Scabies Cases Surge Across the UK and Europe

In a dimly lit room at a care home in London, a resident named Margaret scratches tirelessly at her arms, her skin marked with angry red welts. At 82, she never imagined that the unbearable itch she’d thought was merely a sign of aging could actually be a highly contagious skin infestation caused by microscopic mites. Unfortunately, Margaret’s ordeal is becoming increasingly common as scabies cases surge across the UK and Europe, threatening to become an overlooked public health crisis.

What is scabies and how do people catch it?

Scabies is an infestation caused by tiny mites known as Sarcoptes scabiei. Transferred primarily through skin-to-skin contact—whether it’s a parent cuddling a child, care workers attending to elderly residents, or intimate encounters—these mites can easily crawl from one person to another. Occasionally, they may also spread through contaminated clothing or bedding. Notably, a study by the University of London indicated that outbreaks in institutions often coincide with periods of peak physical interaction among residents, leading to rapid dissemination.

Are scabies cases rising in the UK, and if so why?

Indeed, data collected in England and Wales showcases a staggering trend. Our investigation revealed 241 outbreaks within a single year in institutions like care homes and schools. However, scabies is often underreported; many individuals self-treat using over-the-counter remedies, making it challenging to gauge the full extent of the problem in the wider population. Reports from general practitioner surgeries indicate that cases have risen sharply, with one GP stating, “It’s alarming how many patients now come in believing they have scabies, and many self-medicate before seeking help.”

Part of the crisis stems from severe disruptions in supply chains in 2023 and 2024, which left pharmacy wholesalers unable to meet the demand for scabies creams. As a result, an increasing number of individuals became infested while waiting for treatments that never arrived.

Who is most at risk of catching scabies?

While scabies can affect anyone, certain demographics are at higher risk:

• Children, due to close physical interactions at schools and daycare centers
• Sexually active young adults, who often engage in skin contact
• The elderly, particularly in care homes where close living conditions contribute to outbreaks

Migrant centers and prisons are also hotspots for transmission, exacerbating the situation further.

Is scabies caused by poor personal hygiene?

Absolutely not. Contrary to popular belief, bathing habits have no effect on the likelihood of scabies infestation. As Dr. Lisa Hargrave, a dermatologist, explains, “These mites thrive regardless of hygiene. Soap and alcohol-based hand sanitizers do nothing to deter them.” This misinformation adds to the stigma surrounding scabies, often leading to feelings of shame among those affected.

What are the symptoms?

The primary symptom of scabies is an intense itch, particularly during the night. Symptoms can take four to six weeks to manifest, especially in first-time infections. Typical signs include S-shaped burrows on the skin, primarily between fingers and in genital areas. Notably, in elderly patients, symptoms may present differently, with some displaying no significant itching at all.

How contagious is scabies and how long can mites survive off the body?

Scabies is highly contagious. Just a moment of skin-to-skin contact can result in the transfer of mites between individuals. Under ideal conditions, these mites can survive off the human body for up to a week, though their preferred habitat remains human skin.

Why does scabies treatment sometimes fail or seem not to work?

While conventional cream treatments can be effective, their application is often challenging. Patients must thoroughly cover their entire body, abstain from washing off the cream for several hours, and ensure that any clothing and bedding are sanitized. Moreover, close contacts should also undergo treatment regardless of symptoms, complicating compliance. Failure to adhere to these steps can result in treatment failure. Furthermore, itching may persist for weeks post-treatment, leading many to mistakenly believe they are still infested.

Why was an oral medication recently introduced?

To address the increasing rate of infections, a previously underutilized oral medication, ivermectin, has been made available in the UK. “Ivermectin simplifies treatment regimens considerably,” notes Dr. Melanie Roberts, a public health expert involved in getting the drug licensed. However, similar to creams, it typically requires re-treatment after seven days for maximum efficacy.

Is scabies becoming resistant to medicated cream?

Concerns about scabies mites developing resistance to permethrin, a common cream treatment, have surfaced. Yet, experts contend that most treatment failures in the UK stem from challenges associated with proper application rather than the medication itself losing effectiveness.

What are the emotional and mental health effects of scabies on patients and families?

Beyond the physical symptoms, the stigma surrounding scabies can lead to profound emotional repercussions. Many patients express feelings of shame and social withdrawal, as highlighted in a study published in the Journal of Community Health. “Patients often describe feeling judged and ostracized,” Dr. Eliza Morgan states. The combination of persistent itching and social stigma can exacerbate mental health issues, creating a vicious cycle of isolation.

Why do shame and embarrassment make scabies harder to control?

Timely diagnosis and treatment are crucial in curbing the spread of scabies. However, fear of judgment often results in delays, allowing the infestation to expand. As one healthcare worker in a care facility noted, “People delay seeking help, thinking it’s a sign of poor hygiene, when in reality, it’s not.” This delay can cause a wider outbreak and overwhelm healthcare systems already burdened by the pandemic.

What should people do if they think they have scabies?

If you suspect you have scabies, it’s vital to consult a general practitioner as soon as possible. They can conduct a thorough examination of your skin and provide an effective treatment plan, safeguarding not just your health, but also that of those around you.

Source: theconversation.com