Scabies—Child Care and Schools

What are the signs or symptoms?

• Rash, severe itching (increased at night).

• Itchy red bumps or blisters found on skinfolds between the fingers, toes, wrists, elbows, armpits, waistline, thighs, genital areas, abdomen, and lower buttocks.

• Children younger than 2 years are likely to be infested on the head, neck, palms, and soles of feet or in a diffuse distribution over the body.

What are the incubation and contagious periods?

• Incubation period

  • Four to 6 weeks for those who have never been infected

  • One to 4 days for those who have been previously infected (Repeated exposures tend to be milder but produce symptoms earlier after exposure.)

• Contagious period: Until the insect infestation is treated

How is it spread?

Prolonged and close person-to-person contact

How do you control it?

• Treatment of the affected child and family by a health professional, usually with a cream containing 5% permethrin.

• Launder bedding and clothing (hot water and hot drying cycle) worn next to skin during the 3 days before start of treatment.

• Items that cannot be laundered should be placed in plastic bags for at least 4 days. Scabies mites cannot survive away from humans for more than 4 days.

What are the roles of the teacher/caregiver and the family?

• Report the infection to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.

• Contact the child's health professional if itching continues for several weeks after treatment. This could represent a reinfestation.

• Family members and very close contacts should be treated at the same time as the child, even if no signs or symptoms are present.

Exclude from group setting?

At the end of the day, the child should consult a health professional and, if scabies is confirmed, the child should start treatment before returning. If treatment is started before the next day, no exclusion is necessary.

Readmit to group setting?

Yes, when treatment has been completed (usually overnight)

Comments

• Scabies affects people from all socioeconomic levels without regard to sex, age, or personal hygiene.

• Itching is related to an allergic reaction to the mites and often goes on for weeks after effective treatment.