title: The management of scabies outbreaks in residential care facilities for the elderly in England: a review of current health protection guidelines.
abstract: Commonly thought of as a disease of poverty and overcrowding in resource-poor settings globally, scabies is also an important public health issue in residential care facilities for the elderly (RCFE) in high-income countries such as the UK. We compared and contrasted current local Health Protection Team (HPT) guidelines for the management of scabies outbreaks in RCFE throughout England. We performed content analysis on 20 guidelines, and used this to create a quantitative report of their variation in key dimensions. Although the guidelines were generally consistent on issues such as the treatment protocols for individual patients, there was substantial variation in their recommendations regarding the prophylactic treatment of contacts, infection control measures and the roles and responsibilities of individual stakeholders. Most guidelines did not adequately address the logistical challenges associated with mass treatment in this setting. We conclude that the heterogeneous nature of the guidelines reviewed is an argument in favour of national guidelines being produced.
authors.affiliation: Department of Primary Care and Public Health,Brighton and Sussex Medical School,Falmer,Brighton,UK.
authors.forename: L C J
authors.initials: LC
authors.lastname: White
authors.affiliation: Department of Primary Care and Public Health,Brighton and Sussex Medical School,Falmer,Brighton,UK.
authors.forename: S
authors.initials: S
authors.lastname: Lanza
authors.affiliation: Department of Primary Care and Public Health,Brighton and Sussex Medical School,Falmer,Brighton,UK.
authors.forename: J
authors.initials: J
authors.lastname: Middleton
authors.affiliation: Surrey and Sussex Health Protection Team (Public Health England South East Centre),Horsham,UK.
authors.forename: K
authors.identifier: 0000-0003-3044-019X
authors.initials: K
authors.lastname: Hewitt
authors.affiliation: Department of Primary Care and Public Health,Brighton and Sussex Medical School,Falmer,Brighton,UK.
authors.forename: L
authors.initials: L
authors.lastname: Freire-Moran
authors.affiliation: Surrey and Sussex Health Protection Team (Public Health England South East Centre),Horsham,UK.
authors.forename: C
authors.initials: C
authors.lastname: Edge
authors.affiliation: Surrey and Sussex Health Protection Team (Public Health England South East Centre),Horsham,UK.
authors.forename: M
authors.initials: M
authors.lastname: Nicholls
authors.affiliation: Surrey and Sussex Health Protection Team (Public Health England South East Centre),Horsham,UK.
authors.forename: J
authors.initials: J
authors.lastname: Rajan-Iyer
authors.affiliation: Surrey and Sussex Health Protection Team (Public Health England South East Centre),Horsham,UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Cassell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control*; D004739:England / Q000453:epidemiology; D006801:Humans; D017410:Practice Guidelines as Topic; D012112:Residential Facilities; D012532:Scabies / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control*
keywords: Elderly medicine; infectious disease control; outbreaks; residential care; scabies