Controlling recurrent scabies outbreaks in a geriatric hospital: impact of a prevention bundle and lessons from a...

Scabies represents a significant infection control challenge in geriatric care facilities. Traditional reactive strategies, such as isolating identified cases, have frequently proven inadequate in preventing recurrent outbreaks, underscoring the need for proactive, systematic approaches. This study aimed to evaluate the effectiveness of a comprehensive, proactive intervention strategy in controlling nosocomial scabies transmission in a large specialized geriatric hospital.

A before and after study was conducted, comparing a pre-intervention period (January 2021-December 2024) with an intervention period (January-December 2025). The multimodal strategy included mandatory admission screening and transfer isolation for all new inpatients, weekly active symptom surveillance of caregivers, and strict implementation of a "one patient, one caregiver" model coupled with infection prevention training.

Pre-intervention, 114 scabies cases were recorded, including 62 definite nosocomial transmissions and 18 infected caregivers. Post-intervention, 13 imported cases were intercepted at admission. Only one nosocomial transmission event (involving a nurse) was recorded, and no caregiver infections occurred. The reduction in nosocomial transmission was statistically significant (P < 0.001).

A proactive, multimodal intervention bundle effectively interrupted nosocomial scabies transmission in a high-risk geriatric setting. This strategy should be considered for integration into standard infection control protocols in long-term care facilities.