mites
Pimple-like rash or burrows between fingers, on wrist, elbows, armpits, belt line, navel, abdomen, and/or buttocks
Intense itching over most of the body, especially at night
Sores on the body caused by scratching
Incubation period:
2-6 weeks without previous exposure
1-4 days after re-infestation (usually milder)

Scabies Diagnosis

Confirmed by skin scrapings of papules or intact burrows

Burrows and mites may be few in number (only 10-12) and difficult to find

Scabies Treatment

Applicaton of scabicide over entire body below head:
5% permethrin cream (wash after 8-14 hrs)
1% lindane cream (wash after 8-12 hrs)
Ivermectin, single dose, orally
Itching may continue for several weeks despite successful treatment
In ~5% of cases, 2nd treatment may be necessary after 7-10 days.


Scabies Control
Prompt diagnosis and treatment of patients
Simultaneous, prophylactic therapy:
household members,
sexual contacts, and
caregivers with prolonged skin-to skin contact
Launder all clothing worn within 48-72 hrs. of treatment in hot water and dry in hot dryer
Thorough vacuuming of carpets and upholstered furniture