While in a skilled nursing facility, a male client contracted scabies, which is diagnosed the day after discharge. The client is living at her daughter’s home, where six other persons are living. During her visit to the clinic, she asks a staff nurse, “What should my family do?” The most accurate response from the nurse is:
A. “All family members will need to be treated.”
B. “If someone develops symptoms, tell him to see a physician right away.”
C. “Just be careful not to share linens and towels with family members.”
D. “After you’re treated, family members won’t be at risk for contracting scabies.”
Correct Answer: A. “All family members will need to be treated.”
When someone in a group of persons sharing a home contracts scabies, each individual in the home needs prompt treatment whether he’s symptomatic or not. Scabies is a contagious skin condition caused by the mite Sarcoptes scabiei which burrows into the skin and causes severe itching. Scabies is transmitted by direct skin-to-skin contact or indirectly by contact with contaminated material (fomites).
Option B: Skin-to-skin contact transmits the infectious organism therefore, family members and skin contact relationships create the highest risk. Scabies was declared a neglected skin disease by the World Health Organization (WHO) in 2009 and is a significant health concern in many developing countries.
Option C: Towels and linens should be washed in hot water. The classic form of scabies may have a population of mites on an individual that range between 10 to 15 organisms. It typically takes ten minutes of skin-to-skin contact for mites to transmit to another human host, in cases of classic scabies. Transmission of the disease can also occur by fomite transmission via clothing or bed sheets.
Option D: Scabies can be transmitted from one person to another before symptoms develop. Infested individuals require identification and prompt treatment because a misdiagnosis can lead to outbreaks, morbidity, and an increased economic burden. Adult female mites dig burrow tunnels 1 to 10 millimeters long within the superficial layers of the epidermis and lay 2 to 3 eggs daily. The mites die 30 to 60 days later, and the eggs hatch after approximately 2 to 3 weeks. It merits mentioning that not all treatment options can penetrate the eggs stored within the skin.
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