Implications from an Ongoing Scabies Outbreak During the COVID-19 Isolation Period: Clues for Controlling Scabies Today

Abstract

Background: Contrary to the expectation that the number of scabies cases will decrease during the COVID-19 isolation period, scabies has been frequently reported in Turkey. 
 Objective: The aim of this study is to investigate the epidemiological pattern of the scabies outbreak in the context of the pandemic to provide additional information for the control of the devastating scabies outbreak that continues today.
 Methods: Patients seen in our dermatology clinic before and during the pandemic were evaluated retrospectively. 
 Results: There was no decrease in the rate of scabies patients among all dermatology admissions during the pandemic period (n=143/2912; 4.9%) compared to the pre-pandemic period (n=526/11679; 4.5%) (p=0.348). The high incidence of the new scabies cases before the detection of COVID-19 in the country decreased in the quarantine period. However, the high recurrent admissions of old scabies cases, who already got scabies before pandemic but could not be cured despite repeated treatments, contributed to the ongoing high prevalance of scabies during the pandemic (one-third of all scabies cases seen during the pandemic, n=30/87).
 Conclusions: We suggest that self-quarantine and increased hygiene during COVID-19 reduced re-infestations and led to a decrease in new cases. Treatment failure of old cases has been observed to contribute to the high prevalence of scabies in the pandemic. Permethrin resistance may have led to inadequate treatment success, given that treatment application errors, which may also lead to treatment failure, are managed with active surveillance in our patient population. Studies addressing permethrin resistance are needed as a priority.