Scabies Cases on the Rise: What You Need to Know

The Scabies Surge: Navigating Treatment Shortages and Misconceptions

A Growing Concern in Dermatology Clinics

In recent months, dermatologist Naveed Ijaz has witnessed an increasing number of patients at his Manchester, UK clinic presenting with intensely itchy rashes caused by scabies. This highly contagious skin condition, triggered by the Sarcoptes scabiei mite, can lead to widespread itchy rashes across the body. Ijaz expresses his concern, primarily due to the scarcity of available treatments, which is exacerbated by the tendency for outbreaks to occur more frequently during the winter months when people spend more time together indoors.

Scabies Cases on the Rise

Scabies is a prevalent condition, affecting approximately 200 million people worldwide annually. Kamila Hawthorne, chair of the UK’s Royal College of GPs, reported to The Zero Byte that weekly incidences per 100,000 in northern England remain significantly above the national and five-year average. Recent surveillance reports documented 1,926 cases nationwide between early December and January.

The surge in UK cases is part of a broader, long-term trend, with scabies cases consistently rising across Europe and globally over the past decade. This increase is attributed to a combination of factors, including treatment shortages, treatment failure, and the persistent stigma surrounding the disease, which deters some individuals from seeking prompt medical attention.

The Life Cycle of Scabies Mites

Scabies mites can reproduce, burrow, and lay eggs under the skin until the condition is treated, causing ongoing sores and itching cycles. The mites can easily spread to others, particularly through skin-to-skin contact, such as during sexual activity. Ijaz has encountered several cases where individuals contracted the infection from a sexual partner, and some data on the current UK outbreak’s extent has been derived from sexual health clinics.

Michael Head, a senior research fellow in global health at the University of Southampton, explains that mites can crawl off human beings and onto sofas or bedding, contributing to the sustenance of outbreaks. Scabies is relatively common in schools, prisons, care homes, and sometimes hospital wards or hostels, as the mite is quite hardy and adept at its own job.

Treatment Challenges and Emerging Concerns

The primary treatments for scabies are permethrin and malathion, skin lotions that must be applied across an infected person’s body to eliminate all mite and egg reservoirs. Although these treatments have traditionally been highly effective, recent years have seen increasing reports of treatment failure. A recent review published in the British Journal of Dermatology indicates that the treatment failure rate can reach up to 30 percent. While the review acknowledges that drug resistance among mites is an emerging concern, relatively little is known about this threat.

Jo Middleton, a research fellow at Brighton and Sussex Medical School involved in scabies research in the UK and globally, highlights the difficulty in