Highly contagious 'scabies-like rash' reported locally

Spencer Hospital officials have confirmed a suspected "scabies-like rash" in northwest Iowa.

"We have, at the hospital, had some suspected cases of a skin rash," Susan Zulk, the hospital's director of public relations and marketing, said Monday afternoon. "To say whether it's scabies, that isn't confirmed."

"Diagnosing scabies involves skin scrapings to locate the scabies mite," she continued. "And the rash that is a symptom typically of scabies has a series of red bumps. Where those bumps are does not mean that there's a mite. Rather, it means a mite has been there. So, diagnosis could involve scraping a lot of areas of the body. The typical recommendation from health care providers and from physicians is to treat based on the symptoms rather than doing a confirmed skin biopsy."

A patient was treated for another illness at the Spencer Hospital earlier this month. According to Zulk, it was later discovered that he had a skin rash and had exposed some staff to it.

"Last week, we had treated our staff members who had been presented with skin rashes, as well as any patients who potentially would have been exposed," Zulk said. "Last week, anyone who had presented a rash to Employee Health was sent home and given the cream for the medicated treatment. The hospital has also ordered a large supply of the medicated cream, and all hospital employees are being treated prophylactically."

"Scabies is a highly contagious skin disorder, and we are aggressively treating it here at Spencer Hospital, as well as prophylactically treating scabies or the suspected scabies. If anyone in the community suspects that they may have been exposed, they should contact their personal physician," she advised.

"I think we're doing our best to prophylactically treat all of our employees to prevent any further spread," Dee Vaage, Spencer Hospital's infection control nurse, added. "We've been in contact with the Iowa Department of Public Health and are using their recommendations to treat it as aggressively as we can to protect not only our employees, but our patients."

Iowa Lakes Community College is among the entities which began notifying its students and staff this weekend via its e-mail and voicemail alert system.

"The Saturday night announcement indicated that nursing students in the associate degree nursing program and practical nursing students were not to report on Monday for any nursing class, clinical or to any other classes that they might have. Another (alert) went out on Sunday. It directed all students to go to our Web site and to click on Emergency Information," said Jane Campbell, the northwest Iowa college's executive director of marketing.

There, they read: "Due to an outbreak in northwest Iowa of the skin condition called scabies, all Iowa Lakes nursing students are not to attend classes or clinical experiences April 27-28. Instead, nursing students are to go to eCompanion to receive more information. Nursing students are required to be treated prior to returning to class, clinical or Iowa Lakes campus housing. All other students are to attend their regular classes. Those who are concerned that they may have been exposed to scabies should contact their local health care provider for appropriate diagnosis and treatment."

"(Some of) our individuals have been diagnosed with symptoms characteristic of scabies," Campbell reported. "I don't want to give a specific number, but I will tell you that less than 3 percent. We have over 220 students in those two programs -- because we have the evening and weekend classes and regular daytime classes -- and this applies to everybody."

"This action we've taken is based on the fact that we want to limit further exposure and address this now -- and not be dealing with this in the future," Campbell concluded.

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Q. What is scabies?

Scabies is a skin disease caused by an almost invisible bug called a mite. Scabies mites burrow under the skin, producing pimple-like bumps.

Q. What are the symptoms of scabies?

The major symptom of scabies is intense itching, particularly at night. In adults, the areas of the skin most affected by scabies include the webs and sides of the fingers, wrists, elbows, armpits, waist, genitals, breasts and lower buttocks. In children, the feet and toes are also commonly affected.

Q. How soon do symptoms appear?

Symptoms will appear in 2-6 weeks in people who have never had scabies. People who have had scabies before may show symptoms within 1-4 days.

Q. How is scabies spread?

Scabies mites spread by direct skin-to-skin contact. Transfer of scabies from undergarments or bedclothes can happen only if these are reused immediately after being used by an infected person. Scabies can also be spread during sexual contact.

Q. Who gets scabies?

Anyone can get scabies. Scabies most commonly occurs in nursing homes, institutions and child care centers.

Q. How long is a person infectious?

A person can spread scabies until mites and eggs are destroyed by effective treatment.

Q. What is the treatment for this illness?

Skin products are available from a doctor for the treatment of scabies. The products are generally applied to the whole body except the face and neck. Itching may continue during and for several days after treatment. Clothes and bedding should be washed in hot water. A few persons may require a second treatment 7-10 days later. Skin care is important to reduce itching due to skin dryness, which may be caused by the treatment.

Q. Do infected people need to be excluded from school, work or child care?

People may return to school, work or a child care center after receiving an initial treatment.

From the Iowa Department of Public Health