Hospitals are reporting an increase in scabies, a skin condition that was widespread during the Victorian era. The British Association of Dermatologists (BAD) reports that the number of cases in the country is increasing, with clinicians warning that some cases are proving increasingly difficult to eradicate. Infections are appearing in hospitals, social care homes, schools, and student accommodation.
Hospital Wards Face Closures and Visitor Restrictions
In Wales, Bronllys Hospital in Brecon restricted visitors on one of its wards after confirming a small number of scabies cases. Gareth Thomas, head of nursing for infection prevention and control, noted that the hospital decided to treat both patients and staff preventatively to prevent further transmission. He emphasized that although the number of cases remains low, medical staff do not want to underestimate the situation.
Prince Philip Hospital in Llanelli also recorded problems. In late September, the hospital restricted visitors and temporarily closed some wards due to the occurrence of scabies. According to updated information from October 7, two wards have already reopened following the necessary cleaning. Restrictions on visitors remain in force on the Mynydd Mawr rehabilitation ward. Glangwili Hospital had to adopt similar measures during the summer.
The occurrence of the disease was also confirmed last year at a higher education college in Devon. Reports of suspected cases have also appeared in several schools.
| Healthcare Facility | Location | Action Taken | Timeline |
|---|---|---|---|
| Bronllys Hospital | Brecon, Wales | Visitor restrictions implemented; preventative treatment for staff and patients | Current |
| Prince Philip Hospital | Llanelli, Wales | Ward closures and visitor limits; partial reopening after cleaning | Late September to October |
| Glangwili Hospital | Wales | Infection control measures and containment protocols | Summer months |
Transmission Dynamics and Diagnostic Challenges
Scabies is caused by microscopic mites, specifically Sarcoptes scabiei, which burrow into the top layers of the skin and lay eggs there. The result is intense itching and an unpleasant rash. The disease is transmitted mainly by prolonged direct skin-to-skin contact, so it can spread very quickly between partners or members of the same household. Transmission is also possible under certain circumstances through contaminated bedding or clothing, although direct skin contact remains the most common route.
Diagnostic delays complicate containment efforts. For individuals contracting the parasite for the first time, it can take several weeks before a person notices that something is wrong. During this period, the person can transmit the infection to others. If a person has had scabies in the past, symptoms usually appear faster upon reinfection. Dermatological presentations are often mistaken for eczema, an allergic reaction, or simple skin irritation. Typical eruption zones include spaces between the fingers, wrists, elbows, armpits, waist, groin, or the buttock area. The UK Health Security Agency (UKHSA) warns that intense scratching can damage the skin and in some cases lead to a bacterial infection.
Treatment Bottlenecks and Pharmaceutical Shortages
Scabies is usually treated with special preparations that kill the mites. One of the commonly used active ingredients is permethrin. The preparation is applied to the skin according to the doctor’s instructions or the package leaflet, and treatment usually needs to be repeated after seven days. Tess McPherson, a professor at the University of Oxford, points out that delayed diagnosis, late initiation of treatment, or insufficient public awareness may play a significant role. She notes that scabies often appears in environments where people live or spend a lot of time in close contact. The increase in cases may be partially related to the return of students to dormitories after the holidays. Experts emphasize that scabies is not proof of insufficient personal hygiene. Anyone can get infected regardless of age, social status, or the cleanliness of the household.
Leyla Hannbeck of the Independent Pharmacies Association highlighted repeated shortages of medicines intended for the treatment of scabies. According to her, the number of cases fell during pandemic measures, returned to pre-pandemic levels in 2022, and subsequently increased significantly. The unavailability of treatment may contribute to the infection spreading further. An alternative in some cases may be ivermectin, a drug used in the form of tablets. The NHS began using it for the treatment of scabies in 2023. It is not suitable for everyone, and its use must be assessed by a doctor.
Medical professionals emphasize that when scabies is confirmed, it is not enough to treat only the person who has visible symptoms. At the same time, members of the household and other close contacts should undergo treatment if recommended, even if they do not yet feel itching. It is also important to thoroughly wash bedding, towels, and clothing used in the period before starting treatment. Washing at a temperature of 60 degrees Celsius is recommended if the material allows it. Items that cannot be washed can be closed in a plastic bag for several days according to medical recommendations. After starting treatment, it is also necessary to limit close physical contact with other people, usually during the first 24 hours.
