Scabies outbreaks in residential care homes: Factors associated with late recognition, burden and impact. A mixed methods study in England

K. A. Hewitt*, A. Nalabanda, Jackie Cassell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks.

Original languageEnglish
Pages (from-to)1542-1551
Number of pages10
JournalEpidemiology and Infection
Volume143
Issue number7
DOIs
Publication statusPublished - 6 May 2015

Bibliographical note

Publisher Copyright:
© 2014 Cambridge University Press.

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

  • Ectoparasites
  • occupation-related infections
  • outbreaks
  • public health
  • scabies

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