The 10 outbreaks were studied over 15 months by dermatology-trained physicians. They examined 230 residents with a median age of 86·9 years, 157 of whom had dementia. Over a quarter of residents examined were diagnosed with scabies and more than half of those diagnosed only had signs on areas of the body that are normally covered. The odds of receiving a scabies diagnosis were increased 2.4 times for residents with dementia.
Scabies is a WHO designated Neglected Tropical Disease which remains a public health challenge in the UK. It is mainly transmitted through skin to skin contact, which may include care activities such as washing or dressing. Outbreaks regularly occur in residential and nursing care homes for the elderly, and can be difficult to manage, distressing and highly stigmatising.
First Author and Head of the Department of Primary Care and Public Health at BSMS, Professor Jackie Cassell, said: “Although scabies has long been known to be a problem in residential care for the elderly, our study has shown why it has been so difficult to recognise and control in this setting.
“Symptoms in this vulnerable population are typically very different from what doctors have been taught to expect, which makes it harder for care home staff and clinicians to diagnosis scabies. What’s more, those with dementia are particularly at risk of being left undiagnosed, given their difficulties with communicating discomfort and itching.”