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SCABIES CONT.
Division of Public Health Services Disease Handbook for Childcare Providers
Bureau of Infectious Disease Control REVISED –January 2018
SCABIES
Scabies is a common skin infestation caused by
microscopic parasites called a mite. The female
mite burrows under the skin to lay her eggs,
which subsequently hatch and start the infestation
cycle again.
Symptoms of scabies do not appear until weeks
after exposure. The skin reaction is probably due,
in part, to a sensitization or “allergic” reaction to
the mites. On re -exposure, symptoms can start
within days. The infestation is in the form of an
intensely itchy rash, which consists of red bumps
and burrows (i.e., short, wavy, thread -like lines in
the skin). Itching tends to increase at night.
Who gets this disease?
Anyone who has contact with the mite can
become infested with scabies.
How is it spread?
The mite is spread by direct skin -to-skin contact,
or by skin contact with clothes, bedding, etc. that
the mites have crawled onto. The mites can
survive only three days off the body and cannot
jump or fly. They require direct contact with skin
to spread. The incubation period for this dis ease
is two to six weeks after exposure.
How is it diagnosed and treated?
It can be diagnosed by the typical appearance of
the rash and accompanying symptoms and by
examining skin scrapings under the microscope to
see the mite or its’ eggs.
Scabies is treated with one of several prescription
mite-killing creams or lotions, which are applied
once to the skin and then washed off after a
specified period of time. Medicine to relieve the
itching is often necessary. (Note: Even after
effective therapy, itching can persist for up to 2 to
4 weeks). Treatment is recommended for all
household members – even those without
symptoms – due to the high likelihood of spread
within a household. Prophylactic treatment is also
recommended for people who have had direc t
skin-to-skin contact with an infected individual.
How can the spread of this disease be
prevented?
1. Follow previously outlined principles of
hand washing and cleanliness at the
childcare facility.
2. Children should not share personal items,
cribs, mats or clothing.
3. Each child’s dirty clothing should be
stored separately and sent home for
laundering.
4. If a case of scabies occurs in the daycare
facility:
a. Wash and dry on the hot cycle all
washable items belonging to the
center that came into contact with
the child’s skin during the 72 hours
prior to treatment.
b. Difficult to wash items (e.g.,
stuffed toys, pillows) can be stored
in tightly closed plastic bags for
four days and then used again.
(Note: The mite cannot live off the
body for more than three days).
c. Thoroughly vacuum any carpet or
upholstered furniture.
SCABIES CONT.
Division of Public Health Services Disease Handbook for Childcare Providers
Bureau of Infectious Disease Control REVISED –January 2018
5. Pesticide sprays are not recommended and
can be harmful to people and animals.
6. If a rash, which appears suspicious for
scabies, is noticed on a child in the
childcare center, tell the parents the child
should be seen by a healthcare provider.
Who should be excluded?
Infected individuals should be excluded until
treatment is completed. If two or more cases
occur in the daycare center, call the Division of
Public Health Services, Bureau of Infectious
Disease Control for further recommendations.
Reportable?
No, scabies is not reportable by New Hampshire
law to the Division of Public Health Services,
Bureau of Infectious Disease Control . However,
Public Health Professionals are available for a
consultation at (603) 271-4496.