Scabies is a skin disease caused by parasites, more specifically scabies mites. The vernacular does not call the infection “scabies” for nothing – the typical symptom is an excruciating itch, which – especially in the warmth of the bed – awakens in the affected person the need to scratch incessantly. Read here everything about the symptoms, course and treatment of scabies.
Scabies – a well-known disease
Scabies, colloquially known as mange, scabies or grind, was already known in ancient times. As early as 1,000 years ago, the Arab At-Tabari meticulously described the animal pathogen and how to find it in the skin, as well as ways to manage the disease. Unfortunately, this knowledge was ignored by most doctors over the centuries, although the people often knew how to help themselves: the mites were plucked out of the blisters with a needle point and crushed with the fingernails. Ointments containing sulfur and mercury were also in circulation to treat scabies.
How is scabies transmitted?
Today, doctors are smarter and treatment options are more effective. However, the scabies mite (Sarcoptes scabiei) still occurs worldwide. This parasite is highly contagious and is transmitted through close body contact. This does not necessarily have to be sexual intercourse – even unfavorable living conditions with many people in a confined space are enough. This is why shared facilities are often affected. Hygiene deficiencies, shared sleeping places and changing sexual contacts favor the infection.
About the scabies mite
The itch mites are about 0.2 to 0.5 millimeters in size and like to make themselves comfortable at room temperature, even in clothing, bedding, on upholstered furniture or carpets. In this way, they can survive for up to three days (up to two weeks in cold weather) without a human host. If a suitable victim is within reach, the fertilized females bore under its skin within a few minutes and dig angularly bent tunnels that are 1 cm long and 0.5 to 2 mm wide. They remain at the end of these for the rest of their lives, or about a month, depositing feces and one to two eggs daily. The hatched larvae bore outward and after about two weeks a new cycle begins. Usually, about ten to 50 live female mites are found in an infected person. However, there is also a particularly contagious form (scabies norvegica), in which up to 200 mites can be found on one square centimeter of skin.
Symptoms and course of scabies
In the case of an initial infection with scabies mites, symptoms are felt after three to six weeks; in the case of a new infection, symptoms are felt after only 24 hours (as a result of the already activated immune system). The following symptoms are typical of scabies:
- Skin irritation in the form of vesicles and pustules and redness occur as a result of drilling.
- Mite, fecal pads and eggs cause severe itching.
- Comma-shaped, usually reddish, ducts may be present on all parts of the body except the face and hairy head.
The little animals particularly like to stay in the following body regions:
- Between the fingers
- In the axillary folds
- At the elbows
- On the nipples
- On the navel
- On the penis
- On the inner edge of the foot and ankle
Due to the pronounced scratching, a bacterial infection may also additionally develop in the corresponding skin areas. Without treatment, it can come to self-healing after about a quarter of a year.
Diagnosis of scabies
The diagnosis is often made on the basis of the typical symptoms. Microscopic detection of the mites on a skin scraping or after free dissection with a needle is not always successful. Nevertheless, therapy is recommended if there is sufficient suspicion.
What helps against scabies?
Usually ointments applied to the skin are sufficient to treat scabies, but if the infestation is pronounced, a special remedy must be swallowed. All persons who are in close contact with the infected person must also be treated. The therapy is repeated after one week. General measures are also important to safely put an end to the mites. These include:
- The frequent change and boiling of towels, bed linen and underwear.
- The thorough vacuuming of upholstered furniture, carpets and pillows.
- The seven-day airing of textiles that can not be washed.
Even better is dry cleaning outerwear and blankets.
Is scabies reportable?
There is an obligation to report scabies according to the Infection Protection Act only if the disease breaks out in communal facilities, because the cause of the infestation by the scabies mites must be investigated to the bottom. A suspected infestation must also be reported immediately to the relevant health authority. Thus, facilities such as:
- Kindergartens
- Schools
- Homes for the elderly
- Children’s homes
- Other community facilities
Infected persons are not allowed to stay or work in such communal facilities during the disease phase.
Hard facts and dark figures
According to the World Health Organization, approximately 300 million people worldwide are infected with scabies. All climates and socioeconomic classes are affected – but epidemics are more likely to occur in socially deprived, heavily populated areas with poor sanitation and compromised water supplies. Mites seem to be particularly comfortable in urban areas of the tropics. In the Northern Hemisphere, the frequency of their occurrence increases during the winter months.
7 important facts about scabies
The most important info about scabies can be found here at a glance:
- Scabies is highly contagious and occurs worldwide.
- Scabies is caused by the so-called scabies mite.
- The transmission of scabies occurs mainly through direct physical contact, but can also take place indirectly through laundry or upholstery.
- Typical symptom is a strong itching, especially at night.
- Family members and sexual partners must also be treated.
- In addition to specific therapy with an antimycotic agent, general hygienic measures must also be taken.
- Scabies is reportable only in the event of an outbreak and suspicion in communal facilities.
