Skip to main content Accessibility help
×
Home

The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines

  • L. C. J. WHITE (a1), S. LANZA (a1), J. MIDDLETON (a1), K. HEWITT (a2), L. FREIRE-MORAN (a1), C. EDGE (a2), M. NICHOLLS (a2), J. RAJAN-IYER (a2) and J. A. CASSELL (a2)...

Summary

Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: Ms. L. C. J. White, Scabies Research Project, Department of Primary Care and Public Health, Brighton and Sussex Medical School, Room 323, Mayfield House, Falmer BN1 9PH, UK (Email: L.White1@uni.bsms.ac.uk)

References

Hide All
1. Suwandhi, P, Dharmarajan, TS. Scabies in the nursing home. Current Infectious Disease Reports 2015; 17: 453.
2. Hewitt, KA, Nalabanda, A, Cassell, JA. Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England. Epidemiology and Infection 2015; 143: 15421551.
3. Hengge, UR, et al. Scabies: a ubiquitous neglected skin disease. Lancet Infectious Diseases 2006; 6: 769779.
4. Fuller, LC. Epidemiology of scabies. Current opinion in Infectious Diseases 2013; 26: 123126.
5. Green, M. Epidemiology of scabies. Epidemiological Reviews 1989; 11: 126150.
6. Walton, SF. The immunology of susceptibility and resistance to scabies Parasite Immunology 2010; 32: 532540.
7. Vos, T, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 386: 743800.
8. Mounsey, K, et al. Retrospective analysis of institutional scabies outbreaks from 1984 to 2013: lessons learned and moving forward. Epidemiology and Infection. Published online: 28 March 2016. doi:10.1017/S0950268816000443.
9. Hay, RJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. Journal of Investigative Dermatology 2013; 134: 18.
10. Bouvresse, S, Chosidow, O. Scabies in healthcare settings. Current Opinion in Infectious Diseases 2010; 23: 111118.
11. Wilson, MG, Philpott, CD, Breer, WA. Atypical presentation of scabies among nursing home residents. Journal of Gerontology: Medical Sciences 2001; 56: M424M427.
12. Chosidow, O. Scabies and pediculosis. Lancet 2000; 355: 819826.
13. Lay, CJ, et al. Risk factors for delayed diagnosis of scabies in hospitalized patients from long-term care facilities. Journal of Clinical Medicine Research 2011; 3: 7277.
14. Hawker, J, et al. Communicable Disease Control Hand-book, 2nd edn. New Jersey: Wiley-Blackwell, 2005, pp. 200203.
15. Lassa, S, Campbell, MJ, Bennett, CE. Epidemiology of scabies prevalence in the U.K. from general practice records. British Journal of Dermatology 2011; 164: 13291334.
16. British National Formulary (BNF). 13·10·4 Parasitical preparations: scabies. (https://www.medicinescomplete.com/mc/bnf/current/index.htm). Accessed 30 August 2015.
17. Department of Health. Health Protection Legislation (England) Guidance 2010, 2010 (http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_114510). Accessed 26 August 2015.
18. Department of Health, Public Health England, Local Government Association. Protecting the health of the local population: the new health protection duty of local authorities under the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives). Regulations 2013, 2013 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/19977/Health_Protection_in_Local_Authorities_Final.pdf). Accessed 10 August 2015.
19. Public Health England. Communicable disease outbreak management: operational guidance, 2014. (https://www.gov.uk/government/publications/communicable-disease-outbreak-management-operational-guidance). Accessed 17 September 2015.
20. Health Protection Agency England. HPA National Measles Guidelines for Local & Regional Services, 2010 (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/32293/National_Measles_Guidelines.pdf). Accessed 12 January 2016.
21. Barkwell, R, Shields, S. Deaths associated with ivermectin treatment of scabies. Lancet 1997; 349: 11441145.
