![]() HPTs are not responsible for clinical diagnosis or prescribing of treatments, which ultimately lies with the NHS. The HPT can provide advice and support to the setting manager on the co-ordination of treatment, control measures and communications. Broadly, the HPT can support settings and infection control teams by undertaking a risk assessment in conjunction with the setting manager or clinicians. The role of the HPT will vary depending on local arrangements. Although scabies is not a notifiable disease, due to these challenges UKHSA HPTs are able to support settings with the recognition and management of outbreaks. Scabies outbreaks can be challenging to manage due to difficulties in diagnosis ( 2) and in implementation of infection control and treatment measures required to break the chain of transmission. The role of the health protection team in scabies management ![]() There is considerable stigma associated with scabies, which can contribute to under-reporting both in the community and among staff and residents in care facilities. Reliable estimates of scabies incidence are not possible, but it has been estimated that 1 in 50 long-term care facilities will experience an outbreak each year ( 4). Reports are predominantly from long-term care facilities however, outbreaks are also reported in prisons, schools, and immigration detention centres. It is not a notifiable disease, and the majority of data comes from outbreaks reported to HPTs in England and reports from sexual health services via GUMCAD. The epidemiology of scabies in the UK is poorly understood and available disease surveillance data is limited. Institutional settings such as care homes and prisons are especially susceptible to outbreaks ( 4). The elderly, young (children and young adults) and immunocompromised are particularly vulnerable to scabies. Outbreaks of scabies are most likely to occur where people live in close proximity, and in settings where individuals receive personal or health care or staff working in these settings. Itching may be severe, particularly at night and scratching may lead to secondary bacterial infection and its complications.Ĭrusted scabies, formerly known as Norwegian scabies, is a hyperinfestation where a much higher density ( 3) of mites is present, developing as a result of an insufficient immune response by the host. Scabies is most often transmitted by prolonged or frequent skin-to-skin contact. Symptoms may last for weeks or months, can be hard to recognise and are often mistakenly attributed to other skin conditions, leading to avoidable transmission. However, asymptomatic infection has been demonstrated in the elderly ( 2). The typical clinical presentation of infection is intense itching associated with burrows, nodules and redness. Scabies is a skin condition caused by an immune reaction to the mite Sarcoptes scabiei and their saliva, eggs and faeces. British Association for Sexual Health ( BASHH) and HIV UK national guideline on the management of scabies (2016).Scabies: symptoms, diagnosis and treatment ( BMJ Best Practice) (2022).NICE clinical knowledge summaries: scabies (2022).Care homes: infection prevention and control.Infection control in prisons and places of detention.Health protection in children and young people settings, including education (2022). ![]() This document should be used alongside other resources available including: Warn and inform visitors to setting until mass treatment completed. If 2 or more linked cases within an 8 week period, assess all individuals (staff and residents) within the setting for scabies infection.Ĭo-ordinate treatments of all cases and contacts linked to the setting.Īdvise on appropriate PPE for staff and visitors.Ĭonsider isolation of residents or exclusion of staff until mass treatment completed. Provide hygiene and exclusion advice and avoid transfers to other settings during treatment.Īdvise on appropriate personal protective equipment ( PPE) for staff and visitors. Identify close contacts (up to 8 weeks prior to diagnosis) including visitors.Ĭo-ordinate treatment of case and contacts to break cycle of transmission. Summary of public health management of cases and outbreaks of scabies in long-term care facilities and other closed settings Management of single cases It is intended as a basis for consistent practice nationally, drawing upon the best available evidence and experience base. The guidance is split broadly into 2 sections: management of single cases, and management of outbreaks. Previously, HPTs in England have developed and used local guidance which made variable recommendations ( 1). This national guidance has been developed to aid UK Health Security Agency ( UKHSA) health protection teams ( HPTs) and others involved in the management and control of scabies cases and outbreaks in long-term care facilities and other closed settings.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |