502 NOSOCOMIAL SCABIES INFECTIONS: EPIDEMIOLOGY IN THE OUTPATIENT CLINIC

Abstract

Scabies infestation appears to be increasing over the past few years. Nosocomial spread of this disease has been rarely reported. In October of 1978, 2 nurses and a medical student developed pruritic, papular eruptions on wrists, shoulders, neck and axillary areas. Scabies was diagnosed in each case by clinical and microscopic findings. Since all 3 of these individuals were assigned to the general pediatric outpatient clinic, an epidemiologic investigation was initiated. Both nurses and the medical student remembered prolonged close contact (during lumbar puncture procedure) with a 6-year-old child with aseptic meningitis and scabies. This index child had been diagnosed infested with scabies 24 hours previously, but had not received the prescribed treatment. A total of 41 persons who had both direct and indirect contact with the scabietic child were identified and examined. Scabies was diagnosed in 12 cases: 6 family members of the index child, 5 family members of the nurses, and a single child visiting one of the infested children. Topical application of 1% gamma benzene hexachloride was initiated for all diagnosed individuals and persons sharing living facilities were simultaneously treated to avoid reinfection. A re-education of staff, stressing the importance of proper handling of infected and suspected patients was initiated. Proper gowning and careful hand-washing between patients may have prevented this outbreak.