22. National Institute for Health Care Excellence (NICE). Clinical knowledge summaries. Scabies, 2011 (http://cks.nice.org.uk/scabies). Accessed 26 August 2015.
23. Fitzgerald, D, Grainger, RJ, Reid, A. Interventions for preventing the spread of infestation in close contacts of people with scabies. Cochrane Database of Systematic Reviews 2014; 2: CD009943.
24. Scott, GR, Chosidow, O. European guideline for the management of scabies, 2010. International Journal of STD & AIDS 2011; 22: 301303.
25. British Association for Sexual Health and HIV (BASHH). United Kingdom national guideline on the management of scabies infestation 2007, 2007. (www.bashh.org/documents/27/27.pdf). Accessed 26 January 2016.
26. Castor, C, Bernadou, I. Community-based scabies epidemics - a guide to investigation and management, 2008 [in French], (http://www.invs.sante.fr/publications/2008/epidemie_gale_commmunautaire/). Accessed 26 January 2016.
27. National Coordination Centre for Prevention of Infectious Disease. Manual for ‘scabies’, scabies in care homes, 2006 [in Dutch]. (http://www.rivm.nl/Documenten_en_publicaties/Professioneel_Praktisch/Draaiboeken/Infectieziekten/LCI_draaiboeken/Scabies_schurft_in_zorg_instellingen). Accessed 31 August 2015.
28. Ladbury, G, et al. An outbreak of scabies in multiple linked healthcare settings in The Netherlands. Infection Control & Hospital Epidemiology 2012; 33: 10471050.
29. International Committee of the Red Cross (ICRC). Healthcare in detention: managing scabies outbreaks in prison settings. 2015 (https://www.icrc.org/eng/resources/documents/publication/p4241.htm). Accessed 6 June 2016.
30. Department for Health and Ageing, Government of South Australia. Scabies management in care facilities, 2012, 2012 (http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources/policies/scabies+management+in+care+facilities Accessed 12 June 2016.
31. Centers for Disease Control and Prevention (CDC). Scabies, resources for health professionals: institutional settings (http://www.cdc.gov/parasites/scabies/health_professionals/institutions.html Accessed 12 June 2016.
32. Wolf, R, Davidovici, B. Treatment of scabies and pediculosis: facts and controversies. Clinical Dermatology 2010; 28: 511518.
33. Strong, M, Johnstone, P. Interventions for treating scabies. Cochrane Database of Systematic Reviews 2007; 3: CD000320.
34. Coyne, PE, Addiss, DG. Deaths associated with ivermectin for scabies. Lancet 1997; 350: 215216.
35. Bockarie, MJ, et al. Treatment with ivermectin reduces the high prevalence of scabies in a village in Papua New Guinea. Acta Tropica 2000; 75: 127–30.
36. Heukelbach, J, Feldmeier, H. Scabies. Lancet 2006; 367:1767–74.
37. Usha, V, Gopalakrishnan Nair, T V. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies. Journal of the American Academy of Dermatology 2000; 42: 236240.
38. NHS England. Notifications required by the Health and Social Care Act 2008: Guidance for English NHS providers, 2013 (http://www.cqc.org.uk/sites/default/files/documents/statutory_notifications_for_nhs_bodies_-_provider_guidance_v6.pdf). Accessed 27 August 2015.
39. Tsutsumi, M, Nishiura, H, Kobayashi, T. Dementia-specific risks of scabies: retrospective epidemiologic analysis of an unveiled nosocomial outbreak in Japan from 1989–90 BMC Infectious Diseases 2005; 5: 85.
40. Mental Capacity Act 2005. Chapter 9 (http://www.legislation.gov.uk/ukpga/2005/9) Accessed 6 June 2016.
41. NHS Business Services Authority. Help with healthcare costs, 2012 (http://www.nhsbsa.nhs.uk/792.aspx). Accessed 6 June 2016.

Keywords

Type Description Title
WORD
Supplementary materials

White supplementary material S1
White supplementary material

 Word (212 KB)
212 KB
WORD
Supplementary materials

White supplementary material S2
White supplementary material

 Word (14 KB)
14 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed