SCABIES

Summary

The hazard: Scabies is a communicable disease of the skin that is caused by a tiny bug called a mite that digs into the skin and lays its eggs. Symptoms include intense itching and sores can become infected from scratching.

How scabies spread: The disease is spread by skin contact with "infested persons"..

Who is at risk: Health care and day care workers, classroom aides, and others who have contact with an infected person can get scabies.

Prevention: Isolate infected people and notify workers, avoid contact with skin, clothing, and linens of infected people, and hand washing after contact.

WHAT IS SCABIES?

Scabies is a communicable disease of the skin that is caused by a tiny bug called a mite. The mites dig into the skin and lay their eggs. The mites can burrow beneath the skin surface in 2 ½ minutes. Symptoms include intense itching, especially at night. Sores can become infected from scratching. Common places to see where the mites have burrowed include the finger webs, the folds of the elbows and wrist, and the belt line. Men are often affected in the genital area and women are often affected at the nipples, abdomen and lower buttocks.

HOW IS SCABIES SPREAD?

Scabies is transmitted when a person's skin comes into contact with someone else's skin that is infected. Scabies can also be spread by contact with contaminated undergarments and bedclothes. It takes two to six weeks (incubation period) to become infected for persons that have not previously been infected. It only takes one to four days to become infected for those who have had the infection before.

WHO IS AT RISK?

Anyone who comes into contact with an infected person can get scabies. Health care workers can get scabies by contact with infected patients. Day care workers, classroom aides, and others who work with children can be exposed at the workplace.

HOW CAN WORKERS BE PROTECTED FROM SCABIES?

In addition to avoiding discomfort, it is important to prevent scabies because some of the products used to treat scabies contain toxic chemicals. Therefore, the following precautions should be taken to prevent the spread of the disease.

• Isolation and notification: Hospitalized patients must be isolated from other patients or residents for 24 hours after the start of effective treatment. Workers need to know patients or residents have scabies. Isolation cards with easy to understand instructions need to be posted in the area near the infected patient(s). Visitors who have had skin-to-skin contact with the infested person should be notified about the infection and treatment measures. School employees, day care workers and social service workers should immediately contact a parent, guardian of a child or the client themselves in the event that a case of scabies is suspected so that the individual can be seen by a physician and treatment can be started.

· Avoiding contact (work practices): Workers need to avoid skin-to-skin contact with infected individuals.

· Protective clothing: Gloves must be worn when contact is necessary.

· Handwashing: Workers must wash hands immediately after touching patients, clients, children, or other infested persons, as well as potentially contaminated bedding or garments.

· Laundry: Underwear, clothing, and bed sheets worn or used in the 48 hours prior to treatment need to be discarded or laundered using hot cycles of the washer and dryer. Contaminated articles should be bagged and labeled. Plastic bags that dissolve in water should be used for all contaminated materials and loaded directly into washing machines.

· Training: Workers need training about scabies, how it is spread and how to control infections. Complaints of itching and/or even a minimal rash should be reported to a supervisor so that a physician can examine the patient to make the diagnosis.

WHAT IS THE TREATMENT FOR SCABIES?

There are various creams or lotions that may be prescribed for scabies. The treatments include: Permethrin (Elimite), Lindane (Kwell) or Crotamiton 10% (Eurax).

January 2001

For more information about protecting workers from workplace hazards, contact the AFSCME Health and Safety Program at (202) 429-1228, or 1625 L Street, N.W., Washington, DC 20036.