The explosion of scabies infestations in Spain

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MADRID – The Spanish Ministry of Health notes an explosion of cases of scabies in the country. This is partly due to the pandemic.

The confinement to prevent the spread of the coronavirus; the delay in diagnosis due to the flooded primary care and the resistance of the mite that causes the disease is increasing the number of scabies outbreaks in Spain.

‘Sometimes four infections in a day’

“We are overwhelmed. Before the pandemic, I saw hardly two or three cases a month. Now I see ten a week and sometimes four in a day,” explains Miquel Casals in El País. He is in charge of the pediatric dermatology department at the Parc Taulí hospital in Sabadell (Barcelona).

‘Never seen as many cases as now’

“I’ve never seen so many cases before. Before scabies was something special, a disease you rarely saw, and now it’s something frequent,” says Vicente Baos, a general practitioner at Collado Villalba Pueblo in Madrid.

Very contagious

Scabies is caused by the mite Sarcoptes scabiei. It digs tunnels under the house and causes a terrible itching. The disease is very contagious. An infected person transmits scabies through direct skin-to-skin contact or through sharing the same bed or couch.

Even though experts see the disease as mild, the impact on the patient’s life is often large. In addition to the discomfort of the inflammation and the itching, often the house has to be disinfected. Usually, the patient will require treatment with corticoids and sometimes antibiotics. Moreover, there is often shame in infected people who have to report to their environment that they have scabies.

Scabies never completely gone

Scabies never completely disappeared from Spain. For a long time, the disease was only present very localised among specific population groups. A study published in November shows that the number of infections has increased since 2014. Researchers at the National Centre for Epidemiology link this increase to the consequences of the economic crisis. As a result, many people’s living conditions deteriorated. A trend that has been exacerbated in the past two years by the pandemic.

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Closed Settings

The research also shows that people who live in the worst socio-economic conditions are more likely to contract the disease. The data on scabies outbreaks from the National Network of Epidemic Surveillance (RENAVE) indicate that outbreaks are more likely to occur in closed institutions. During the lockdowns, homes also turned into a kind of closed institution in terms of conditions. The parasite could move freely in it.

Only larger outbreaks are reported

No precise data is known about the actual incidence of scabies in Spain. It is not a reportable illness. Doctors only report larger outbreaks. “We had to consult four different databases to conclude this increase,” said one of the researchers.

Late diagnosis

In addition to the problem of the lockdown, there was also the problem of late diagnosis. Because of the pandemic, many people did not dare to go to a health centre. This allowed infections to continue unhindered. With all its consequences.

Scabies mite resistance

In addition, the scabies mite has become resistant to the previously most commonly used drug against it: permethrin. The patient should cover himself completely with this cream to kill the scabies mite. Due to the resistance, it takes longer and the patient remains contagious for longer. Ivermectin is now also being used in pill form. Before, doctors only used this treatment for major outbreaks.

Once several people have been infected, it is difficult to eliminate the scabies mite. Infected persons often have to reapply themselves. In addition, the patient should thoroughly wash or clean (possibly) infected clothing, bedding, sofa covers, stuffed animals, pillows, and mattresses. Finally, the infected person has to warn all his or her close contacts as soon as possible so that they can also undergo full treatment. 

What is scabies?

Scabies or scabies is a contagious skin condition. The small animal, the scabies mite, causes health problems. The adult female digs superficial tunnels (max. 1.5 cm long) in the skin in which she lays her eggs. Itching is one of the main symptoms of scabies.

Does scabies go away on their own?

Scabies doesn’t go away on their own. Without treatment, the mites continue to spread


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