Arthropod infections

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Scabies

Occurrence:

Worldwide, in overcrowded poor

areas

Organism:

Sarcoptes scabiei

Reservoir.

Humans

Transmission:

Direct contact, or indirectly through

contaminated clothing

Control:

Improvement in personal hygiene

Treatment of affected persons

This is an infection of the skin by the mite, Sarcoptes scabiei. The skin rash typically consists of small papules, vesicles and pustules, characterized by intense pruritus. Another typical feature is the presence of burrows, which are superficial tunnels made by the adult mite. Secondary bacterial infection is common. Lesions occur most frequently in the moist areas of skin, for example the web of the fingers.

The incubation period ranges from a few days to several weeks.

CAUSATIVE AGENT

The infective agent is the mite S. scdjaie. The female mite which is larger than the male, measure 0.3-0.4 mm. The gravid female lays its egg! in superficial tunnels. Within 3-5 days, the eggs hatch to produce larvae and nymphs which pass through four stages and finally moult after 3 weeks to become sexually mature adults. The adults pair and mate on the skin surface.

EPIDEMIOLOGY

The distribution of the disease is widespread in the tropics with particular concentration in poor overcrowded areas; it is also found in the temperate zones, especially in slums and where disasters such as wars have led to crowding and insanitary conditions.

Reservoir

The reservoir of infection is in human beings. There is a related species of mite in animals - S. mange; humans may acquire this infection on contact with infected dogs, but this mite cannot reproduce on human skin.

Transmission

Transmission of scabies is by direct contact with an infected person or indirectly through contaminated clothing. Infection may be acquired during sexual intercourse.

Host factors

All persons are apparently susceptible but infection is particularly common in children; several cases are commonly found within the same household.

LABORATORY DIAGNOSIS

The adult mite can be seen using a hand lens, and identified under the microscope; the female mite can be brought to the surface by teasing the burrows with a sharp pointed needle.

CONTROL

A high standard of personal hygiene must be maintained. Regular baths with soap and water, frequent laundering of clothes, and the avoidance of overcrowding help to prevent the spread of infection.

Infected persons should be treated by the application of benzyl benzoate emulsion or tetraethylthiuram monosulphide following a thorough bath. Other affected members of the family should be treated at the same time to prevent reinfection. Mass treatment may be useful in large institutions such as work camps.

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