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Scabies

Human scabies is not a reportable disease in Oklahoma; however, the Oklahoma State Department of Health will work with facilities to provide educational materials if an infestation of human scabies is identified.  Scabies is caused by a parasitic insect, the human itch mite (Sarcoptes scabiei var. hominis).  These microscopic mites burrow in the upper layers of the skin where they live and lay eggs.

The symptoms of scabies include a red, pimple-like rash and itching, which can be more severe at night.  Nodules or vesicles may also be seen.  Tiny burrows can sometimes be seen as crooked grayish-white or skin colored thread-like lines on the skin surface.  Common sites for scabies are between the fingers, wrists, elbows, armpits, shoulder blades, breasts, waist, buttocks, and genitalia.  In children younger than 2 years of age, a rash can appear on scalp, face, neck, palms, and soles.  Scratching of pimples or vesicles can cause sores that can develop secondary bacterial infections.

When a person is exposed to scabies for the first time, symptoms may not appear for up to 2 months after being infected.  People who have had scabies previously may show symptoms as soon as 1-4 days.  It is important to remember that an infected person can still transmit scabies to others even when there are no apparent symptoms.  Scabies are transmitted through prolonged skin-to-skin contact with a person infected with scabies. Scabies can be easily transmitted to sexual partners or to other household members.  The use of shared items - such as clothing, towels, or bedding of an infected person – can spread scabies infection.  Scabies spreads more rapidly in crowded, institutionalized settings such as child care facilities, nursing homes, extended-care facilities, and prisons.  Suspected scabies should be reported to your healthcare practitioner immediately so that prompt diagnosis and treatment can reduce the chance of spread.

Scabies are treated through a scabicide lotion.  While some of these lotions are available “over-the-counter”, a physician should be consulted for correct diagnosis before treatment.  Package instructions on the medication should be followed carefully.  People who have been in close contact with the infected person should also be treated to prevent reinfestation.  All clothing, linens, and bedding should be washed in hot water.  Furniture and carpet should be thoroughly vacuumed.  Items that cannot be washed should be placed and sealed in a garbage bag for at least 72 hours.  Fumigation is not necessary.

Symptoms can sometimes continue after treatment.  If itching lasts more than two weeks after treatment or if new burrows or rash appear, a physician should be consulted to determine if retreatment is necessary.  A person who has correctly completed one treatment for scabies (along with laundering clothing and bedding) can safely return to work, school, or daycare.

Scabies in a Long Term Care Center:

Who should I notify if I feel my family member has scabies?
You should speak with a nurse at the facility.  A skin scrapping by a physician is recommended to confirm a person has scabies.

Who should I contact if a scabies infestation is occurring at the long term care facility my family member lives at?
Long term care centers notify the Acute Disease Service about suspect scabies infestations to obtain information about control of scabies within an institutional setting.  We provide educational material to the facility on controlling and preventing an infestation.  The facility also notifies the long term care service at the Oklahoma State Department of Health.

Scabies at a School:

Who should I notify if I feel my family member has scabies?
You should notify the school nurse and your health care provider.  A skin scraping by a health care provider is recommended to confirm a person has scabies.  Notify the school nurse if a skin scraping was performed.

Is the school required to send a letter home if an individual with scabies is in the same classroom as my child?
Speak to your school officials to ask when a letter would be sent home to notify parents about a child with scabies.  The Oklahoma State Department of Health Acute Disease Service does not require a letter to be sent home.   

Resources:

Scabies Fact Sheet (55kB.pdf)

Reference Table for Scabies Treatment (127kB.pdf)

Long Term Care Facility Resources:

Guidelines for Controlling Crusted Scabies Outbreaks in Institutional Settings (323kB.pdf)

Guidelines for Controlling Non-Crusted Scabies Outbreaks in Institutional Settings (308kB.pdf)

Other Resources:

Scabies (CDC)

Scabies in Institutional Settings (CDC)

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