Scabies outbreak management in a vulnerable elderly population: Evidence from northeastern Iran.

Area of Science:

• Dermatology
• Infectious Diseases
• Public Health

Background:

• Scabies, caused by *Sarcoptes scabiei*, is a highly contagious neglected tropical disease.
• Vulnerable populations in institutional settings are particularly susceptible to scabies outbreaks.
• Norwegian scabies, a severe form, necessitates prompt and comprehensive management.

Purpose of the Study:

• To describe a scabies outbreak in a 24-h elderly care facility in northeastern Iran.
• To detail the clinical characteristics, management strategies, and long-term consequences of the outbreak.
• To emphasize the importance of integrated control measures in institutional settings.

Main Methods:

• Screening of elderly residents and staff following an index case diagnosis of Norwegian scabies.
• Diagnosis based on 2020 International Alliance for the Control of Scabies (IACS) criteria and confirmed by microscopy.
• Treatment involved topical 5% permethrin cream and oral ivermectin, with permethrin prophylaxis for unaffected individuals.
• Environmental control measures included hot laundering, vacuuming, and isolation.

Main Results:

• An attack rate of 16.7% among residents (4/24) and 0% among staff (0/13).
• Four cases identified: one crusted scabies and three ordinary scabies, all in female residents.
• Complete recovery within 8–19 days, with no new cases during a one-year follow-up.
• Effective outbreak control achieved through early diagnosis, combined therapy, and environmental measures.

Conclusions:

• Integrated management protocols involving early diagnosis, combined therapy, and environmental controls are crucial for managing scabies outbreaks in elderly care facilities.
• The study underscores the necessity of complex, multi-faceted strategies to control scabies, even in low-endemic areas.
• Prompt intervention and adherence to control measures can lead to complete recovery and prevent long-term consequences.