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

Hewitt, K A, Nalabanda, A and Cassell, J A (2014) Scabies outbreaks in residential care homes: factors associated with late recognition, burden and impact. A mixed methods study in England. Epidemiology and Infection. ISSN 0950-2688

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Abstract

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

Item Type: Article
Keywords: scabies; nursing home; residential care; outbreak; epidemic; public health;
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: H Social Sciences
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0639 Transmission of disease
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0648.5 Epidemics. Epidemiology. Quarantine. Disinfection
R Medicine > RL Dermatology > RL0201 Hyperemias, inflammations, and infections of the skin
Depositing User: Jackie Cassell
Date Deposited: 09 Sep 2014 14:01
Last Modified: 06 Mar 2017 14:52
URI: http://sro.sussex.ac.uk/id/eprint/49876

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