Two suspected cases of scabies in a Grand Forks group home last week led to a flurry of concerned phone calls to local health officials and health care providers.
Both cases were treated before scabies could be confirmed, officials said. No additional reports have come in, and the initial public concern appears to have subsided.
Scabies is a fairly common skin disease caused by microscopic mites, which burrow into the skin to lay eggs. That produces pimple-like irritations or linear burrows. The most prominent symptom is intense itching, especially at night.
The disease is spread by direct person-to-person contact. Transmission from inanimate objects, such as chairs, combs or countertops, is rare, except for bedding or clothing worn next to the skin of an infected person.
A suspected case is confirmed through skin scraping and microscopic analysis. Treatment usually consists of application of a medicated cream prescribed by a health care provider.
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Part of the concern raised last week was due to where the suspected cases were found, in a group home, said Theresa Knox, a public health nurse. In such a setting, "it can run rampant if not taken care of," she said.
Health officials received a number of calls from people wanting to know about risks of infestation and whether they should be treated if they may have been in close proximity to a suspected case.
Some health care providers also consulted public health authorities, "asking 'Do I need to treat this person?'" Knox said.
The public health office received no calls about scabies today, she said, suggesting that "either the questions have been answered or there no longer is concern."
Equal opportunity pests, like lice
Scabies, like head lice, is "not ever gone from a community," Knox said. But it is "more a nuisance than a public health hazard. The concern increases when you have close living quarters like a group home or a day-care center."
The local health department has included a scabies fact sheet on its "hot topics" page: http://www.grandforksgov.com/gfgov/Health.nsf/Pages/Scabies .
Kirby Kruger, director of the state Health Department's division of disease control, said the state receives reports of scabies every year, but usually no more than four or five.
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"It's not uncommon," he said. "What's reportable in North Dakota is when infestations occur in institutions, where transmission may be facilitated by crowding. It can happen anywhere, and there's probably a lot out there that goes unreported."
The major symptom is itching, he said. "It needs to be treated once it's diagnosed, but it can be treated fairly easily."
The tiny mite that causes scabies "is an equal-opportunity pest," Kruger said. "All it means is a person bumped into somebody who had them."
Infestations can occur any time of the year. Cases are more common in adults, he said, but may also occur in children.
One case of scabies was confirmed in a Valley City, N.D., care center in October 2010. The year before, Barnes County health officials responded to several cases in Valley City but declined to call it an outbreak.
In 1996, an outbreak was reported at several group homes in Bismarck and Mandan, with state health officials initially confirming 12 cases and suspecting several more.
The cases were confined to people who lived in, worked with or associated with residents of group homes. Health professionals treated all residents and staff members at the homes, including those with no symptoms, with a prescription cream that kills the mites.
"It took a long time to coordinate all that," Kruger said. "We had to get caretakers and different institutions on board. That was challenging. If treatments of individuals get staggered too far apart, you have a tendency for re-infestation."
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More information on scabies is available from the North Dakota Health Department or the U.S. Centers for Disease Control and Prevention .
Reach Haga at (701) 780-1102; (800) 477-6572, ext. 102; or send email to chaga@gfherald.com .
