An investigation of scabies outbreak at a prison in Phetchabun Province, Thailand, November 2019

Abstract

Background: On 15^th November 2019, Social medicine department of Phetchabun hospital received a notification from a prison in Phetchabun province (Prison A). There was a cluster of scabies among inmates. Investigation team conducted an outbreak investigation on 18–21 November 2019 to confirm diagnosis and outbreak, describe epidemiological characteristics of the outbreak, identify associated factors of being scabies and provide proper recommendations to control the outbreak.
Methods: Descriptive study was done by reviewing medical records and interviewing inmates in the prison. Suspected case was an inmate who had rash during 1st August to 21st November 2019 and was diagnosed as a scabies. Laboratory study was performed by scraping the lesion for scabies under microscopy method. We also conducted environmental survey in the prison. Cross-sectional analytic study was conducted to identify associated factors for scabies infection. The results were determined by Chi–square and multiple logistic regression.
Result: We found 54/1,587 cases (attack rate 3.4%) in the prison. The mean age (mean ± SD) was 34.6 ± 11.2 years. The outbreak started on 3rd October 2019 and hit a peak on 11th November 2019. The first case had a history of contacted a scabies patient. The associated factors were contact with scabies patients (AOR 4.5, 95%CI 1.8-11.0), sleep next to the patients (AOR 5.8, 95%CI 2.4-14.0), and work with the patients (AOR 6.3, 95%CI 3.0- 13.4).
Conclusion: This event was a scabies outbreak in a prison. The attack rate was low might be due to early detection and treatment. The probable source was an inmate who was infected before staying in the prison. The associated factors were contact with scabies patients, sleep next to the patients, and work with the patients. The physical examination before attending the prison and isolation the patients might help to prevent the further outbreaks.