In the past few months, Dr. Naveed Ijaz, a dermatology specialist, has noticed a rise in patients with itchy rashes at his clinic in Manchester, UK. These rashes are caused by scabies, a contagious skin condition triggered by the Sarcoptes scabiei mite, leading to widespread itching.
Dr. Ijaz expresses deep concern due to the limited available treatments, especially as outbreaks tend to increase during winter when people spend more time indoors. Scabies, affecting around 200 million globally, is surging in England, with reports of outbreaks in care homes and university accommodations, particularly in the north.
Kamila Hawthorne, chair of the UK’s Royal College of GPs, shares that cases in the north continue to surpass national averages. Recent surveillance reports note 1,926 cases in the UK between early December and January.
The spike in the UK is part of a global trend where scabies cases have been rising for a decade. This is not attributed to climate change but rather a combination of factors: treatment shortages, treatment failure, and the stigma surrounding the disease, preventing timely medical attention.
Scabies mites, if untreated, can reproduce under the skin, causing ongoing itching and sores. Transmission, especially through skin-to-skin contact, is common, and outbreaks persist in schools, prisons, care homes, and hospitals.
The primary treatments, permethrin and malathion lotions, have traditionally been effective, but recent reports suggest a failure rate of up to 30%. Drug resistance among mites is a growing concern, although it remains poorly understood.
In addition to treatment challenges, eradicating outbreaks proves difficult. Decontaminating bedding and furniture is crucial, and the application of medicines like permethrin is intricate.
The UK faces an extended shortage of treatments, attributed to pandemic-related supply chain issues and Brexit-related import problems. Researchers advocate for more rigorous surveillance, given scabies' high incidence and the potential for secondary skin infections if untreated.
Misinformation surrounds scabies, with unfounded associations with refugees and false claims hindering the use of effective medications. While ivermectin is successful in managing scabies globally, it is not routinely used in the UK due to baseless claims about its efficacy against Covid-19.
Dr. Ijaz and others hope that the current UK outbreak can be managed through improved public health campaigns, addressing misconceptions and ensuring proper post-treatment understanding to avoid unnecessary shortages.