Raïssa Tjon-Kon-Fat1,2, Laurène Peckeu1,2, Susan Hahné2, Eric de Coster3, Wendy Tas3, Bas Wintermans4, Anneke Bergmans4, Mariska Petrignani5, Ewout Fanoy6. 1. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. 2. Centre for Infectious Disease Control Netherlands (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands. 3. Public Health Service of the region of The Hague (GGD Haaglanden), The Hague, the Netherlands. 4. Microvida, location Bravis, Roosendaal, the Netherlands. 5. Public Health Service of the region of Amsterdam (GGD Amsterdam), Amsterdam, the Netherlands. 6. Public Health Service of the region of Rotterdam-Rijnmond (GGD Rotterdam-Rijnmond), Rotterdam, the Netherlands.
Abstract
BACKGROUND: Scabies outbreaks are common in nursing homes in the Netherlands. In October 2018, a local public health service (PHS) in The Hague was notified of a new scabies outbreak in a nursing home in that region. The PHS initiated an outbreak investigation. Cases were defined as: possible (reported symptoms), probable (scabies-like lesions) and confirmed (PCR or microscopy in skin flakes). Head-to-toe examinations were performed of all residents and those staff members who reported symptoms suggestive of scabies. Skin scrapings of lesions were tested either with microscopy or by PCR. Experimentally for case finding, skin flakes from bed linens of residents who reported symptoms of itchiness but did not have primary lesions were sent for PCR testing. PRINCIPAL FINDINGS: All residents (41) and 37/44 staff were included in this outbreak investigation. We identified 30 possible, four probable and six confirmed cases. The overall attack rate for probable/confirmed cases was 10/78 (13%). Of the six confirmed cases, two were confirmed by PCR, three by microscopy, and one showed positive findings with both techniques. Two out of the three bed-linen specimens were PCR-positive. CONCLUSIONS: In this outbreak of scabies in a nursing home, PCR was used on skin flakes from bed linens, which led to the detection of two additional cases. This illustrates the potential of PCR during the investigation of scabies outbreaks.
BACKGROUND:Scabies outbreaks are common in nursing homes in the Netherlands. In October 2018, a local public health service (PHS) in The Hague was notified of a new scabies outbreak in a nursing home in that region. The PHS initiated an outbreak investigation. Cases were defined as: possible (reported symptoms), probable (scabies-like lesions) and confirmed (PCR or microscopy in skin flakes). Head-to-toe examinations were performed of all residents and those staff members who reported symptoms suggestive of scabies. Skin scrapings of lesions were tested either with microscopy or by PCR. Experimentally for case finding, skin flakes from bed linens of residents who reported symptoms of itchiness but did not have primary lesions were sent for PCR testing. PRINCIPAL FINDINGS: All residents (41) and 37/44 staff were included in this outbreak investigation. We identified 30 possible, four probable and six confirmed cases. The overall attack rate for probable/confirmed cases was 10/78 (13%). Of the six confirmed cases, two were confirmed by PCR, three by microscopy, and one showed positive findings with both techniques. Two out of the three bed-linen specimens were PCR-positive. CONCLUSIONS: In this outbreak of scabies in a nursing home, PCR was used on skin flakes from bed linens, which led to the detection of two additional cases. This illustrates the potential of PCR during the investigation of scabies outbreaks.
Authors: Babette van Deursen; Mariëtte Hooiveld; Susan Marks; Ingrid Snijdewind; Hans van den Kerkhof; Bas Wintermans; Ben Bom; Barbara Schimmer; Ewout Fanoy Journal: PLoS One Date: 2022-06-24 Impact factor: 3.752