There is great concern caused by the news that a student at a special school in Chania developed Norwegian scabies.
The special school in Chania was temporarily closed after the Norwegian scabies outbreak.
Norwegian or scaly scabies, as it is now called, is a severe form of the parasitic dermatosis. It occurs mainly in patients with weakened immunity. Its main feature is the huge number of mites of the genus Sarcoptes scabiei var hominis and their eggs found in patients.
It is estimated that sufferers have up to 4,000 mites per gram of skin. They often carry more than 1 million mites in total. If you consider that the vast majority of patients with classic scabies are usually infected with 10 to 20 mites, you immediately understand how much more serious Norwegian scabies is.
Scabies is generally transmitted from patient to patient and through contaminated objects. Norwegian scabies is often manifested by patients whose immune system does not effectively fight off the causative mites when they come into contact with them. According to the US Centers for Disease Control and Prevention (CDC), the following are at increased risk of developing it:
The elderly
Patients with a weakened immune system (immunosuppression) due to, for example, HIV/AIDS infection, long-term use of immunosuppressive drugs, corticosteroids (cortisone), etc.
Those suffering from health problems that prevent them from itching (itching) and/or scratching their skin. This category includes, e.g., patients with spinal cord injuries, paralysis, loss of sensation in the skin, severe mental or behavioral disorders, etc.
The symptoms
Patients with Norwegian scabies may not have the usual symptoms and skin lesions caused by classic scabies. They first develop red marks on the skin that develop into thick, hard “plaques” (hyperkeratotic plaques). These may be grayish in color and crumble easily when touched.
Plaques contain thousands of mites and eggs. They may have “cracks” and be accompanied by erythema (redness of the skin). These plaques usually manifest themselves:
Between the fingers
Under the nails
Scattered on the soles and palms
Other common growth sites are the elbows and knees. Mites can also gather in the nail bed (the pink, epithelial tissue on which the nails rest), causing the nail plate to detach.
Pruritus (itching) in Norwegian scabies may be minimal or absent. This is possibly related to the immunosuppression of the sufferers.
How is it transmitted?
Due to the huge number of mites that accumulate on the skin, Norwegian scabies is highly contagious. Even short, direct contact with a patient or with contaminated objects is enough to be transmitted. In fact, this form of scabies is most often responsible for skin disease outbreaks.
The mites that cause it can survive up to 72 hours away from their human host. Because the hyperkeratotic plates of the patient crumble and fall off, the mites easily infect surfaces, furniture, clothes, bedding around him. Even mattresses can become infected.
To prevent the risk of transmission, it is necessary to thoroughly wash all surfaces and objects that have been exposed to the patient. If an item cannot be washed, it should be placed in sealed plastic for 3 to 7 days. Sun exposure also effectively kills mites.
The use of disinfectants is not necessary. Nor is it necessary to throw away the mattresses.
How is it treated?
Treatment for Norwegian scabies must be started promptly and aggressively to prevent an outbreak. This is extremely important for institutions and other mass living spaces.
Patients are given systemic (oral) medication and topical treatment (ointments). The duration of treatment depends on the severity of the skin disease.
Their family members and those who come into close contact with them should also be checked preventively. They must also take preventive medication.
Administered medications treat Norwegian scabies. However, patients are at increased risk of secondary bacterial infections, as well as relapse, due to their weakened immune system. Especially elderly patients have an increased risk of serious complications, such as sepsis.
Source: Iatropedia.gr
#hypercontagious #symptoms
**Interview with Dr. Eleni Stavrou, Dermatologist and Infectious Disease Specialist**
**Editor:** Thank you for joining us today, Dr. Stavrou. We’re discussing the recent outbreak of Norwegian scabies at a special school in Chania. What can you tell us about this severe form of scabies?
**Dr. Stavrou:** Thank you for having me. Norwegian scabies, also known as scaly scabies, is indeed a serious form of this skin condition. It occurs primarily in individuals with weakened immune systems. What makes it particularly concerning is the staggering number of mites involved; patients can host up to 4,000 mites per gram of skin, and often have over a million in total.
**Editor:** That sounds alarming. How is Norwegian scabies different from classic scabies?
**Dr. Stavrou:** The main difference lies in the severity and the number of mites. While classic scabies typically involves only 10 to 20 mites, Norwegian scabies can lead to extensive skin lesions and an overwhelming mite population. Symptoms can also be atypical; for instance, patients may not experience the same intense itching.
**Editor:** Who is most at risk for developing Norwegian scabies?
**Dr. Stavrou:** The highest-risk groups include the elderly, individuals with compromised immune systems—such as those with HIV/AIDS or those on immunosuppressive medications—and people with health conditions that prevent effective itching or scratching, like paralysis or severe mental disorders.
**Editor:** What should we know about the symptoms and transmission?
**Dr. Stavrou:** Symptoms include thick, hard plaques on the skin that can appear grayish and crumble easily upon touch. These plaques tend to form in specific areas such as between fingers, under nails, and on palms or soles. Transmission occurs through direct contact with an infected person or contaminated objects, which is why school environments can be particularly vulnerable.
**Editor:** Given the school’s temporary closure, what steps should other schools take to prevent an outbreak?
**Dr. Stavrou:** It’s crucial for schools to maintain rigorous hygiene practices, including regular cleaning of shared surfaces and items. Health education on recognizing symptoms and the importance of seeking prompt medical treatment can also help control potential outbreaks.
**Editor:** Thank you for shedding light on this serious issue, Dr. Stavrou. It’s essential that the community remains aware and informed.
**Dr. Stavrou:** Thank you for having me and for highlighting this important topic. Awareness is key to prevention and care.