‘Nightmare’ surge in scabies cases prompts alarm from doctors

An “alarming” rise in scabies cases has prompted a health crisis in the United Kingdom, with experts calling the situation an “absolute nightmare.”

Scabies — a “highly contagious,” itchy skin infestation by mites that is spread through direct skin contact — has particularly spiked in nursing care homes, reported the Guardian, was recently seen in a recent outbreak among students at the University of the Arts’ Central Saint Martins college in north London.

Areas in northern England reportedly saw double the expected number of cases in November.

Physicians especially have raised concerns about sufficiently tamping down the parasitic problem before it becomes more widespread.

“A major concern is scabies spreading in care homes, university halls of residence and other communal living facilities,” Prof. Mabs Chowdhury, the president of the British Association of Dermatologists, told the Guardian. “This makes treatment much more difficult. If even one person isn’t treated completely, everyone can be reinfected. Given the challenges in social care and the treatment shortages, public health bodies need to plan for outbreaks in care facilities.”

Supply chain issues may make things even more difficult, as permethrin and malathion — the primary insecticides used to treat scabies in the UK — have been in shorter supply in the wake of the war between Russia and Ukraine.

In addition, the problem could be more severe than feared because of “very limited” tracking of scabies patients, one dermatologist told the Guardian. The publication commissioned a survey that found eight of nine regional representatives recorded a spike in their specific locales this year. The study also found that seven of nine regions noted a shortness of malathion and permethrin.

According to a UK Times report, the rate of scabies in November was double the norm for this time of year, logging three cases per 100,000 people, according to data from the Royal College of General Practitioners. By contrast, experts noted 1.4 cases per 100,000 people between 2018 and 19.

A whopping 484 cases in the week starting Nov. 27 were recorded by 500 general practitioners in England and Wales, according to the Times. At the same time in 2021, only 56 were logged, with a total of 94 found in 2022.

During a scabies infestation, microscopic mites burrow into the upper layer of a person’s skin, causing a rash and itching, with the severity spiking in overnight hours.

According to the New York City Department of Health and Mental Hygiene, infected areas often include:

• wrists
• arms
• elbows
• knees
• genitals
• between fingers
• around the waist
• between the buttocks
• under the arms

In addition, the issues can present in the form of:

• red patches
• pimples
• bumps
• rash
• blisters
• short, dark lines across the skin
• thickening of the skin in the form of a “crust,” signifying a more serious infestation

For the general public, the alarm over potential outbreaks is real: One student who witnessed the London university outbreak told Metro, “It was madness … People were so nervous because they had been sitting in the studios all day without knowing that they could have contracted something.”

While a spike hasn’t yet been logged in the United States, some areas have seen upticks in both lice and scabies.

A Las Vegas homeless shelter recently started screening guests for the pests amid a Southern Nevada Health District investigation into a spike in unhoused persons.

In September a Chicago police station was temporarily closed for deep cleaning, according to NBC 5, after a case was discovered there; treatment also was given to the affected person.

And in early 2019, two FDNY firehouses were closed due to infections of personnel.

While not inherently serious, cases of scabies can “affect a patient’s quality of life, so quick treatment is important,” Prof. Kamila Hawthorne, the chair of the Royal College of GPs, told the Guardian.

Unfortunately, there is one other barrier that physicians can face when tackling the problem: patients who get scabies can experience shame because they can be wrongly seen as somehow unhygienic.

“We must reduce any stigma associated with having scabies so that people do seek treatments when needed,” Dr. Tess McPherson, the president of the British Society for Paediatric and Adolescent Dermatology, told the Guardian.