1. SCABIES
animal.discovery.com

2. What is scabies? contagious disease caused by a mite sarcoptes scabiei
Originally, scabies was a term used by the Romans to denote any pruritic skin disease.
In the 17th century, Giovanni Cosimo Bonomo identified the mite as one cause of scabies.

3. The scabies mite

5. How is scabies transmitted?
Skin contact with infected person.
Infected persons who have no itching can pass the mite on to others
Scabies is usually not transmitted via clothing or bedding its very uncommon (the usual wash cycle can be used when these items are laundered)

6. In routine scabies, a single mite is seen
In routine scabies, a single mite is seen. Eosinophilic spongiosis may be present (H&E, 400X). Court

8. SIGNS and SYMPTOMS scabies rash
Classical sites of scabies rash...
between fingers
wrists
auxiliary areas
female breasts (particularly the skin of the nipples)
the umbilical area
penis and scrotum
buttocks
inside of legs
ankles

11. DIAGNOSIS
Definite diagnosis - a definite diagnosis is made by taking skin scrapings from burrows and identifying the mites, their eggs or faeces by microscopy
Presumptive diagnosis - it is often difficult to find burrows and obtain suitable specimens, therefore presumptive diagnosis relies on history and clinical appearance

12. TREATMENT scabicides Use a scabicide for the treatment of scabies
Permethrin (Elimite) -- In 5% cream.

13. TREATMENT application of lotion or cream

14. Ivermectin (Mectizan, Stromectol) Binds selectively with glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, causing cell death.

15. OUTBREAKS prevention Promote good surveillance of new residents
Observe for rashes on arrival at the home, then at 3 weeks and at 6 weeks
Maintain a high level of suspicion if patients present with undiagnosed skin rashes
Families are treated all at the same time.

16. Scabies references
Burgess I, Sarcoptes scabiei and scabies, Advances in parasitology, Vol 33, Academic Press Limited
Burgess I, Cohen J, Treating lice and scabies, Pages , Prescriber, 19 November 2000
Walker GJA, Johnstone PW, Interventions for treating scabies, The Cochrane Library, Issue 3
Roberts DT, 2000 Editor – Lice and Scabies – A Health Professionals Guide to Epidemiology and Treatment. Public Health Laboratory Service, London
Notes to trainer on this presentation
Recommendations for Standard Precautions are intended primarily for the care of patients in acute hospitals. However, the principles should be applied in other settings where patient care is undertaken.
Some healthcare workers still have knowledge gaps and a lack of understanding of certain practices and their effectiveness in reducing the transmission of infections between people. Current practice relies upon risk assessment, where potential risks can be removed, reduced or managed.
Historically, infection control has been perceived as a hospital problem, with community issues seen as less significant. Today, as more patients receive their healthcare in community settings (outside of the acute hospitals) infection prevention and control has become relevant to all clinical staff wherever they may practice.
This presentation provides healthcare workers with an introduction to the principles and practice of Standard Precautions.