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At a single institution in Spain, the number of scabies cases dramatically increased over a period of confinement due to the COVID-19 pandemic (64 patients) compared with the average of the same quarters for the previous 5 years (18.6 patients). Changes in the characteristics of these cases were also seen. Cases during confinement were more likely to have affected cohabitants (81.25% vs 65.59%, P < .05), create family clusters (54.68% vs 19.35%, P < .05), have a longer duration of symptoms, and have already been given topical permethrin by their primary care provider (75% vs 15.05%, P < .05). A total of 60.93% of cases during the pandemic required treatment with oral ivermectin compared with 4.3% prior to the pandemic (P < .05).
The authors hypothesize that increased transmission via direct contact or fomites increased symptom duration prior to treatment and, thus, later diagnosis of the index case, and increased rates of permethrin failure have contributed to the significantly higher numbers of scabies cases during the COVID-19 pandemic. The authors suggest considering oral ivermectin to control infestation, such as would be used to control a major institutional outbreak.
– Margaret Hammond, MD
This abstract is available on the publisher's site.
In response to the rapid spread of COVID-19 at the start of the pandemic, governments introduced severe measures of home confinement and isolation of the population in an effort to prevent their health systems from collapsing. On March 14, with more than 4000 confirmed cases,1 Spain began its nationwide lockdown which has extended for almost three months.