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PHEConf 2016 Cassell et al A prospective study of scabies outbreaks in ten residential for the elderly in South-East England 2014-15 care facilities.pdf (904.61 kB)

A prospective study of scabies outbreaks in ten residential care facilities for the elderly in South-East England, 2014-15

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posted on 2023-06-09, 03:12 authored by Jackie Cassell, Ananth Nalabanda, Stefania Lanza, Jo MiddletonJo Middleton, Michael G Head, Jennifer Bostock, Kirsty Hewitt, Chris JonesChris Jones, Charles Darley, Simran Karir, Stephen L Walker
Introduction Scabies is a significant problem in UK elderly residential care facilities (RCF); outbreaks are common and difficult to control. Clinical presentations in the elderly are poorly understood. We studied scabies outbreaks in RCFs to investigate the clinical signs and risk factors in this population. Methods We visited RCFs with suspected scabies outbreaks. We examined residents, performed dermoscopy and skin scrapings, and classified their scabies diagnosis as definite (mite visualised)/probable (compatible symptoms, mite not visualised)/possible (non-specific rash + contact with case) or non-scabies. All residents were treated twice with a topical scabicide, and a second visit conducted. Results We examined 230 residents at 10 RCFs between 03/02/2014-11/02/2015. Their median age was 87 years, 76% were female, and 68% had dementia. 61 (27%) had scabies (13% definite); 41% with burrows, 51% had not reported symptoms. Dermoscopy identified the mite in 7 cases (11.5%), skin scrapings in 3. We diagnosed a median 6 cases/RCF. Dementia was strongly associated with scabies (OR=2.4, 95% CI 1.4-4.1). No new cases were identified at the second visit (median interval 44 days), 10 cases still had scabies (2 probable, 8 possible). Discussion Scabies diagnosis is difficult in this population; half of cases were asymptomatic, and dermoscopy and skin scrapings were of limited diagnostic value. Our study is the first to confirm that dementia is a risk factor for scabies in this group. Careful examination of elderly residents of RCFs with suspected scabies outbreaks is important, particularly those with dementia, as they may have no obvious clinical signs.

Funding

British Skin Foundation

PHE Scabies Research Project; Public Health England South East

History

Publication status

  • Published

File Version

  • Published version

Event name

Public Health England Annual Conference 2016

Event location

University of Warwick, UK

Event type

conference

Event date

13-14 Sept 2016

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • No

Legacy Posted Date

2016-10-05

First Open Access (FOA) Date

2016-10-05

First Compliant Deposit (FCD) Date

2016-10-04

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