Outbreak Management of Scabies in Moderately-sized General Hospital

Abstract

  Our hospital is a moderately-sized general hospital with 250 beds. Our Infection Control Team (ICT), which consists of an Infection Control Doctor (internist), Infection Control Nurse and bacteriological laboratory technician, has assessed the information of multiple drug-resistant strains in our hospital and made rounds every other week. Our hospital does not have a dermatology department, so when scabies was suspected in a hospitalized patient, each chief physician asked the cooperating dermatologist to visit their patients. However, we experienced an outbreak of scabies extending to 36 individuals including 5 patients, patient's family members, helpers, and staff members and their families. Analysis of the infection route suggested that a physical therapist and other staff might have been infected by the source patient and acted as the vector. Crusted scabies patients were isolated and ivermectin was administered to all infected patients. Furthermore, scrubbing with sulfureous water and standard precautions were enforced. This outbreak of scabies was attributable not to simple underdiagnosis but to the fragile informaiton system of our ICT. Information on the suspicion of scabies should be automatically delivered to the ICT through the head nurse or coordinating staff. The ICT must intervene at the stage of suspicion of scabies and prompt the chief physician to begin early treatment for scabies, especially in a hospital which has no dermatologist.