SCABIES

New Zealand Listener, Volume 7, Issue 164, 14 August 1942, Page 13

SCABIES

(Written for "The Listener"

by DR.

H. B.

TURBOTT

"Director of the

Division ot School Hygiene, Health Department)

CABIES is on the increase. In 1939, in many cities in Britain, scabies affected nearly 1 per cent. of the population. In 1941 this incidence has risen to between 2 and 4 per cent., and it was just as common among civilians as among army personnel. In New Zealand scabies has at times been rampant in Maori communities. It requires constant vigilance and work on the part of both native school teachers and district nurses to keep the disease down to minimum. proportions. Now, however, the trouble is appearing quite frequently in the European population. It is present in the Armed Forces and seems to be increasing among civilians. Scabies, or the "Itch," is a skin disease caused by a small spider-like insect, just visible to the naked eye, about the size of the. eye-hole of a fine sewing needle. The female digs slanting tunnels in the layers of the skin, depositing eggs as she advances. The irritation causes fluid to be exuded in the skin, intensely itchy vesicles being formed-little red lumps with clear fluid blisters at the top. If these are scratched they often become infected, common sores develop and complicate the scabies. These vesicles make the scabies rash, commonly found at the wrists or between the fingers, at the armpit borders, in the groin, or between the buttocks, down the thighs, or over the abdomen. The itching becomes worse when the clothes are removed at night and can be very troublesome. « How It Is Spread Personal contact is the usual way scabies is spread, and it has to be close contact. In an experiment over a whole year, infected and uninfected individuals lived in one house, ate at the same table, used the same bathroom and lava-. tory, living a normal social life but avoiding close personal contact. Not a single case of scabies appeared in the control "uninfected" people. When volunteers slept in the same bed with a scubies patient, even though pyjamas were worn, in three out of four times the volunteer became infected. Sleeping conditions of greater intimacy facilitate the passage of the insect from one person to another. Bedding and clothing used to be regarded as the chief method of spread of the disease. Whether blankets were common means of spread was tested by allowing volunteers on 272 occasions to sleep nake for several nights in blankets previously used by scabies patients; only four times was the infection conveyed. In 38 experiments, the volunteers used underclothing immediately after it was removed from the scabies patient, and wore it day and night for seven days; in two cases only did the volunteers become infected. The risk of spread from bedding and clothing is small; thc risk from personal contact with a sufferer is great. Only Method of Control The only way scabies can be controlled is by recognising the disease

early, and getting every case quickly treated and healed. Whatever the drug used, its application should be preceded by a hot bath, during which the body is soaped and scrubbed in order to lay open the burrows, thus rendering the insects and eggs more accessible. Sulphur has been thé curative drug used in the past. It now has three chief rivals: benzyl benzoate, rotenone (from derris root), and organic sulphur compounds. We have used the Danish ointment successfully over the last-decade for Maori work, and this can be made up by any chemist, its preparation being given in pharmacopeeias. The patient is given a hot bath and after drying is rubbed all over with the ointment. After waiting

15 minutes he goes to bed. The next night he gets another bath, fresh underclothes or nightclothes, and is usually cured. The ointment may have to be repeated a second, and very rarely a third time, in bad cases. Although spread of infection through clothing and bed clothes is not frequent, it will be advisable to boil all boilable underclothes, sheets, etc., and to soak blankets in disinfectant solution, then wash and hang in the sun to dry. Remember that the real risk of infection will come from_ leaving any member of an_ infected household untreated-a singie pin-point of scabies should mean a thorough treat-ment.-(Next week: "We Gave Them Beans." By Dr. Muriel Bell.)