Scabies Transmission Risks in Everyday Life

Scabies transmission situation?

1.
Recently, I learned about scabies and discovered that a family member belongs to a high-risk group (working in a nursing home).
This person does not have the habit of showering and changing clothes immediately upon returning home, so they sit on chairs or lie on beds while still wearing outdoor clothes.
If they were to come into contact with scabies mites, would it be easy for them to leave the mites in the home environment? Many people do sit or lie on beds while wearing outdoor clothes, which could increase the risk of contracting scabies, right?
2.
The long incubation period makes me worried that if they are already infected, other family members may not notice immediately, leading to further transmission.
Their clothing and bedding should naturally be prioritized for avoiding contact, but there are still many shared items in the home, such as light switches, water bottles, and toilets.
I found some information indicating that scabies mites are indeed highly contagious.
Some articles even state that trying on clothes in a store, sitting on public transport, holding onto escalator handrails, or using public computers' mice and keyboards could also pose a risk of transmission.
Although scabies mites typically die within about two days outside the human body, many items in public places are frequently used by others.
However, I haven't seen any reports of large-scale scabies outbreaks, so I would like to ask about the actual transmission risk from these non-clothing contacts.
After researching, I now hesitate to touch public items, avoid sitting on public transport, and wash my hands after using a water bottle at home, which is quite distressing.
3.
Sometimes, during rush hour on the subway, there are many people crowded together.
If someone next to me is a scabies patient, is it possible for me to get infected? Especially with summer approaching and people starting to wear short sleeves, the likelihood of direct skin contact increases when people are packed together.
4.
Lastly, I would like to ask, if there is a concern about coming into contact with scabies mites, and if the mites have not yet burrowed into the skin (as some articles state it takes about 10 minutes or more to burrow), can I simply wash them off with water? Or is it necessary to use cleaning products? I apologize for the many questions, and I appreciate your help, doctor.

David, 20~29 year old female. Ask Date: 2021/04/30

Dr. Wu Yuxin reply Dermatology

1.
It's possible.
2.
3.
The chances are low.
4.
It's still recommended to scrub thoroughly.

Reply Date: 2021/04/30

More Info

Scabies, caused by the Sarcoptes scabiei mite, is a highly contagious skin condition that can spread through direct skin-to-skin contact and, to a lesser extent, through contaminated objects and surfaces. Understanding the transmission risks associated with scabies is crucial, especially for individuals in high-risk environments, such as nursing homes, where close contact among residents and staff is common.

1. Transmission in the Home Environment: If a family member works in a nursing home and does not change clothes or shower upon returning home, there is indeed a risk of transferring scabies mites to shared surfaces, such as chairs and beds. Scabies mites can survive off the human body for up to 48-72 hours, which means that if the individual has been exposed to scabies at work, they could potentially leave mites on clothing or furniture. This is why it is advisable for individuals in high-risk occupations to change clothes and shower immediately after returning home to minimize the risk of transmission.

2. Common Household Items: You are correct in your concern about shared items in the home. While scabies mites do not survive long away from the human body, they can still be present on frequently touched surfaces like light switches, water bottles, and toilet handles. The risk of transmission through these surfaces is lower compared to direct skin contact, but it is not negligible. To reduce the risk, it is wise to maintain good hygiene practices, such as regular handwashing and cleaning commonly used surfaces with disinfectants.

3. Public Spaces and Close Contact: In crowded public spaces, such as public transportation, the risk of transmission increases, especially if there is direct skin contact with an infected person. While scabies is primarily spread through prolonged skin-to-skin contact, brief contact can also pose a risk, particularly in close quarters. If someone with scabies is in close proximity, there is a potential for transmission, especially during warmer months when people wear less clothing and skin contact is more likely.

4. Preventive Measures: If you suspect you have come into contact with scabies mites, it is important to take preventive measures. Washing the affected area with soap and water can help remove mites that have not yet burrowed into the skin. However, it is advisable to use a medicated scabicide treatment if you suspect exposure, as this is the most effective way to eliminate any potential infestation. Over-the-counter treatments may not be sufficient, so consulting a healthcare provider for appropriate treatment is recommended.

In summary, while scabies is highly contagious, the risk of transmission through casual contact or contaminated surfaces is lower than through direct skin-to-skin contact. Practicing good hygiene, changing clothes after being in high-risk environments, and being cautious in public spaces can significantly reduce the risk of scabies transmission. If there are concerns about exposure or symptoms of scabies, seeking medical advice is essential for proper diagnosis and treatment.

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