Malathion

• Outbreaks happen regularly – with an estimated 450 million cases occurring globally each year.
• But since the start of winter, outbreaks in the UK have been higher than normal.
• While there a probably a few factors that can explain this spike, treatment shortages appear to be at the heart of it.
• The skin rash is also more severe, with a crust over the surface of the infected area.
• Itching may take up to a month to completely subside after treatment.

Outbreak causes

• This means mites spread more easily in places where people come into close contact with each other for extended periods of time – such as schools, universities and prisons.
• Residential care and nursing homes are particularly high-risk settings for scabies outbreaks, with vulnerable populations and staff members alike at risk of infection.

• Another factor in the outbreak could be stigma against having scabies, with many people claiming the disease is caused by being unclean or a lack of bathing.
• In reality, there’s no good evidence about a lack of washing being a risk factor.
• While some evidence suggests that scabies incidence is higher in the winter, in reality outbreaks can happen at any time of the year.
• Since September 2023, there’s been a shortage of both permethrin and malathion in the UK due to supply issues.

Preventing infection

• If anyone has symptoms that might be scabies or another skin infection, such as itching and a rash or skin wounds, these should be reported to a doctor or healthcare provider as early as possible.
• This is especially important if they have potentially been in close contact with a known case.
• Scabies outbreaks can be brought under control – but diagnosis and treatment as early as possible is required for that to happen.

Michael Head has previously received funding from the Bill & Melinda Gates Foundation and the UK Department for International Development, and currently receives funding from Research England and the UK Medical Research Foundation.