the Infection Risks of Norwegian Scabies in Healthcare Settings

Norwegian scabies

Dear Director Wu,
I have a patient with Norwegian scabies who has been using BB lotion for several days.
The patient is currently in the intensive care unit (not in a private room).
Although isolation precautions such as gowns, gloves, hair covers, masks, and hand hygiene after contact are being implemented, there are still close contacts (such as repositioning, percussion, suctioning, and drawing blood).
Is the risk of infection high in this situation? This is my first encounter with a Norwegian scabies patient, and I am quite concerned.
Thank you.

Xing, 20~29 year old female. Ask Date: 2015/03/28

Dr. Wu Yuxin reply Dermatology

The difference between Norwegian scabies and regular scabies lies in the significantly higher number of adult mites and eggs present on the host in Norwegian scabies, which naturally increases its infectivity.
Due to the increased likelihood of close contact, there remains a risk of infection even with isolation measures in place.
I would recommend not waiting until infection or symptoms appear to initiate treatment; instead, consider administering continuous medication for two weeks, as prevention is better than cure.

Reply Date: 2015/03/28

More Info

Norwegian scabies, also known as crusted scabies, is a severe form of scabies caused by the Sarcoptes scabiei mite. It is characterized by thick crusts of skin that harbor a large number of mites, making it highly contagious. In healthcare settings, particularly in intensive care units (ICUs) where patients may be immunocompromised or have other underlying health conditions, the risk of transmission can be significant if proper precautions are not taken.

Infection Risks in Healthcare Settings
1. Transmission Dynamics: Norwegian scabies is primarily transmitted through direct skin-to-skin contact. The mites can also be spread indirectly through contaminated clothing, bedding, or surfaces. In a healthcare setting, close contact with an infected patient, especially during procedures like turning the patient, suctioning, or drawing blood, increases the risk of transmission.

2. Protective Measures: The use of personal protective equipment (PPE) such as gowns, gloves, masks, and hair covers is crucial in preventing the spread of Norwegian scabies. These barriers help to minimize direct contact with the patient’s skin and any potential contaminated surfaces. However, it is essential that healthcare workers adhere strictly to these protocols, including proper hand hygiene before and after patient contact.

3. Environmental Considerations: In a shared room setting, the risk of transmission can be heightened. The mites can survive for a short period on surfaces, which means that any shared equipment or surfaces should be thoroughly disinfected after use. Regular cleaning and disinfection protocols should be in place to mitigate this risk.

4. Monitoring and Management: Patients with Norwegian scabies should be closely monitored for any signs of secondary infections or complications. Healthcare workers should also be vigilant for any symptoms of scabies in themselves, such as itching or rash, and report these symptoms immediately.

5. Education and Training: It is vital for healthcare staff to be educated about the nature of Norwegian scabies, its transmission, and the importance of infection control measures. Training sessions can help reinforce the protocols for handling patients with scabies and ensure that all staff members are aware of the risks and necessary precautions.

Conclusion
In summary, while the risk of transmission of Norwegian scabies in a healthcare setting, particularly in an ICU, is present, adherence to strict infection control measures can significantly reduce this risk. The use of appropriate PPE, thorough hand hygiene, and environmental cleaning are critical components in preventing the spread of scabies. If you have concerns about exposure or symptoms, it is advisable to consult with an infection control specialist or your healthcare facility's infection prevention team for further guidance and support. Regular communication and vigilance are key to ensuring the safety of both patients and healthcare workers in managing infectious diseases like Norwegian scabies.

Similar Q&A

Understanding Norwegian Scabies: Infection Risks and Prevention

Hello, I would like to ask, there is a wheelchair-bound patient, an elderly woman with Norwegian scabies, who happened to be at the entrance where our nursing staff frequently pass. I was just about to take out the trash and was very careful not to touch the door, but I am unsure...

Dr. Wu Yuxin reply Dermatology
The probability is low.

Could This Skin Condition Be Scabies? Understanding Symptoms and Risks

Hello, Doctor: Today I went to the hospital for a blood test. In front of me was an elderly patient in a wheelchair, whose exposed arms showed white, patchy skin. At that moment, I didn't know what disease it could be. When it was my turn, the lab technician did not change g...

Dr. Wu Yuxin reply Dermatology
Volunteers are not dermatologists, so there's no need to be overly anxious about their comments. The diagnosis of scabies is not based solely on appearance; it requires a thorough examination of the patient's skin, which takes some time. If there are any concerns regard...

Understanding Scabies Infection Risk in Dermatology Clinics

Hello, doctor: I would like to ask a question. I visited a dermatology department at a teaching hospital, and while waiting for my appointment, I learned that the previous patient was diagnosed with scabies. I saw the doctor shortly after (within 3 minutes) while sitting in the s...

Dr. Li Yufen reply Dermatology
Hello: Generally, the likelihood of contracting scabies from brief contact is low. However, if you are really concerned, you can apply scabies cream all over your body from the neck down as a preventive treatment. Thank you. Wishing you peace and happiness.

Understanding Scabies and Pubic Lice: Infection Risks and Prevention

Hello, doctor. I am a staff member at a clinic, and we often have patients with scabies or pubic lice coming in for treatment. However, sometimes we are unsure if they actually have these conditions. I would like to ask: 1. If I encounter a patient with scabies or pubic lice an...

Dr. Wu Yuxin reply Dermatology
The chances are very low, so please rest assured. Just adhere to the principle of frequent handwashing. The risk of infection from money, health insurance cards, and medical records is very low.