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Instituto Nacional de Salud Pública

2004, Number 3

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salud publica mex 2004; 46 (3)

Nosocomial outbreak of scabies from a Norwegian scabies case

Fajardo-Velázquez R, Urdez-Hernández E, Ysita-Morales A

Language: Spanish
References: 21
Page: 251-254
PDF size: 98.72 Kb.


ABSTRACT

Objective. To describe a nosocomial outbreak of scabies occurred in August 1999, resulting from exposure to an undiagnosed Norwegian scabies case, in Mexico City. Material and Methods. After reviewing the index case, we isolated the patient and identified secondary scabies cases among employees working in the affected ward, their relatives, and inpatients. Only individuals complaining from skin lesions and pruritus were included as infested cases. Control measures as contact isolation, proper handling of contaminated clothes,and topical treatment were implemented. Results. A patient with AIDS (index case) with a severe water and electrolyte imbalance was admitted to the Hos-pital de Infectología (Infectious Diseases Hospital) of the Centro Médico Nacional La Raza (La Raza National Medi-cal Center) in Mexico City from July 19 to August 20, 1999. Twenty-eight days after the index case admission, scabies cases occurred among health workers. Norwegian scabies was suspected and confirmed by microscopic evidence of the mites on a specimen of scabs from the index case. We identified 48 secondary cases with clinical scabies: 71% health workers, mainly nurses (79%); 23% health workers' rela-tives; and 6% inpatients.The mean incubation period was 15 days (range 12 to 27). Skin rashes commonly involved the upper extremities (60%) but not the hands. Conclusions. This paper highlights the difficulties in diagnosing Norwe-gian scabies in an immunosuppressed host, as well as the importance of ensuring that health workers follow standard precautions at all times.


REFERENCES

  1. Espy PD, Jolly HW. Norwegian scabies. Arch Dermatol 1976;112:193-196.

  2. Jucowics P, Ramon ME, Don PC, Stone RK, Bamji M. Norwegian scabies in an infant with acquired immunodeficiency syndrome. Arch Dermatol 1989; 125:1670-1671.

  3. Sirera G, Rius F, Romeu J, Llibre JM, Ribera M, Soriano V et al. Hospital outbreak of scabies stemming from two AIDS patients with Norwegian scabies. Lancet 1990; 335:1227.

  4. Lerche NW, Currier RW, Juranek DD, Baer W, DubaY NJ. Atypical crusted Norwegian scabies: Report of nosocomial transmission in a community hospital and approach to control. Cutis 1983; 31:637-643.

  5. Gooeh JJ, Stanley R, Strasius R, Beamer B, Reiter MD, Pharm D et al. Nosocomial outbreak of scabies. Arch Dermatol 1978;114:897-898.

  6. Funkhouser ME, Craig O, Ross A, Berger TG. Management of scabies in patients with human immunodeficiency virus disease. Arch Dermatol 1993;129: 911-913.

  7. Corbett EL, Crossley I, Holton J, Levell N, Miller RF, De Cock KM. Crusted (Norwegian) scabies in a specialist HIV unit: Successful use of ivermectin and failure to prevent nosocomial transmission. Genitourin Med 1996;72:115-117.

  8. Orkin M. Scabies in AIDS. Semin Dermatol 1993; 12:9-14.

  9. Schlesinger I, Oelrich DM, Tyring SK. Crusted (Norwegian) scabies in patients with AIDS: The range of clinical presentations. South Med J 1994; 87:3:352-356.

  10. Almond DS, Green CJ, Geurin DM, Evans S. Norwegian scabies misdiagnosed as an adverse drug reaction. Br J Dermatol 2000;230:35-36.

  11. Haydon MJR, Caplan RM. Epidemic scabies. Arch Dermatol 1971;103:168-172.

  12. Lettau LA. Nosocomial transmission and infection control aspects of parasitic and ectoparasitic diseases. Part III. Infect Control 1991;12:179-185.

  13. Obasanjo OO, Wu P, Conlon M, Karanfil LV, Pryor PMG, Anhalt GchRE. An outbreak of scabies in a teaching hospital: Lessons learned. Infect Control Hosp Epidemiol 2001;22:13-18.

  14. Donabedian H, Khazan U. Norwegian scabies in patient with AIDS. Clin Infect Dis 1992;14:162-164.

  15. Burns DA. An outbreak of scabies in a residential home. Br J Dermatol 1987;117:359-361.

  16. Orkin M, Maibach HI. Current concepts in parasitology: This scabies pandemic. N Engl J Med 1978;298:9:496-498.

  17. Schneider WJ. Considerations regarding infection during hospital employment. J Occup Med 1982;24;1:53-57.

  18. Clarck J, Douglas LF, WilliamsWA. Management of an outbreak of Norwegian scabies. Am J Infect Control 1992;20:217-220.

  19. Estes SA, Estes J. Therapy of scabies: Nursing homes, hospitals, and the homeless. Semin Dermatol 1993:12:26-33.

  20. Arlian LG, Estes SA, Vyszenski, Moher DL. Prevalence of Sarcoptes scabiei in the homes and nursing homes of scabietic patients. J Am Acad Dermatol 1988;19:806-811.

  21. Arlian LG, Runyan RA, Sorlie LB. Host seeking behavior of Sarcoptes scabiei. J Am Acad Dermatol 1984;11: 594-598.




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