The sale of medicines against scabies in Spain has shot up 64% in the last year and has reached a volume that almost triples that registered in the years prior to the pandemic. This is revealed by the data from the consultant specialized in the pharmaceutical sector Iqvia, which confirms the notice launched by public health doctors in recent days. “I had never seen as many cases as now. It has gone from being a fairly exceptional thing to a frequent diagnosis,” Vicente Baos, a family doctor at the Collado Villalba Pueblo health center, in the Madrid municipality of the same name, told this newspaper a week ago.
Scabies is not a notifiable disease, so there are no official data on its incidence. The sales of medicines to treat it thus offer the best image to get an idea of the impact that the disease has on society.
In the 12 months between February 1, 2021 and January 31, Spanish pharmacies sold a total of 489,021 bottles of Sarcop and Perme-Cure. These two creams, which contain 5% permethrin, are the treatment of first choice to eliminate the mite that causes the disease, the Sarcoptes scabiei.
In the previous 12 months, sales amounted to 297,000 units, a figure that already represented a notable increase compared to previous years, which were —always from February 1 to January 31 of the following year— of 246,000, 220,000 and 177,000 bottles. , respectively.
To the products based on permethrin we must add those that have ivermectin as an active ingredient, used when the former have no effect (sarcoptes scabiei has begun to develop resistance, according to specialists) or to treat outbreaks in closed institutions, such as nursing homes or hospitals. Between February 2021 and last January 31, 164,000 treatments of Ivergalen (in pills) and another 61,000 of Soolantra, for topical use (225,000 in total), were sold in Spain. In this case, however, a historical series is not available that makes it possible to follow the evolution of sales.
“These data confirm the importance of the problem, which is greater than we expected despite the significant increase in cases that we had detected,” says Vicente Baos after knowing the drug sales data.
At least 150,000 patients in the last year
The available data does not allow a precise estimate to be made of how many people have suffered from scabies in Spain in the last year, although a prudent estimate places them at over 150,000 people. “There are patients who need more than one bottle to be cured. Other times, creams are prescribed as prophylaxis for cohabitants. In addition, if the whole family does not comply with the treatment properly, sometimes a person becomes infested again”, summarizes this family doctor.
Scabies, also known as scabies, causes intense itching. It is highly contagious between close people, either by direct skin-to-skin contact or by sharing spaces such as a bed, a sofa… Although it is considered a mild disease, it can have a significant impact on the patient’s life since it prevents sleeping normally and alters life habits. In addition, it causes inflammation with showy eczema that may require treatment with corticosteroids and even antibiotics in the case of infection by some opportunistic bacteria.
Although it has never been eradicated, the disease has long been considered a minor problem that is highly localized to particular population groups and locations. Traditionally, it has affected more people who live in precarious conditions or collectivities such as nursing homes, centers for minors and prisons, among others.
An investigation by the National Epidemiology Center, however, revealed an increase in the incidence of the disease as of 2014which its authors related to the negative effects that the economic crisis had on part of the population.
“The trend was already upward, but these new sales data support the hypothesis that scabies cases have increased during confinement and the pandemic. The most likely reason is that those closed institutions where outbreaks are not uncommon have been further closed in these two years. And homes have in turn become a kind of closed institutions, which has favored transmission and made it more difficult to control the disease. Some cases that until then were isolated became family outbreaks, ”explains Zaida Herrador, principal investigator of the study from the National Center for Epidemiology.
Miquel Casals, head of pediatric dermatology at Hospital Parc Taulí in Sabadell (Barcelona), detected a significant increase in scabies during the pandemic and summarized his findings in another article published in a scientific journal with the eloquent title of Scabies: an epidemic within the pandemic.
Berta Alvira, a 44-year-old geriatrician, works at the Getafe Hospital. She contracted scabies in December while comforting a patient. “She was an older woman, with very delicate health and she had a sad day. She began to explain to me what was bothering her and I stayed with her for about 15 minutes, during which I held her hand. She had some skin lesions that we had attributed to her basic ailment, but later, when the family came to look for her, they asked us about the itching they had on her. It turns out that all of them, 12 people who live in the same house, were infected, ”she recalls.
Alvira and a nursing assistant at the hospital contracted scabies. Then began a process that he remembers with “horror”. “I did the prophylaxis treatment, which consists of putting the cream all over your body twice, on the first day and on the seventh. But either I didn’t do it right or the mite was already resistant”, she relates.
This doctor then received the next planned treatment, with ivermectin, although it did not work either and after six days she began to have skin lesions characteristic of scabies. “In the end, we did a combined treatment taking permethrin cream and ivermectin pills again, but simultaneously. Along the way, I infected my husband and we haven’t gotten rid of the scabies until 20 days ago. You end up obsessing because the itching is exasperating. And it’s not just that and the marks on the skin, it’s that you don’t stop cleaning everything 20 times. All clothes, sheets and towels must be washed. And what you cannot put in the washing machine, leave it in quarantine for several days without touching it, ”he relates.
Experts recommend seeing your family doctor if you experience symptoms consistent with scabies. The most common warning signs, in addition to someone living with them contracting the disease, are intense itching (especially at night, which is when the mite is most active); a skin rash, especially between the fingers and toes, the underside of the wrists, the armpits, the breasts, and the buttocks; skin ulcers from scratching and burrowing of the parasite; and observe thin reddish lines on the skin, a sign of the path followed by the mite.
Doctors recommend that all people who live in the same house strictly comply with the treatment, since reinfections are common if any of them do not.
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