Dear Doctor: My wife and I had to go back to our offices, so our 4-year-old son is back in day care. About six weeks in, he got an itchy rash that drove him nuts. His pediatrician says it’s scabies. What is that? She says it’s likely he got it at day care, and we’re worried it will happen again.
Dear Reader: The word “scabies” comes from the name of a microscopic mite known as Sarcoptes scabiei var. hominis—the human itch mite.
Scabies are minute insectlike organisms—about the size of the point of a pin—that are related to ticks. They’re extremely contagious and are passed along through direct and prolonged human contact. You won’t get scabies from a quick hug or a handshake. However, in situations such as a day care, where children spend a lot of time together in close quarters, are physical in their play, and often share communal toys, pillows and blankets, an infestation can spread quickly.
Impregnated female mites burrow under the topmost layers of skin, where they create tunnels and lay two to three eggs per day. Once hatched, the mite larvae return to the skin’s surface. There, they construct what are known as molting pouches, where they mature. The new adults will then either migrate to other parts of the body, or to another person’s skin.
The itch associated with scabies arises from the body’s allergic reaction to the mites, their eggs and their waste. In someone who has never had scabies, it can take four to eight weeks for an allergic reaction to develop. Once it begins, it’s an often-maddening itch that becomes especially persistent at night.
In addition to itching, symptoms of scabies include the rash such as the one your son experienced. It may resemble hives; clusters of tiny bumps, knots or pimples; or patches of scaly skin. In children, the mites are most commonly found on the face, neck and scalp, and they can also be present in the palms of the hands, webs of the fingers and the soles of the feet. Diagnosis is based on the distinctive appearance and distribution of the rash, and on the presence of burrows.
Scratching can lead to open sores, which are susceptible to a secondary infection. Treatment with prescription medications known as scabicides is effective. Over-the-counter products have neither been tested nor approved for scabies treatment. Antihistamines, anti-itching lotions and steroid creams might be prescribed to allay the itch.
Because scabies is so contagious, it’s important for any affected person to alert those around them. It is recommended that entire families or contact groups, such as the children, staff and parents involved in your day care, undergo treatment at the same time.
Bedding, clothing and other textiles should be treated as well. Without a host, scabies can’t survive beyond 72 hours, so contaminated items should be fully sealed in plastic bags for at least that long. Also effective are washing them in very hot water and drying them in a very hot dryer. Although it’s possible that the issue may reoccur, a thorough and vigilant response should eradicate the problem.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
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Editor’s note: Please call ahead to the meal site to ask about any COVID-19 protocols in place.
Meals are served in the Marinette Senior Center on Ludington Street, Monday through Friday. Reservations may be made by calling 715-735-9686 the day before the meal. Beverages are served with each meal. Suggested donation is $4.50.
Meals are served at the Peshtigo Center Monday, Wednesday and Friday. Reservations may be made by calling 715-582-9920.
Meals are served at the Crivitz-Pound meal site (Crivitz Senior Center) Tuesday through Friday. Reservations may be made at 715-854-7453 or 800-990-4242.
Residents of Wausaukee can be put on a home delivery list and to be put on the list, people may call 715-854-7452. For Niagara Senior Center, meals are served Monday through Thursday. Reservations for Niagara may be made by calling 715-251-1603.
The Goodman meal site, held at Goodman Town Hall, is open Monday, Wednesday and Thursday. Reservations may be made at 715-336-2343.
Monday: Ham and scalloped potatoes, green bean casserole, dinner roll and cake.
Tuesday: Beefy tomato casserole, carrots and peas, biscuit and chocolate chip cookie.
Wednesday: Barbecue baked chicken, calico beans, mexi-corn, Mandarin oranges and vanilla pudding.
Thursday: Beef chili, corn bread, apple, crackers and ice cream.
Friday: Pork roast, mashed potatoes with gravy, broccoli and spice cake.
Participants in the meals at the Menominee Senior Center should call in reservations the previous day to 906-863-2158. For Stephenson call 906-753-6986. All meals served with bread, margarine and milk. Suggested donation is $3. Menus subject to change without notice. Substitutions are made for diabetics.
Monday-Friday: Not available at press time.