Patient Safety Topics

Scabies is a highly contagious parasitic infestation of the skin and a clinically significant cause of morbidity, especially among people who are debilitated, immunocompromised, institutionalized, or elderly. Successful control of a scabies outbreak requires a facility-specific outbreak control plan, including techniques for early case identification and treatment, robust infection and environmental controls, and protocols for communication and education.

Key Data and Statistics

​Pennsylvania nursing homes reported 484 cases of scabies and 37 outbreaks. One hundred ten scabies events were reported from hospital inpatient, emergency, and outpatient settings, as well as from ASFs, with one outbreak occurring in a psychiatric unit (Table). Event report narratives from hospital and ASF settings identified problems associated with inadequate communication to receiving units or facilities, including delays in diagnosis, treatment, and instituting precautions; cancelled surgeries; and unrecognized contacts resulting in exposures.

Table. Hospital and Nursing Home Scabies Cases​ ​ ​ ​
SettingTime Frame​​Number of Cases​Outbreaks
​Hospital inpatient medical, surgical, specialty, and psychiatric units, imagin, and laboratories*​June 2004 through November 201570​​1 psychiatirc unit outbreak for 3 total cases
​Hospital outpatient, emergency department, and ultrasound*​June 2004 through November 2015​33​None reported
​Ambulatory surgical facility* ​June 2004 through November 2015​7​None reported
​Nursing HomesApril 2014 through November 2015​484​37 outbreaks

* Hospital and ambulatory surgical facility case reports found in PA-PSRS.

Nursing homes began reporting scabies cases through PA-PSRS in April 2014.

Five of the 37 nursing home outbreaks totaled 272 cases.​ ​ ​ ​

Educational Tools

Scabies Transmission, Symptoms, Diagnosis, and Control
A working knowledge of scabies clinical indicators is critical to avoid scabies treatment failures and outbreaks. This graphic displays the key elements of scabies transmission, symptoms, diagnosis, and control.

Scabies Case/Contact Investigation Line List
This line listing can be initiated at the first suspicion that a patient, staff member, or visitor has scabies symptoms.

Scabies Outbreak Control Checklist
This checklist identifies specific tasks for members of a multidisciplinary team to address and document the timed implementation.


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