title: Control of large institutional scabies outbreaks.
abstract: BACKGROUND
  Scabies outbreaks in community facilities may reach large dimensions and take a protracted course. Highly contagious crusted scabies is a major cause of nosocomial outbreaks.
  
  
  METHODS
  On the occasion of an extensive scabies outbreak in a north Bavarian sheltered workshop and its associated residential homes with over 500 exposed individuals, a multifaceted control strategy was developed and pursued. Knowledge from a comprehensive review of the literature was utilized.
  
  
  RESULTS
  Our successful scabies elimination concept includes: 1) Careful organization (formation of an outbreak management team, registration and information of all exposed individuals, prospective time management, financial calculation); 2) simultaneous clinical examination of all individuals at risk; 3) synchronous topical treatment of all exposed individuals with permethrin 5 % cream on day 0, repeated treatment of proven and doubtful cases on days 1 and 14; systemic treatment of selected cases with oral ivermectin; 4) decontamination and quarantine measures; 5) follow-up investigations and repeated treatment if indicated.
  
  
  CONCLUSIONS
  Management of large institutional scabies outbreaks requires a high degree of motivation, communication skills and perseverance.
authors.affiliation: Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Josef-Schneider-Straße 2, Würzburg, Germany. Stoevesandt_J@klinik.uni-wuerzburg.de
authors.forename: Johanna
authors.initials: J
authors.lastname: Stoevesandt
authors.forename: Lydia
authors.initials: L
authors.lastname: Carlé
authors.forename: Martin
authors.initials: M
authors.lastname: Leverkus
authors.forename: Henning
authors.initials: H
authors.lastname: Hamm
mesh_terms: D000977:Antiparasitic Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D011159:Population Surveillance; D015995:Prevalence; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012532:Scabies / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D000977:Antiparasitic Agents