Itchy Subject

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Eva Haynes’ husband, Roy, lives at the Bay Center Nursing Home in Panama City. Because she works at Fort Rutger in Alabama, she didn't learn her husband was infested with scabies until this weekend.

"And just before I entered his room, I was called by one of the staff there and informed that I needed to put on a gown before entering his room and I asked why and I was told he was being treated for scabies."

In fact, Haynes says he is actually in his second week of treatment and she was never told about the initial infestation.

Since scabies is not a public health threat, it is not monitored by the Health Department. However, Rick Davis with the Health Department says the facility did contact them to request an educational seminar scheduled this Friday.

"It's caused by a little teeny mite, if you will, and the mite is passed either through human to human contact and that is usually something more than a handshake."

Haynes says she wants others to learn about the outbreak before they visit their family.

"I didn't want any of the other family members that has loved ones at this facility not alerted about it and I didn't want them to feel the way I felt."

The Health Department says washing and drying linens on the hot cycle can help prevent scabies. Sharing clothing, towels or bedding can spread the infestation along with close personal contact, and while irritating, scabies is not life threatening and can easily be treated with medical lotions.

Newschannel Seven called the Bay Center Nursing Home several times Monday for a response, but they did not return our calls. Extended Web Coverage

What is Scabies?
Scabies is an infestation of the top layer of skin caused by the parasite, Sarcoptes scabiei, often called scabies or mites. The female parasite burrows under the skin and begins laying eggs within a few hours of infection and continues to lay 2 to 3 eggs daily. It takes approximately 10 days for the eggs to hatch and become adult mites. At this point, the cycle will begin again.

How is Scabies Transmitted?

Sexual Transmission:
Scabies are transmitted through close physical contact. Transmission is more likely when partners spend the night together than during a brief sexual encounter.

Nonsexual Transmission:
Sexual contact is not necessary to spread scabies. Prolonged contact between household members may allow transmission to occur. Transmission is also possible through prolonged contact with infested linens, furniture, or clothing. It is unlikely that scabies would be transmitted during casual contact (e.g. shaking hands or hugging) or contact with inanimate objects, such as a toilet seat.

The type of scabies that infest humans is specific to human beings and are different than the type that infest dogs and other animals, more commonly known as mange. Mites from animals infested with mange can burrow into human skin but cannot reproduce, and therefore die within a few days.

How Long Before Symptoms Appear?
If a person has never been infected with scabies before, symptoms appear approximately 4 to 6 weeks after infection. If a person has been infected with scabies before, he/she will begin to experience symptoms within 1 to 4 days after infection, because of previous exposure to scabies.

How Long is a Person Considered Infectious?
A person is considered infectious from the time he/she becomes infected until treatment is successfully completed. Linens and clothing are considered infectious until treatment or until 2 weeks after the last exposure. After treatment, a person may unknowingly become reinfested through exposure to the primary source of contact or contact with a different infested source.

What are the Symptoms of Scabies?

  • Persistent itching that usually becomes worse at night.
  • Presence of the mite burrow(s), often in a zigzag or "S" pattern.
  • Presence of lesions, such as brown nodules, rashes, or pimple-like irritations.

Common sites of infestation are: webs and sides of fingers and toes, pubic and groin area, armpits, bends of elbows and knees, wrists, navel, breasts, lower portion of buttocks, penis and scrotum, waist and abdomen; rarely, they are found on the palms of the hands, the soles of the feet and the neck upward.

How is Scabies Diagnosed?

  • Microscopic Exams of Scrapings from Suspicious Lesion(s)
    • Scrapings are placed on a slide and examined under a microscope to determine whether scabies are present.

  • Burrow Ink Test (BIT)
    • The suspicious area is rubbed with ink from a fountain pen. The surface is then wiped off with an alcohol pad; if the person is infected with scabies, the characteristic zigzag or S pattern of the burrow across the skin will appear.

  • Topical Tetracycline Solution
    • A topical tetracycline solution may be applied to the suspicious area as an alternative to the BIT. The excess solution is wiped off the area with alcohol and examined under a special light to see if the characteristic zigzag or S pattern of the burrow appear.

  • Shave Biopsies
    • A very fine layer of skin is shaved off at the possible site of infestation and examined under a microscope for evidence of mites.

  • Needle Extraction of Mites
    • A needle is carefully inserted into the length of the burrow where the mite is likely living. The mite is then extracted with the needle and placed on a slide to be examined under a microscope.

How is Scabies Treated?

Recommended Treatment:
Permethrin cream (RID®; A-200®)

  • The cream is applied in a thin layer to all areas of the body from the neck down.
  • Rinse off after 8 to 14 hours.

Alternative Treatments:
Lindane (Kwell®)

  • The cream is applied in a thin layer to all areas of the body from the neck down.
  • Rinse off after 8 hours.

What Else Do I Need to Do to Get Rid of Scabies?

  • Use medication as directed.
  • Notify and treat all partners and household members.
  • Abstain from intimate or sexual contact until treatment is completed successfully.
  • Wash infested clothing and linen on the hot cycle setting (130 degrees Fahrenheit). Dry on hot cycle for at least 20 minutes.
  • Infested articles that cannot be laundered may be dry-cleaned or placed in a bag for 2 weeks to ensure decontamination.
  • Furniture and carpeting may be vacuumed to rid infested area of mites. Dispose of vacuum bag afterwards.
  • Fumigation of living areas is not necessary.
  • Retest for cure is advised if new burrows or rashes appear. NOTE: Current rashes and itching may continue for 2-3 weeks even after successful treatment.

How Can I Keep From Getting Scabies?

  • Avoid direct contact with infected bed linens, clothing, and furniture.
  • Prompt, qualified and appropriate medical intervention, treatment, and follow-up are important steps in breaking the disease cycle.
  • Abstain from intimate or sexual contact until treatment is successful.
  • Latex condoms, while not considered to be effective against scabies transmission, can prevent the transmission of other STDs.
  • Mutual monogamy (having sex with only 1 uninfected partner who only has sex with you) does not provide effective protection against scabies, but it is effective in preventing other STDs.
  • Limit the number of sexual partners to reduce exposure to all STDs.

What about Complications from Scabies?
Scabies does not usually cause anything more than discomfort and inconvenience. Occasionally, secondary bacterial infections may occur due to aggressive scratching.

Crusted scabies, also known as Norwegian scabies, is a severe infestation of scabies. This normally occurs in people with compromised immune systems, such as the elderly and HIV-infected individuals.