Scabies: Application of the Novel Identify-Isolate-Inform Tool for Detection and Management

Cheng, Tabitha A.; Mzahim, Bandr; Koenig, Kristi L.; Alsugair, Abdulrahman; Al-Wabel, Abdussalam; Almutairi, Bandar Saad; Maysa, Eshmawi; Kahn, Christopher A.

To eradicate and prevent reinfestation of the scabies mites, close contacts (within the previous 30 days) should be treated simultaneously. Additionally, items used by patients and close contacts in the preceding several days such as clothing and linens should be washed and dried at high temperatures (≥60°C), dry-cleaned, or placed in a plastic bag for at least 72 hours if unable to launder. 36, 46 Another aspect of controlling this disease is avoidance of direct skin-to-skin contact with suspected or confirmed cases of scabies until 8 hours after treatment. 36 Treatment failures occur in some instances due to improper or inadequate application of the medications, reinfestation secondary to mishandling of clothes and bed linens, undertreatment of close contacts, and resistance to some medications, such as lindane. 34, 35, 37, [41] [42] [43] 47 Prevention and control of crusted (Norwegian) scabies is more complicated given that brief skin-to-skin contact can spread the infection. In these cases, numerous contacts may need treatment to prevent a large-scale outbreak. 35, 41 In communities with a high prevalence of scabies, mass drug administration of scabicides has been used for effective control. This may be a strategy for large outbreaks; however, local health authorities should be consulted prior to instituting this approach. 48