How is scabies spread?
Scabies or scabies is a skin infestation caused by the mite Sarcoptes scabiei. It is transmitted mainly through direct, close and relatively prolonged skin-to-skin contact with an infested person. Casual contact, such as a handshake, is usually not enough. It can also be transmitted, less frequently, by sharing recently used clothing, towels, or bedding by an affected person. The risk increases when several people live closely together for long periods. Crusted scabies is an exception, because it contains a huge number of mites and is much more contagious.
Are there reasons to relate this outbreak to the arrival of immigrants or is there no direct relationship?
With the data currently available, a direct causal relationship cannot be scientifically established. Scabies is not linked to a nationality or a specific geographical origin. What facilitates its transmission are certain epidemiological circumstances: prolonged physical contact, close coexistence, overcrowding or difficulty in identifying and treating the patient's contacts simultaneously. These circumstances may appear in shelters, residences, hospitals, barracks or any other community environment. Therefore, attributing the outbreak to a specific group without an epidemiological investigation that demonstrates the chain of transmission would be speculative.
What are the symptoms and how many weeks does it take to be noticed?
The characteristic symptom is intense itching, especially at night, accompanied by small papular lesions and, sometimes, the characteristic grooves of the mite. The most common areas are the spaces between the fingers, wrists, armpits, waist, genital region and buttocks. In a first infestation, symptoms can take approximately 4-8 weeks to appear, although during this period the person can already transmit the disease. If someone has had scabies previously, the immune response is faster and symptoms can begin in as little as 1-4 days.
What is the treatment?
Scabies is a curable disease. One of the first-choice treatments is topical 5% permethrin, applied appropriately to the body surface and generally repeated after 7 days. Another very effective alternative is oral ivermectin, the use of which depends on the characteristics of the patient and the epidemiological situation. Just as important as treating the patient is treating close contacts simultaneously, even if they are still asymptomatic, to avoid reinfestations. In addition, recently used clothing, sheets and towels should be washed at high temperatures. Itching may persist several weeks after the mite has been correctly eliminated and does not necessarily mean therapeutic failure.
Could overcrowding or poor housing conditions for the military have been the cause?
There has been different information about the accommodation conditions of different groups of people in Ceuta, but to affirm that these conditions were the origin of this outbreak it would be necessary to have an epidemiological investigation. Overcrowding and close living arrangements are factors that favor the transmission of scabies, but we must always distinguish between a risk factor and the proven cause of an outbreak.
