Can a person get scabies by trying on clothes in a store? Experts say that if someone infected puts on a pair of pants, wears them for a few minutes, and shortly after another customer repeats the process with the same item of clothing, it’s not impossible for something like this to happen. But that is very difficult. In fact, no one has heard of an outbreak of these characteristics. And, despite this, a video uploaded to the TikTok social network has added hundreds of thousands of visits in recent hours by stating that there is “a plague” of scabies in clothing fitting rooms. A statement that specialists attribute to a very common mistake, establishing a causal relationship between two fortuitous events close in time, influenced by an event that is real: the explosion of scabies cases in Spain.
“We are overwhelmed. Before the pandemic, I only saw two or three cases a month. Now I am seeing 10 a week and, sometimes, up to four in one day”, explains Miquel Casals, head of pediatric dermatology at Hospital Parc Taulí in Sabadell (Barcelona). “I had never seen as many cases as now. Before, scabies was something quite exceptional, a rare disease to see, and now it has become something frequent”, adds Vicente Baos, a family doctor at the Collado Villalba Pueblo health center, in the province of Madrid.
Scabies, also known as scabies, is caused by the mite Sarcoptes scabiei, that produces intense itching as it moves through the epidermis digging tunnels. It is quite contagious between close people, either by direct skin-to-skin contact or by sharing spaces such as a bed, a sofa… It is a clinical process considered mild, but it has a notable impact on the patient’s life because, in addition of the discomfort, the inflammation that it produces and the scratching very often ends in showy eczema that may require treatment with corticosteroids and even antibiotics if an infection by some opportunistic bacteria occurs.
Scabies has never been eradicated, but for a long time it was a minor problem that was very localized in specific population groups and places. A study carried out by researchers from the National Center for Epidemiology, published last November, however, detected an increase in the incidence in Spain that had been occurring since 2014. The authors link this increase with the consequences of the economic crisis, which worsened the living conditions of part of the population. A trend that the effects of the pandemic have triggered in the last two years.
“The primary care data that we used in the research allowed us to verify that people with worse socioeconomic conditions have a higher risk of suffering from the disease. And the [datos] of outbreaks of the National Epidemiological Surveillance Network (RENAVE) point to closed institutions as the place where a greater number of cases occur. On this basis, what has happened with the pandemic is that each house has become like a closed institution and this has greatly favored the circulation of the parasite in the last two years”, explains Zaida Herrador, principal investigator of the study.
There are no precise data on the real incidence of scabies in Spain. It is not a notifiable disease and only the most important outbreaks are usually reported. “We had to resort to four different databases that allowed us to verify the increase: the National Epidemiological Surveillance Network (RENAVE), hospital records, primary care databases and also a database of occupational diseases, because many of the affected are health and socio-health professionals, ”adds Herrador.
Scabies: an epidemic within the pandemic. This is an eloquent title of the study published a year ago in a scientific journal by Miquel Casals, who was constantly surprised by the sustained increase in cases diagnosed in the consultation since the outbreak of the coronavirus. “It has been something spectacular and to which several things have contributed. With the confinement, and especially in the smallest homes, all the cohabitants were infected first. Then, with the saturation of primary care, the diagnosis has been greatly delayed. And later, when people have been recovering normality, there were many infected people who in turn could infect others, “explains the dermatologist.
Specialists warn of other reasons that keep blood circulation at high levels. Sarcoptes scabiei. “The mite has begun to become resistant in some cases to the treatment of first choice, which is topical permethrin. This delays the healing of many processes, which in turn increases the risk of new infections. In the end, many times we have to give ivermectin in pills, a treatment that was previously reserved for large outbreaks,” Casals details.
The diagnosis of the disease is not easy either, especially in the early stages of an infection, when the symptoms (itching, small pimples…) can be confused with other skin ailments. “We had been going for years with a very low incidence, family doctors were not used to seeing it and scabies is sometimes difficult to diagnose because there are other pathologies with a similar clinical picture”, Zaida Herrador points out.
One last factor highlighted by experts is the difficulty of ending scabies when it has settled in a house or community. “First you have to apply the cream properly all over your body, from the neck down, which for some people is not easy either. You have to sleep with it until you shower in the morning. Then you have to wash all the clothes, bedspreads, sheets… And it is also very important to make a good diagnosis of the contacts and that all those infected comply with the treatment. It is enough that one does not do it well for everyone to be reinfected again and have to start the process all over again. This is something that happens too often”, concludes Vicente Baos.
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