Abstract

FAJARDO-VELAZQUEZ, Ramón; URDEZ-HERNANDEZ, Elena  and  YSITA-MORALES, Antonio. Nosocomial outbreak of scabies from a Norwegian scabies case. Salud pública Méx [online]. 2004, vol.46, n.3, pp.251-254. ISSN 0036-3634.

OBJECTIVE: To describe a nosocomial outbreak of scabies occurred in August 1999, resulting from exposure to an undiagnosed Norwegian scabies case, in Mexico City. MATERIAL AND METHODS: After reviewing the index case, we isolated the patient and identified secondary scabies cases among employees working in the affected ward, their relatives, and inpatients. Only individuals complaining from skin lesions and pruritus were included as infested cases. Control measures as contact isolation, proper handling of contaminated clothes, and topical treatment were implemented. RESULTS: A patient with AIDS (index case) with a severe water and electrolyte imbalance was admitted to the Hospital de Infectología (Infectious Diseases Hospital) of the Centro Médico Nacional La Raza (La Raza National Medical Center) in Mexico City from July 19 to August 20, 1999. Twenty-eight days after the index case admission, scabies cases occurred among health workers. Norwegian scabies was suspected and confirmed by microscopic evidence of the mites on a specimen of scabs from the index case. We identified 48 secondary cases with clinical scabies: 71% health workers, mainly nurses (79%); 23% health workers' relatives; and 6% inpatients. The mean incubation period was 15 days (range 12 to 27). Skin rashes commonly involved the upper extremities (60%) but not the hands. CONCLUSIONS: This paper highlights the difficulties in diagnosing Norwegian scabies in an immunosuppressed host, as well as the importance of ensuring that health workers follow standard precautions at times

Keywords : nosocomial outbreak; scabies; AIDS and Norwegian scabies; Mexico.

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