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Warning After Outbreak Of SCABIES Hits UK School - As Cases Of Ancient Disease Soar Across The Country
A leading sixth form college in the South West has been hit by an outbreak of highly-contagious scabies — a parasitic infection caused by mites that burrow into the skin.
Parents of students at Truro and Penwith College have been warned that several students at its Truro campus have caught the disease, which can be transmitted via shared towels, bed linen and even cushions.
The warning email issued by the school advises parents to take children with an itchy rash that is worse at night to their GP and tell the doctor they have been in contact with scabies.
'If they are diagnosed with scabies it is important that all members of the household are also treated at the same time, regardless of whether they have any symptoms,' CornwallLive reported.
More commonly associated with Victorian or Dickensian times, scabies manifests as an intensely itchy and bumpy rash caused by the saliva, eggs and faeces of the parasitic mite Sarcoptes scabiei.
Hospital cases of the condition — which can, in rare cases, lead to life-threatening blood infections — jumped by 73 per cent since last year, according to the latest data.
The new outbreak comes just months after GPs warned of a rise in cases of the infection with the number diagnoses by family doctors 'above the five-year average and rising'.
This followed another warning in January about infection rates doubling in a year, leading to fears the mites were becoming resistant to routine medications.
Parents of students at Truro and Penwith College have been warned that several students at its Truro campus have caught the disease, which can be transmitted via shared towels, bed linen and even cushions
More commonly associated with Victorian or Dickensian times, scabies manifests as an intensely itchy bumpy rash caused by the saliva, eggs and faeces of the parasitic mite Sarcoptes scabiei (pictured)
Scabies is highly contagious and is infamous for sweeping through places with shared accommodation, such as university halls, care homes, prisons and immigration detention facilities.
People being to experience the characteristic rash, which looks like a row of raised dots as the mites burrow into the skin and lay eggs, up to eight weeks after contact with an infected person or their belongings.
Scabies is most often transmitted by prolonged or frequent skin-to-skin contact, such as sex or the sharing of towels, bedding, or clothing.
The infection is incurable without treatment.
NHS guidance recommends using either permethrin or malathion creams, which must be rubbed all over the body, including under the nails.
It should be kept on for up to 24 hours and has to be repeated after a week.
As an alternative, evidence suggests ivermectin — taken in pill form — is safe and equally as effective.
European regulators recommend it in two doses two weeks apart for standard scabies. It can be used alongside the creams for more severe cases.
In the UK, however, a prescription can be issued only by a specialist — usually a dermatologist — for severe cases, or to treat an outbreak, according to the UK Health Security Agency (UKHSA).
While scabies is not typically dangerous by itself, scratching by the infected can lead to secondary bacterial infections of the skin.
People with compromised immune systems, such as cancer patients undergoing chemotherapy, are vulnerable to hyper-infestations of the mites called crusted scabies.
Truro and Penwith College is a lauded sixth form college in the South West, that was the first tertiary college to be awarded 'Outstanding' status by Ofsted in 2006, according to the school's website.
Its also been listed in the top 20 state schools for students getting places in Oxford or Cambridge.
School Kids Develop 'nightmare' Rashes In Victorian Disease Outbreak As Cases Surge By 73% – Don't Ignore Key Signs
SCHOOL kids have developed "nightmare" rashes in an outbreak of a Victorian disease - with cases surging by 73 per cent.
Truro and Penwith College in Cornwall has warned parents after scabies was discovered on campus.
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Truro and Penwith College in Cornwall
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A scabies miteCredit: GettyIn an email seen by CornwallLive, the college said: "Scabies is infectious but it can take up to eight weeks for the rash to appear.
"If your child has or develops symptoms, that is an itchy rash that is worse at night or when they are hot, please see your GP.
"Let them know that they have been in contact with someone who has scabies.
"If they are diagnosed with scabies it is important that all members of the household are also treated at the same time.
"Regardless of whether they have any symptoms, they are close contact and are at risk of developing scabies."
SCABIES ALERTAccording to the HSE and the World Health Organisation, the symptoms of scabies include:
The rash or spots may look red, and can appear anywhere, but it often starts between the fingers.
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'NIGHTMARE'
Doctors said our son, 6, had a Christmas bug - then came devastating diagnosisIt usually spreads across the whole body, but not the head.
You may develop a rash on your head and neck if you:
The HPSC said: "It usually starts with itching, which can affect the whole body, and can be worse at nighttime. A rash can also be present in affected areas of skin; it may be seen in skin folds, for example between fingers and toes."
