Control of large institutional scabies outbreaks

Area of Science:

• Epidemiology
• Infectious Disease Control

Background:

• Scabies outbreaks in institutional settings can become extensive and prolonged.
• Crusted scabies, a highly contagious form, frequently causes healthcare-associated outbreaks.

Purpose of the Study:

• To develop and implement a comprehensive control strategy for a large-scale scabies outbreak in a sheltered workshop and residential homes.
• To detail the key components of a successful scabies elimination plan in an institutional setting.

Main Methods:

• A multifaceted control strategy was developed, informed by a literature review.
• Key interventions included organized management, simultaneous clinical examinations, and synchronous topical treatment with permethrin 5% cream.
• Systemic treatment with oral ivermectin, decontamination, quarantine, and follow-up investigations were also employed.

Main Results:

• The implemented strategy led to successful scabies elimination among over 500 exposed individuals.
• The concept involved careful organization, widespread clinical examination, and coordinated topical and systemic treatments.
• Decontamination, quarantine, and diligent follow-up were crucial for eradication.

Conclusions:

• Effective management of large institutional scabies outbreaks necessitates strong organizational structures.
• High levels of motivation, communication, and perseverance are essential for successful outbreak control.