how to kill scabies ? - all think to know

Aims and Objectives of Presentation

• What the scabies mite looks like

• A little about their history

• What signs and symptoms to look for

• And understand the difference between ‘normal’ scabies and ‘crusted’ scabies

• How to apply treatment

• That you do not want to catch them –ever

Presented by: http://www.drscabies.com

Sarcoptes Scabiei (Scabies)

• Scabies is an itchy, highly contagious skin disease caused by an infestation by the itch mite Sarcoptes Scabiei.

• Direct skin-to-skin contact is the mode of transmission

• A severe and relentless itch is the predominant symptom of scabies

• However, It can affect any individual irrespective of social class, caste, age , gender or race


The Scabies Mite


History of Scabies

• Scabies has been seen in humans since ancient time. Archeological evidence from Egypt and the Middle East suggests scabies was present as early as 494 BC

• It is suspected that some biblical “leprosy” (Hansen’s disease) was actually scabies

• Aristotle (384-323 BC) mentioned "lice in the flesh" that produced vesicles

• Greek physician Celsus is credited with naming the disease "scabies" and describing its characteristic features.


Some Stats About Scabies

• World wide there are an estimated 300 million cases a

year

• Immunocomprimised people more likely to develop

Norwegian (crusted) scabies.

• 7% of people will develop nodular scabies (nodules

can last for several months)


Life Cycle of the Scabies Mite


Population of Scabies Mites

• Numbers of adult mites (burrows) build up slowly

• Symptoms only start after several weeks

• The number of active females increases until

• Immune response inhibits increase

• Scratching eliminates many burrows


Adult Female Mite (Mother of Scabies)

• Adult female mites form burrows in the stratum corneum (dry horny layer of skin)

• They cut into the cells using sharp “elbow” joints on the front pair of legs and secrete a skin dissolving enzyme

• Usually only have 10 – 15 live mites on the body

• Obligate parasite (lives its entire life on the host)


Adult Female Mite (Mother of Scabies)

• Newly matured females form a short burrow and wait for a male to find them

• Males and females mate in the burrow

• Males then wander off – in search of other females

• They lay eggs, defecate (scybala), and die in the burrow

• The female enlarges the burrow and stays there for the rest of her life – burrows about 2-5mm per day (nodular scabies if she goes too deep)?

• Larva makes its way to skin surface

• Female may live for 60 days

• Can lay 150 – 180 eggs

• Can ‘travel’ 10 – 15 cm under the skin



http://en.wikipedia.org/wiki/File:Scabies-burrow.jpg

http://en.wikipedia.org/wiki/File:Scabies-burrow.jpg

How is Scabies Transmitted

• Direct skin-to-skin contact is the mode of transmission

• They can only live off of a host body for 24-36 hours

under most conditions

• sharing bedclothes that had mites in them the night

before.

• Sexual physical contact,


Signs and Symptoms of Scabies

• Can be up to 6 – 8 weeks before first symptoms develop:

• Unfortunately, these signs are often overlooked, long

term can result in eczema and dry areas

• Infants often develop pustules on hands and feet


Some Random Pictures of Scabies

Scabies on Wrist and Hand


Webbing (between fingers)


Diagnosis of Scabies aka Seven Year Itch

• Scabies is a great masquerader that mimics other skin problems, e.g. impetigo, vasculitis, insect bites, psoriasis, all of which complicate diagnosis

• Removing a mite from a burrow with a needle or skin scraping. Examined under a microscope to confirm the presence of mites or eggs


Precautions for Treatment of Scabies

• Although mites may only burrow in certain places juveniles may be found over the whole body

• Wearing gloves and a disposable apron, apply cream or lotion to cool dry skin to all skin surfaces from head to toe (study):

including under nail ends – is especially important for infants and elderly

awkward places such as the back, soles of the feet, between fingers and toes, and the genitals.

Pay special attention to the areas where mite burrows most commonly occur, the front of the wrists and elbows, beneath the breasts, the armpits, and around the nipples in women.

• Repeat treatment after 7 days

• If you wash your hands before end of treatment - reapply


Scabies Treatment Drugs

• Dr. Scabies

• Made-up of natural

extracts

• Eliminates contagious

scabies mites and eggs

rapidly

• Highest Concentration

Formula

• Contains Permethrin


Scabies Treatment Outbreak in a Nursing Home

Resident Staff Member

Yes Affected No

D1 Permethrin Permethrin

D7 Permethrin No Treatment, monitor over the next 7 days

Monitor & retreatif necessary usinga topical + Ivermectin

D14

D21A 2nd Ivermectin dose + topical may be needed in cases of severe crusted scabies

AffectedYes No

Staff Family Unaffectedmember family member

Staff

If signs & symptoms are evident begin treatment

Unaffected family members

Permethrin Permethrin Permethrin Permethrin No treatment

Permethrin Permethrin No Treatment No Treatment but monitor

Monitor & retreat if necessary

N.B. The itch of scabies continues for 2 weeks or more following treatment. Relieve the itch with Eurax or calamine.

In severe cases of crusting using an emollient to help remove crusts will enable treatment to work more effectively.


Environmental Precautions

• Patients clothing should be placed into soluble bags

• Hoover bags should be discarded after each use into a plastic bag and tied immediately

• Clothes, towels, and bed linen should be machine washed at 50°C or above after the first application of treatment. This kills the scabies mites.

• Keep any items of clothing that cannot be washed, in plastic bags for at least 72 hours to contain the mites until they die

• Pressing clothes with a warm iron, dry cleaning, or putting items in a dryer on the hot cycle for 10–30 minutes is also effective

Norwegian (Crusted Scabies)

• Highly contagious due to the large number of parasites embedded in the crusts possibly close to 1 million mites!

• Crusted scabies is more easily transmitted through contact with towels, bedding and upholstery


Points to take Care

• Notify the Health Protection Unit (HPU) of outbreak (two or more residents affected)

• Do liaise with the local infection control team or HPU for support and advice

• temporarily close to admissions / respite patients until completion of the first

• Follow the outbreak care

• All GPs should be informed of the problem

• Staff who have had one treatment can return to work


Credits

• Presentation by Dr. Scabies

• A well known name of Scabies Remedy provider

• Please visit http://www.drscabies.com/ for more info

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how to kill scabies ? - all think to know

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