Johanna Stoevesandt1, Lydia Carlé, Martin Leverkus, Henning Hamm. 1. Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Josef-Schneider-Straße 2, Würzburg, Germany. Stoevesandt_J@klinik.uni-wuerzburg.de
Abstract
BACKGROUND: Scabies outbreaks in community facilities may reach large dimensions and take a protracted course. Highly contagious crusted scabies is a major cause of nosocomial outbreaks. PATIENTS AND METHODS: On the occasion of an extensive scabies outbreak in a north Bavarian sheltered workshop and its associated residential homes with over 500 exposed individuals, a multifaceted control strategy was developed and pursued. Knowledge from a comprehensive review of the literature was utilized. RESULTS: Our successful scabies elimination concept includes: 1) Careful organization (formation of an outbreak management team, registration and information of all exposed individuals, prospective time management, financial calculation); 2) simultaneous clinical examination of all individuals at risk; 3) synchronous topical treatment of all exposed individuals with permethrin 5 % cream on day 0, repeated treatment of proven and doubtful cases on days 1 and 14; systemic treatment of selected cases with oral ivermectin; 4) decontamination and quarantine measures; 5) follow-up investigations and repeated treatment if indicated. CONCLUSIONS: Management of large institutional scabies outbreaks requires a high degree of motivation, communication skills and perseverance.
BACKGROUND: Scabies outbreaks in community facilities may reach large dimensions and take a protracted course. Highly contagious crusted scabies is a major cause of nosocomial outbreaks. PATIENTS AND METHODS: On the occasion of an extensive scabies outbreak in a north Bavarian sheltered workshop and its associated residential homes with over 500 exposed individuals, a multifaceted control strategy was developed and pursued. Knowledge from a comprehensive review of the literature was utilized. RESULTS: Our successful scabies elimination concept includes: 1) Careful organization (formation of an outbreak management team, registration and information of all exposed individuals, prospective time management, financial calculation); 2) simultaneous clinical examination of all individuals at risk; 3) synchronous topical treatment of all exposed individuals with permethrin 5 % cream on day 0, repeated treatment of proven and doubtful cases on days 1 and 14; systemic treatment of selected cases with oral ivermectin; 4) decontamination and quarantine measures; 5) follow-up investigations and repeated treatment if indicated. CONCLUSIONS: Management of large institutional scabies outbreaks requires a high degree of motivation, communication skills and perseverance.
Authors: Samson S Y Wong; Rosana W S Poon; Sandy Chau; Sally C Y Wong; Kelvin K W To; Vincent C C Cheng; Kitty S C Fung; K Y Yuen Journal: J Clin Microbiol Date: 2015-04-22 Impact factor: 5.948
Authors: Jackson Thomas; Greg M Peterson; Shelley F Walton; Christine F Carson; Mark Naunton; Kavya E Baby Journal: BMC Infect Dis Date: 2015-07-01 Impact factor: 3.090