Investigation of Scabies Outbreak in Homeless shelter, Pak Kret District, Nonthaburi Province, Thailand, November 20–22, 2024
DOI:
https://doi.org/10.59096/wesr.v56i7.5695Keywords:
scabies, psychiatric, homeless shelter, NonthaburiAbstract
Background: A joint investigation team (JIT) of the Department of Disease Control was notified by the Office of Disease Prevention and Control 4, Saraburi, on November 19, 2024 of a suspected scabies cluster at a homeless shelter in Pak Kret District, Nonthaburi. The JIT conducted an investigation from November 20 to 22, 2024, to confirm the diagnosis, describe epidemiological characteristics, identify risk factors, and provide recommendations for appropriate prevention and control measures.
Methods: We reviewed the scabies outbreak situation in Nonthaburi and screened patients who had itching symptoms, along with any of the following symptoms; rash, red bumps, clear blisters, pustules, raised spots, and pus-filled dermatitis during June 1 to November 20, 2024. To confirm diagnosis, skin scraping from affected area was randomly collected and sent for mites or eggs by microscopic examination. A retrospective cohort study was performed to identify risk factors of developing scabies. Additionally, an environmental study was conducted. Control measures were implemented.
Results: Of 545 residents, 106 cases were identified (19.4%). Mites and eggs were detected in 2 cases from 19 cases examined. No one showed severe symptoms. The most common symptom was itching (94.3%), with lesions on finger web and hand (34%). Most of the cases had psychiatry disease (67.9%). Sleeping close by a suspected case was a significant risk factor (Adjusted odds ratio = 2.74, 95% CI: 1.75 – 4.27). We provided treatment and prophylaxis for contacts. Clothes and personal items were disinfected by sealing in bags and drying in the sun for three days before washing. After monitoring for three months, no new cases were detected.
Conclusions and Discussions: The scabies outbreak was confirmed by detecting mites and eggs from patients. Most of the cases were psychiatric patients, contributing to poor personal hygiene, unable to report symptoms and delayed diagnosis and treatment. The investigation team recommended training delegates to monitor symptoms and report to staff. Isolation rooms should be designed in each residential building to separate suspected cases and prevent disease transmission.
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