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Scabies in Chronic Health Care Institutions

D. Linn Holness, MD, MHSc; Joel G. DeKoven, MD, MHSc; James R. Nethercott, MD
[+] Author Affiliations

Accepted for publication February 27, 1992.

Reprint requests to the Division of Occupational Health, School of Hygiene and Public Health, 615 N Wolfe St, Baltimore, MD 21205 (Dr Nethercott).


From Department of Occupational and Environmental Health, St Michael's Hospital (Dr Holness) and Division of Dermatology, Faculty of Medicine (Dr DeKoven), University of Toronto (Ontario); and Division of Occupational Health, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Md (Dr Nethercott).


Arch Dermatol. 1992;128(9):1257-1260. doi:10.1001/archderm.1992.01680190113015
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• Background.—  The diagnosis and management of outbreaks of scabies in health care facilities may be difficult. As there is little information available regarding the extent of this problem we conducted a questionnaire study to provide an indication of the occurrence of scabies in chronic health care facilities in the province of Ontario, Canada. It also documented the facilities' approach to the management of the disease.

Observations.—  Two outbreaks of scabies in chronic health care facilities are described. The questionnaire study revealed that 25% of the institutions reported that they had problems with scabies over a 1-year period. A minority had a written policy with respect to dealing with the management of scabies, particularly in the setting of a mass outbreak.

Conclusions.—  Scabies is a common problem in chronic health care facilities; however, diagnosis and management may be difficult. The development of a specific protocol for the management of such outbreaks by the appropriate public health agencies would be useful.(Arch Dermatol. 1992;128:1257-1260)

REFERENCES

Estes SA.  Diagnosis and management of scabies . Med Clin North Am. 1982;;66:955-963.
Hubler WR, Clabaugh W.  Epidemic Norwegian scabies . Arch Dermatol. 1976;;112:179-181.
Meyers LN.  Clinical presentation of scabies in a nursing home population . J Am Acad Dermatol. 1988;;18:396-397.
Moberg SAW, Lowhgen GBE, Hersle KS.  An epidemic of scabies with unusual features and treatment resistence in a nursing home . J Am Acad Dermatol. 1984;;11:242-244.
Browne S.  Scabies investigation at a local nursing home . Can J Public Health. 1988;;79:134-135.
Burns DA.  An outbreak of scabies in a residential home . Br J Dermatol. 1987;;117:359-361.
Lerche NW, Currier RW, Juranek DD, Baer W, Dubay NJ.  Atypical crusted `Norwegian' scabies: report of nosocomial transmission in a community hospital and an approach to control . Cutis . 1983;;31:637-684.
Parish LC, Millikan LE, Witkowski JA, Schwartzman R.  Scabies in the extended care facility . Int J Dermatol. 1983;;22:380-382.
Yonkosky D, Ladia L, Gackenheimer L, Schultz MW.  Scabies in nursing homes: an eradication program with permethrin 5% cream . J Am Acad Dermatol. 1990;;23:1133-1136.
Currier RW, Christie C, Wintermeyer LA.  Scabies in health-care facilities: Iowa . MMWR. 1988;;37:178-179.
Blumental DS, Taplin S, Schultz MG.  A community outbreak of scabies . Am J Epidemiol. 1976;;104:667-671.
Schultz MW, Gomez M, Hansen RC, et al.  Comparative study of 5% permethrin cream and 1% lindane lotion for the treatment of scabies . Arch Dermatol. 1990;;126:167-170.

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Estes SA.  Diagnosis and management of scabies . Med Clin North Am. 1982;;66:955-963.
Hubler WR, Clabaugh W.  Epidemic Norwegian scabies . Arch Dermatol. 1976;;112:179-181.
Meyers LN.  Clinical presentation of scabies in a nursing home population . J Am Acad Dermatol. 1988;;18:396-397.
Moberg SAW, Lowhgen GBE, Hersle KS.  An epidemic of scabies with unusual features and treatment resistence in a nursing home . J Am Acad Dermatol. 1984;;11:242-244.
Browne S.  Scabies investigation at a local nursing home . Can J Public Health. 1988;;79:134-135.
Burns DA.  An outbreak of scabies in a residential home . Br J Dermatol. 1987;;117:359-361.
Lerche NW, Currier RW, Juranek DD, Baer W, Dubay NJ.  Atypical crusted `Norwegian' scabies: report of nosocomial transmission in a community hospital and an approach to control . Cutis . 1983;;31:637-684.
Parish LC, Millikan LE, Witkowski JA, Schwartzman R.  Scabies in the extended care facility . Int J Dermatol. 1983;;22:380-382.
Yonkosky D, Ladia L, Gackenheimer L, Schultz MW.  Scabies in nursing homes: an eradication program with permethrin 5% cream . J Am Acad Dermatol. 1990;;23:1133-1136.
Currier RW, Christie C, Wintermeyer LA.  Scabies in health-care facilities: Iowa . MMWR. 1988;;37:178-179.
Blumental DS, Taplin S, Schultz MG.  A community outbreak of scabies . Am J Epidemiol. 1976;;104:667-671.
Schultz MW, Gomez M, Hansen RC, et al.  Comparative study of 5% permethrin cream and 1% lindane lotion for the treatment of scabies . Arch Dermatol. 1990;;126:167-170.

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