[Management of a scabies epidemic in the Strasbourg teaching hospital, France].
BACKGROUND
An outbreak of scabies occurred in the geriatric department of the Strasbourg University Hospital in September 2005. The index case presented with hyperkeratosic scabies, an extremely contagious form. The epidemic spread to several wards and pavilions and also contaminated healthcare staff and patient's families.


OBJECTIVE
Our objective was to describe the outbreak, its progression, and the measures taken to eradicate it.


METHODS
All healthcare workers, patients, and families affected in the outbreak were retrospectively studied, using medical prescriptions recorded by the hospital pharmacy, listings established by the occupational health department, and patient files.


RESULTS
Two epidemic waves were recorded, between August 31 and December 16, 2005, affecting 51 patients and staff members in the geriatric department, with a total of 58 episodes of scabies, seven of which were recurrences. Three main measures were taken to eradicate the epidemic: setting up of "contact" isolation precautions, information for the affected individuals, and treatment of the infected patients associated to mass treatment of contact cases. The mass treatment was widely applied, involving 490 patients and 592 caregivers. All of these measures successfully curtailed the outbreak in 3 months.


CONCLUSIONS
Rapid and radical action is essential to prevent extension of scabies within a community.
Meyer
E-P
EP
Équipe Opérationnelle d'Hygiène (UF1301), Service d'Hygiène Hospitalière et de Médecine Préventive, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
Heranney
D
D
Foeglé
J
J
Chamouard
V
V
Hernandez
C
C
Mechkour
S
S
Passemard
R
R
Berthel
M
M
Kaltenbach
G
G
Lipsker
D
D
Christmann
D
D
Lavigne
T
T
D056810:Acaricides / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000453:epidemiology / Q000469:parasitology* / Q000635:transmission; D019468:Disease Management; D004196:Disease Outbreaks; D005192:Family Health; D005602:France / Q000453:epidemiology; D005853:Geriatrics; D006748:Hospital Departments; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D006920:Hygiene; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control; D008875:Middle Aged; D009784:Occupational Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D010564:Personnel, Hospital; D012008:Recurrence; D012189:Retrospective Studies; D012532:Scabies / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission
D056810:Acaricides