Outbreak of scabies in Norwegian nursing homes and home care patients: control and prevention

Over a period of five months (October 1998-February 1999), an outbreak of scabies affected 19 persons associated with a nursing home in Oslo, Norway. Scabies was diagnosed in 13 patients; six long-term patients, five short-term patients also cared for at home, and two home care patients associated with the same institution. Six healthcare workers who had assisted with infected patients in their own homes were also diagnosed with scabies. Two separate index cases were found. Both had had pruritus for several months, diagnosed as eczema, and were repeatedly treated at dermatology outpatient clinics before the diagnosis was made. Both index cases were cared for at home and in the nursing home (short-term). Repeated treatments with permethrin were tried before effective treatment with benzyl benzoate. Altogether 370 persons (patients, staff, relatives) were treated. In June-July 1999, scabies was diagnosed in two other nursing homes; six patients or staff, and 156 persons were treated. Patients with scabies were contact isolated and disinfection and cleaning was performed. Simultaneous treatment and washing or disinfection of clothing, bedding and environment of all potentially affected individuals is imperative to control an outbreak of scabies.