TREATMENTPharmacies can provide creams or lotions to apply over your entire body to treat scabies.
Everyone in the house must be treated at the same time, even if they do not have symptoms, along with anyone you have had sexual contact with in the past 8 weeks.
The HPSC advises: "Following the first application of treatment, all clothing, bedding and towels should be washed in a minimum 50 degrees Celsius wash cycle or put in a tumble dryer for 30 minutes at a minimum of 50 degrees Celsius to destroy mites.
"Alternatively, items can also be sealed in a plastic bag for four days.
"These may include items which have been exposed to prolonged direct contact with the skin, for example shoes, coats, hats, soft toys and removable covers of child car seats and buggies.
"Other items, such as mattresses and car seats, which have had prolonged direct contact with skin can be vacuumed."
You may go back to work or school 24 hours after the first treatment - though the treatment kills the mites quickly, the itching may last for a few weeks.
A second treatment is required a week later.
SEVERE MEDICINE SHORTAGEHowever, currently there is a severe shortage of cream available, adding to the rise in cases and leaving medical professionals concerned.
North Dublin GP, Ray Walley said: "We've had shortages of some of the main treatments for years.
"The big concern is if scabies gets into care homes, where it can afflict vulnerable older residents."
He added that the further rise in cases is "inevitable" as a result of treatment shortages.
Usual treatment for scabies is two applications of permethrin, or malathion as a second‐line treatment, applied one week apart.
However, permethrin is currently unavailable in its proprietary and generic forms, according to Dr Walley.
Malathion, sold under the Derbac trade name is currently on the Health Products Regulatory Authority's medicine shortage list as being unavailable.
It had an expected return date of January 31, though Dr Walley said it has not been available "for years".
A third option, benzyl benzoate, can be used when the two other treatments are unavailable, but Dr Walley noted that this is not available on the medical card.
Speaking about scabies, Dr Walley said: "It's not about being dirty; you could get it from shaking hands with the driver of a Rolls Royce. It can affect any age group."
He noted that scabies medications need to be added to the EU's list of priority medicines.
You are advised to contact your GP if your skin is still itching 4 weeks after treatment has finished.
To stop scabies from spreading, the HSE advises:
Though not usually serious, scabies can sometimes lead to complications.
Scratching the rash may cause skin infections including impetigo, and scabies can also make eczema or psoriasis worse.
If there are a lot of mites present, crusted scabies can form - a more serious conditions, but not common, that can affect older people and those with a lowered immune system.
What are the symptoms of scabies?
The spots may look red.
They are more difficult to see on dark skin, but you should be able to feel them.
A scabies rash (collection of spots) usually spreads across the whole body, apart from the head.
However, older people, young children and those with a weakened immune system may develop a rash on their head and neck.
Source: NHS
Scabies Crustosa
A 62-year-old woman presented reporting a history of nocturnal pruritus and multiple papules. Excoriated nodules and large areas of erythema were visible over the whole integument. Moreover, large yellowish scabs were present on the patient's feet and around the navel (Figure, left). However, no ductal structures typical of scabies could be detected. Light microscopy revealed numerous agile scabies mites, eggs, and scybala in scabs removed from the umbilicus (Figure, right). This provided swift, simple confirmation of the diagnosis of crusted scabies. The patient's husband was then examined and found to have skin manifestations typical of scabies, namely comma-shaped mite passages and crusty papules. The patient was admitted to hospital and treated in isolation, while persons with whom she had come into contact were treated according to the recommendations of the Robert Koch Institute. The crusts came off and the pruritus rapidly resolved. Crusted scabies is considered highly contagious because an extremely high density of mites must be assumed, particularly in the crusts and scabs. Even brief skin contact can lead to infection. Patients with crusted scabies are of particular relevance in the event of local outbreaks of scabies in care homes and hospitals.Lepios Klinik Weissenfels, Weißenfels, d.Kohn@asklepios.Com
Dr. Med. Diana Kohn, PD Dr. Med. Tino Wetzig, Asklepios Klinik Weissenfels, Facharzt Dermatologie, Weißenfels, dr.Diana.Kohn@gmail.Com; d.Kohn@asklepios.Com
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by David Roseveare.
Cite this as: Kohn D, Wetzig T: Crusted scabies. Dtsch Arztebl Int 2020; 117: 60. DOI: 10.3238/arztebl.2020.0060a
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