Table 1.
Frequency with which key codes appeared in Health Protection Team guidelines, n = x/20 (%)
| Background information | |
| Classical scabies | |
| Clinical features | 18 (90%) |
| Incubation period | 18 (90%) |
| <8 weeks | 6 (30%) |
| <6 weeks | 8 (40%) |
| <4 weeks | 4 (20%) |
| Transmission by direct prolonged skin–skin contact | 17 (85%) |
| Complications such as secondary bacterial infection | 9 (45%) |
| Possible unusual clinical presentations in the elderly | 14 (70%) |
| Crusted scabies | |
| Clinical features | 12 (60%) |
| Highly contagious | 15 (75%) |
| List of at risk populations (e.g. the elderly, immunosuppressed) | 17 (85%) |
| Diagnosis | |
| GP to make clinical diagnosis | 20 (100%) |
| Dermatologist also able to make clinical diagnosis | 17 (85%) |
| Dermatologist diagnosis preferred | 4 (20%) |
| Other (e.g. dermatologist specialist nurse, GP with special interest in dermatology) | 9 (45%) |
| Microscopic analysis of skin scrapings can confirm uncertain diagnosis | 12 (60%) |
| Management of an individual case | |
| Classical scabies | |
| First line: permethrin 5% dermal cream. Second line: malathion 0·5% dermal cream | 10 (50%) |
| First line: permethrin 5% or malathion 0·5% | 7 (35%) |
| Permethrin 5% only | 2 (10%) |
| Oral ivermectin can be used for the treatment resistant/non-cooperative/immunosuppressed patients | 9 (45%) |
| Crusted scabies | |
| Requires specialist/dermatologist management | 9 (45%) |
| Several applications of topical scabicides required on 2–4 consecutive days | 11 (55%) |
| Oral ivermectin may be used for treatment resistant cases | 12 (60%) |
| Outbreak prevention (e.g. being vigilant to presence of rash in new residents) | 9 (45%) |
| Outbreak management | |
| Prophylactic treatment of staff and residents | |
| Simultaneous mass treatment of all staff and residents | 8 (40%) |
| Simultaneous mass treatment of all high risk staff and residents (e.g. those that directly handle patients) | 8 (40%) |
| Only staff and residents that have been in direct contact with symptomatic cases | 2 (10%) |
| Other | 2 (10%) |
| Further contact tracing for prophylactic treatment | |
| All those who have had skin–skin contact with a case | 10 (50%) |
| Household members/family of staff cases | 13 (65%) |
| Visitors of resident cases | 5 (25%) |
| Sexual and intimate contacts of cases | 10 (50%) |
| Visiting staff (e.g. hairdressers, physiotherapists, agency staff) | 2 (10%) |
| Timing of treatments | |
| Everyone should be treated twice, seven days apart | 3 (15%) |
| Cases need to be treated twice; asymptomatic contacts require one treatment (day 1) | 6 (30%) |
| Cases need to be treated twice; asymptomatic contacts require one treatment (day 7) | 3 (15%) |
| Cases need to be treated twice; asymptomatic contacts require treatment (treatment day not specified) | 8 (40%) |