scabies
SCABIES
Scabies is a contagious disease caused by the mite Sarcoptes scabiei var hominis.
The affected individual usually complains of having a highly pruritic rash that occurs at night.
It occurs more often in children <15 years of age, sexually active young adults, the immunocompromised and in persons living in crowded living conditions (eg nursing homes, military barracks).
Transmission is typically by direct skin contact with an infected person and in adults, sexual transmission is common.

Patient Education

Prevention of Disease Transmission

  • Patient and close physical contacts should be educated about scabies transmission and the necessary steps to prevent spread
  • It is important to treat the infested individuals and their close physical contacts at the same time to avoid re-infestation
  • Infected individuals should avoid skin-to-skin contact with non-infected persons
    • Advise patients to avoid close contact with partner until completion of treatment
  • To help avoid transmission by fomites hygienic measure should be undertaken
    • Infected individual should use clean/fresh clothing or bedding after treatment
    • Wash potentially contaminated clothes, towels and bedding at high temperature (>50°C) or store them in plastic bags for at least 72 hours
    • There is no need to clean coats, furniture, rugs, floors or walls in any special manner

Disease Treatment

  • Educate the patient and the patient’s close physical contacts about the disease treatment
  • Patient should be made aware that itching may persist for up to 2-4 weeks after the end of appropriate treatment
  • The patient should be thoroughly educated about the application of the treatment, and supplementation with written instructions may be helpful
    • Verbal and written instructions should include: The amount of drug to be applied, how the treatment should be applied and where to apply the treatment 
  • Infants and young children: The entire body surface from the neck down should be covered and if necessary, include the scalp and face (avoid the areas around the eyes and mouth)
  • Older children and adults: Apply from the neck down, with particular attention to intensely involved areas eg folds, groin, navel, tips of the fingers and under the nails especially in crusted scabies
  • Skin should be kept cool and dry and patient must change into clean clothing after application
  • If the patient applies the topical treatment him/herself, the hands should not be washed after application
    • If treatment is applied by a non-infected person, the person should wear disposable gloves
  • The nails should be cut short
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