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Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England

journal contribution
posted on 2023-06-08, 18:15 authored by K A Hewitt, A Nalabanda, Jackie Cassell
Scabies is an important public health problem in residential care homes. Delayed diagnosis contributes to outbreaks, which may be prolonged and difficult to control. We investigated factors influencing outbreak recognition, diagnosis and treatment, and staff experiences of outbreak control, identifying areas for intervention. We carried out a semi-structured survey of managers, affected residents and staff of seven care homes reporting suspected scabies outbreaks in southern England over a 6-month period. Attack rates ranged from 2% to 50%, and most cases had dementia (37/39, 95%). Cases were diagnosed clinically by GPs (59%) or home staff (41%), none by dermatologists. Most outbreaks were attributable to avoidably late diagnosis of the index case. Participants reported considerable challenges in managing scabies outbreaks, including late diagnosis and recognition of outbreaks; logistically difficult mass treatment; distressing treatment processes and high costs. This study demonstrates the need for improved support for care homes in detecting and managing these outbreaks

History

Publication status

  • Published

File Version

  • Published version

Journal

Epidemiology and Infection

ISSN

0950-2688

Publisher

Cambridge University Press

Issue

7

Volume

143

Page range

1542-1551

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2014-09-09

First Open Access (FOA) Date

2015-09-09

First Compliant Deposit (FCD) Date

2014-09-09

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