Objective Scabies is a parasitic dermatosis disease worldwide distributed that, sometimes, can be a public health problem. The aim of this study is to describe the management of a scabies outbreak in a social-health centre.
Methods The study population included 505 healthcare workers who develop their work in different units and buildings of the centre. The management of the outbreak began after the diagnosis of the first case in patients, in August 2015, and was completed after the latency period of the latest case appeared in March 2016. We describe the actions taken to avoid the spreading of the disease that where proposed by an interdisciplinary workgroup. We also describe the implemented improvements, the importance of the careful epidemiological surveillance and our experience in the use of permetrin and ivermectin to treat the cases.
Results The workers included in the study ware 505, the rate of attack was 2.7%. All the cases were treated with topical permetrin and two of them required oral treatment with ivermectin due to cutaneous reactions to topical treatment. A 25.5% were classified as close contacts and received chemoprophylaxis with topical permetrin. In all other cases (71.7%) it was taken an active search about alarms signs of early infection. The total number of infected was 35 (21 patients and 14 workers).
Conclusions Lack of compliance with the worker-protection measures, high mobility of patients and professionals in the different buildings of the centre and the delay in the isolation and treatment of the possible index case can be the possible causes that have contributed to the spreading of the disease. Containment of the outbreak relies on the quick and strict implementation of appropriate infection control measures.
- outbreak management
- nosocomial transmission
- institutional scabies
- worker-protection measures
- occupational health