Epidemic Norwegian scabies in a geriatric unit

Area of Science:

• Dermatology
• Infectious Diseases
• Epidemiology

Background:

• Norwegian scabies is a severe, highly contagious skin infestation.
• It disproportionately affects the elderly and immunocompromised individuals.
• Prompt diagnosis and treatment are crucial to prevent outbreaks.

Observation:

• An index case of Norwegian scabies was admitted to a geriatric ward.
• Within two weeks, a significant number of patients and nursing staff contracted scabies.
• The infestation presented as a psoriasiform dermatosis.

Findings:

• A ward-wide outbreak occurred despite initial treatment efforts.
• The epidemic recurred six weeks later, suggesting incomplete eradication.
• Inadequate treatment of the initial case was the probable cause of recurrence.

Implications:

• Healthcare facilities, especially geriatric wards, must maintain high suspicion for Norwegian scabies.
• Early and comprehensive treatment protocols are essential to prevent nosocomial spread.
• Undiagnosed rashes in high-risk populations warrant immediate investigation for scabies.