Directions for the application of a topical scabicide
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Scabies is a skin infestation with a mite called Sarcoptes scabiei. Cases and outbreaks of scabies are common in health and residential care facilities. SA Health has developed the Scabies management in care facilities, 2012 (PDF 382KB) guideline to assist operators of care facilities to take a rational approach to the prevention and control of scabies.
Once diagnosed, most scabies infestations can be easily treated using anti-scabie medications called scabicides.
Initial diagnosis should be confirmed by a medical practitioner using proper diagnostic techniques.
An isolated case of scabies is not an immediate risk to the health of staff and residents; however it must be managed correctly to prevent the infestation spreading. See page 9 of the guideline (PDF 382KB) for detailed information on the following:
Crusted scabies are managed differently, refer to page 14 for detailed management requirements.
Multiple cases of scabies may arise due to transmission of the scabies mite within the care facility. These situations must be managed carefully to ensure the infestation does not turn into a full scale outbreak. See page 11 of the guideline (PDF 382KB) for detailed information on the following:
The most common cause of a scabies outbreak in a care facility is an unidentified or misdiagnosed case of crusted scabies.
Crusted scabies can occur in debilitated, immunocompromised, institutionalised, or elderly persons. It is extremely contagious and special precautions must be taken to minimise the risk of scabies spreading throughout the facility. Crusted scabies is often not obvious as there may be no itch and crusting may be misdiagnosed or hidden beneath clothing or hair. See page 14 of the guideline (PDF 382KB) for detailed information on the following:
In an outbreak scenario, patients should be treated presumptively if diagnosed though contact with known cases and the presentation of characteristic symptoms. However; reassessment by a medical practitioner may be necessary if treatment appears to have failed.