Scabies: Avoiding the Big Itch
By Cole Anderson
As parents and teachers of young children well know, the annual resumption of classes is invariably followed by waves of unwelcoming illness. From coughs and colds, to influenza and stomach bugs (just to name a few), many parents have come to terms with their child's inevitable journey against germs. Despite familiarity with seasonal illnesses, a remerging disease causing agent has left many parents unsettled and uniformed on a particular condition that has been described since the 18th century. This neglected parasitic infection that is often unnoticed, misdiagnosed or worse, untreated is colloquially known as 'the seven year itch 'and denoted in present times as scabies!
The sheer thought or mention of scabies is likely to have most people recoiling in horror. Scabies is an infestation of the skin by the human itch mite, Sarcoptes scabiei. Infestations occur when the mite, barely visible to the naked eye, burrows into the epidermis (outermost layer of skin) and lays eggs, triggering a host immune response that leads to intense itching. Scabies is highly contagious and spreads principally by direct skin"to"skin contact and to a lesser extent through contact with infested garments and bedclothes. The most common signs and symptoms of scabies are intense itching (pruritus), especially at night, and a pimple"like (papular) itchy rash. The itching and rash may affect the majority of the body or be limited to common sites such as the wrist, elbow, armpit and webbing between the fingers. Adult mites can live up to about a month on an infected individual; however, once away from the human body, mites only survive 48"72 hours. Individuals who are infested with scabies for the first time typically experience symptoms after 4 to 6 weeks, unlike those with subsequent infestation where symptoms appear within days. These symptoms and signs include;
- Itching. This is the main symptom of scabies, which is often severe and tends to be in one place at first (often the hands), and then spreads to other areas. The itch is generally worse at night and after a hot bath or shower.
- Mite tunnels (burrows). These may be seen on the skin as fine, dark, or silvery lines about 2"10 mm long. They most commonly occur in the loose skin between the fingers the inner surface of the wrists, and the hands.
- Rash. The rash usually appears soon after the itch starts. It is typically a blotchy, lumpy red rash that can appear anywhere on the body.
- Scratching. Scratching due to intense itching can cause minor skin damage and at times, secondary skin infections leading to improper diagnosis.
- Aggravation of pre"existing skin conditions. Scabies can worsen the symptoms of other skin conditions, particularly itchy skin problems such as eczema, or problems such as psoriasis.
As estimated by the World Health Organization, approximately 300 million cases of scabies occur annually. Scabies is found worldwide and affects people of all races and social classes. However, due to the nature of the disease, scabies can spread rapidly under crowded conditions where close body and skin contact is frequent. This leaves institutions such as child care facilities, nursing homes, homeless shelters and extended"care facilities as common sites of scabies infestations. Scabies (much like head lice) are often wrongfully perceived in society as a sign of uncleanliness and present a social stigma to those infected. Unfortunately, it is precisely this stigma that stops many people getting help immediately. In addition to prolonging a sufferer's discomfort, this delay is a serious public health risk to both the infected and uninfected individuals.
Fortunately, there are products called scabicides, which are available with a doctor's prescription to treat the disease. Individuals with scabies"like symptoms should be checked and treated by their doctor as soon as possible. Due to the contagious nature of scabies, all persons living in the same house and having skin"to"skin contact with someone with scabies should be treated at the same time to prevent rexposure or reinfestation. Bedding and clothing worn or used next to the skin anytime during the 3 days before treatment should be machine washed and dried using the hot water and hot dryer cycles or be dry"cleaned. Items that cannot be dry"cleaned or laundered can be disinfested by storing in a closed plastic bag for several days to a week.
Cole Anderson is a Community Health Worker on the Mobile Health Services team at the NorWest Community Health Centres.
Feel Better, Live Longer, Be Happier