An Outbreak of Scabies in a Chronic Psychiatric Ward

Abstract

An outbreak of scabies that recently occurred at our hospital was characterized by sporadic cases of infection over a period of 14 months among patients whose sources of infection were not identified - even with a thorough tracing survey - and with whom no close contact was noted. Despite our attempt to provide prophylaxis for all patients whose chances of having scabies could not be ruled out on the basis of their skin conditions, two patients on prophylaxis later developed the infection. We therefore implemented mass prophylaxis. We finally resolved the outbreak by using this strategy after obtaining informed consent. We administered oral ivermectin twice, 1 week apart, to a total of 60 patients, including all patients in the relevant ward and those who had been transferred from the relevant ward to other wards within the last 2 months. Staff were not subjected to mass prophylaxis because they had little direct contact with patients, and none of them was confirmed to have scabies. There is room for considering the implementation of prophylaxis restricted to all patients whose chances of having scabies cannot be ruled out on the basis of their skin conditions.