A Resurgence of Scabies

Cases of scabies, a highly contagious parasitic skin disease, are on the rise across Europe. The UK in particular is struggling with a shortage of treatments.

In recent months, Naveed Ijaz, a general practitioner specializing in dermatology, has seen a growing number of patients presenting at his clinic in Manchester, UK, with intensely itchy rashes. Their cause is scabies, a highly contagious skin condition caused by the Sarcoptes scabiei mite, which can result in these itchy rashes spreading all across the body.

Ijaz expresses great concern, mostly due to the scarcity of viable remedies. “People tend to spend more time indoors throughout the winter, which makes outbreaks more likely to occur during that period. This is made worse by the dearth of remedies accessible.

Ijaz expresses great concern, mostly due to the scarcity of viable remedies. “People tend to spend more time indoors throughout the winter, which makes outbreaks more likely to occur during that period. This is made worse by the dearth of remedies accessible.

Scabies is a very common disease that affects about 200 million individuals globally, but cases in England are significantly higher than average. Epidemics at nursing facilities and dorms, mostly in the country’s north, have been documented in reports.

The chair of the Royal College of GPs in the UK, Kamila Hawthorne, told WIRED that the north of England continues to have weekly incidents per 100,000 people that are significantly higher than the five-year and national averages. 1,926 instances nationwide were reported between early December and early January, according to their most current surveillance reports.

Scabies mites can multiply, burrow, and lay eggs beneath the skin until the condition is cured; this results in persistent sores and itching cycles. The mites can spread quickly to other people, especially when there is skin-to-skin contact—during intercourse, for instance. A portion of the information regarding the scope of the current UK outbreak has come from sexual health clinics, according to Ijaz, who has witnessed multiple cases where people were infected by a sexual partner.

“Outbreaks can be sustained in part because the mites can crawl off humans and onto sofas or bedding,” says Michael Head, a senior research fellow in global health at the University of Southampton in the United Kingdom. It’s fairly prevalent in care facilities, schools, and jails. Occasionally, outbreaks occur in hospital wards or dorms. Unfortunately for us, the mite is highly adept at carrying out its own duties and is fairly common as well as hardy.

“Outbreaks can be sustained in part because the mites can crawl off humans and onto sofas or bedding,” says Michael Head, a senior research fellow in global health at the University of Southampton in the United Kingdom. It’s fairly prevalent in care facilities, schools, and jails. Occasionally, outbreaks occur in hospital wards or dorms. Unfortunately for us, the mite is highly adept at carrying out its own duties and is fairly common as well as hardy.

According to Jo Middleton, a research fellow at Brighton and Sussex Medical School who is involved in scabies research in the UK and abroad, the high number of cases in the UK also highlights the challenge of ending an outbreak. It is necessary to fully disinfect bedding and furniture, and using medications like permethrin is not the simplest.

According to Jo Middleton, a research fellow at Brighton and Sussex Medical School who is involved in scabies research in the UK and abroad, the high number of cases in the UK also highlights the challenge of ending an outbreak. It is necessary to fully disinfect bedding and furniture, and using medications like permethrin is not the simplest.

“Permethrin is an excellent medication, but applying it can be somewhat challenging. He states that you must cover your entire body, apply the substance for 12 hours without washing it off, and then repeat the process after 7 days. “The truth is that because the application is so challenging, we see a lot of failures where people start this medication and end up having scabies and infecting other people.”

Another element at work in Britain is a significant lack of medications that has persisted for months. This is because of both ongoing supply chain challenges connected to the epidemic and import issues related to Brexit, according to an email from Paula Geanau of the British Association of Dermatologists to WIRED. Any stock that arrives in the UK is quickly depleted due to the present high demand.

Middleton states, “We’ve seen a shortage of pharmacy supply in some UK regions, particularly in the north.” Which is causing what is unknown. Perhaps there is a lack of medicine because there are more instances, or perhaps it is the other way around.

Because of the relatively high occurrence of scabies, researchers contend that more thorough surveillance of any outbreaks is necessary. This is especially true in light of recent findings that untreated scabies can result in secondary skin infections from staphylococcus and streptococcus bacteria. Particularly at risk are vulnerable individuals, such as those in assisted living facilities; these germs have the potential to destroy organs. According to Head, “there are some connections to the cardiac and renal systems.” “They appear to be real, sporadic side effects of an initial scabies infection, though their exact cause is unknown.”

Perhaps as a result of the harmful stigma associated with scabies—that it is a “disease of the unwashed”—it has long been disregarded. There have occasionally been reports of higher rates in congested settings, such as refugee and asylum seeker camps. This theory might subsequently be applied to attribute the disease’s spread to underprivileged groups without providing any supporting data.

“I will firmly state that there is no proof linking any increase in scabies cases, if they are occurring in Europe, to refugees,” Middleton declares. Scabies is here and has always been here, notwithstanding earlier media reports linking refugees to the disease’s introduction into a nation. Most often, outbreaks occur among young people attending universities and in assisted living facilities. The reason for any increase will come from what’s happening in those areas.

However, ivermectin is not commonly prescribed for scabies in the UK, a fact that researchers attribute to the persistent misinformation about its possible applications in the treatment of Covid-19. Ivermectin was once supported by former US President Donald Trump, however its purported effectiveness against the SARS-CoV-2 virus was never supported by credible research. According to Middleton, this is regrettably preventing the drug from being used in situations when it has been shown to be effective.

According to him, “some people were saying that it had efficacy against Covid.” “To try and control that, you had other people calling it horse paste, even though it is a veterinary medication, just like many human medications.” That consequently gave it a negative reputation. However, we hope to see greater use of it to combat scabies.

According to him, “some people were saying that it had efficacy against Covid.” “To try and control that, you had other people calling it horse paste, even though it is a veterinary medication, just like many human medications.” That consequently gave it a negative reputation. However, we hope to see greater use of it to combat scabies.

Meanwhile, medical professionals like Ijaz are hopeful that better public health efforts may contain the present outbreak in the UK. “People are frequently mismanaged,” he claims. People often mistake the prolonged itching that occurs after treatment for a relapse of scabies, even though it can linger up to six weeks after eradication. They source more permethrin as a result, which causes further shortages.