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Scabies Cases Surge Across Europe: Understanding the Outbreak and prevention
Table of Contents
- Scabies Cases Surge Across Europe: Understanding the Outbreak and prevention
- What is Scabies? Understanding the Symptoms
- Factors Contributing to the Scabies Surge
- Who is Most Vulnerable to Scabies?
- Combating scabies: Dermatologists’ Recommendations
- Scabies Incidence and Migrant Populations
- Diphtheria Outbreaks Among Migrant Populations
- Scabies Treatment Options
- Scabies Cases: A Summary
A critically important increase in scabies cases is raising concerns across Europe, with some regions in Italy reporting a staggering 750% rise between 2020 and 2023. This resurgence of the skin disease, caused by the *Sarcoptes scabiei* mite, is prompting health officials to urge vigilance and proactive measures to combat its spread. The Italian Society of Dermatology and Sexually Transmitted Diseases (Sidemast) has issued an alert, emphasizing the importance of early detection and intervention to control the outbreak, particularly as their Sidemast Special Edition 2025 Congress approaches, held in Rome from June 18-21.
What is Scabies? Understanding the Symptoms
Scabies, often associated with regions that have developing economies, is a contagious skin infestation caused by a microscopic mite that burrows into the skin to lay its eggs. This burrowing triggers intense itching, especially at night, along with the appearance of small, pimple-like papules, particularly on the hands, feet, and genital area. Outbreaks are increasingly affecting schools, nursing homes, hospitals, and large families.
Did You Know? Scabies can be transmitted through prolonged skin-to-skin contact, sharing clothing or bedding, or even from infested surfaces.
While extensive nationwide data is still lacking, studies from the emilia Romagna and Lazio regions in Italy highlight the growing scale of the problem. A study published in *Sexually Transmitted Infections* revealed a dramatic increase in scabies cases in Bologna between 2020 and 2023. Another study in *Infectious Diseases of Poverty* identified a new wave of post-COVID cases in the Lazio region, describing it as an “emerging public health threat.” The 750% increase in outbreaks within long-term care facilities between 2020 and 2023 underscores the severity of the situation.
Factors Contributing to the Scabies Surge
Several factors have contributed to the recent surge in scabies cases. Lockdowns and isolation during the COVID-19 pandemic led to prolonged periods spent in closed and overcrowded environments, ideal conditions for mite transmission.The resurgence of mass tourism and travel following the pandemic facilitated the spread of scabies in shared spaces like hotels and hostels.increased patient turnover in hospitals and potential drug resistance have also played a role.
Dermatologist Michela Magnano explains, “During the pandemic, many people lived for extended periods in closed and overcrowded environments, ideal conditions for parasite transmission. Frequent patient exchange in healthcare facilities also favored contagion. Furthermore, a possible resistance to drugs, particularly permethrin, a topical treatment commonly used in our country, seems to play an important role.”
Pro Tip: Early diagnosis and treatment are crucial to prevent the spread of scabies. If you suspect you have scabies, consult a healthcare professional immediately.
Reports of permethrin resistance first emerged in Germany in 2017-2018, and cases are now documented in Italy, Spain, Turkey, and the United kingdom. According to researchers, mutations in the mite may enable it to neutralize the drug’s active ingredient. Magnano adds, “Failures with permethrin seem attributable to actual resistance to therapy, given that second-line topical treatments (such as benzyl benzoate) have been effective, thus excluding factors related to incorrect cream application. Though, whether we are witnessing actual resistance to this active ingredient, or at least a ‘tolerance’ to the treatment, is still debated.”
Who is Most Vulnerable to Scabies?
Giuseppe Argenziano, president of Sidemast, notes that “the most vulnerable categories are certainly children and teenagers between 5 and 18 years, also due to attendance of community environments such as schools and gyms. Added to these are the elderly, especially those hospitalized in nursing homes, and people with social or health vulnerabilities, including the homeless, migrants, and those living in overcrowded or precarious hygienic conditions” [[1]].
The primary symptom of scabies is intense and persistent itching, frequently enough worse at night.Argenziano advises, “If associated with small papules or skin lesions between the fingers, wrists, navel, or genitalia, it may be scabies.”
Combating scabies: Dermatologists’ Recommendations
Sidemast dermatologists offer four key recommendations:
- Promptly consult a doctor or dermatologist if persistent itching affects multiple family members or does not respond to standard treatments.
- Avoid self-treating, as incorrect diagnoses can prolong the infestation and facilitate contagion.
- If diagnosed with scabies, treat all close contacts, even if they are asymptomatic.
- Wash clothing and sheets in hot water.
Scabies Incidence and Migrant Populations
Scabies outbreaks have been observed in asylum centers across Western Europe, where overcrowding contributes to transmission through direct, prolonged skin contact [[1]]. Mass migration can also increase scabies incidence, highlighting the importance of addressing hygiene and living conditions in vulnerable populations [[1]].
Diphtheria Outbreaks Among Migrant Populations
In addition to scabies, Europe has experienced a significant outbreak of Corynebacterium diphtheriae, primarily affecting displaced populations [[2]]. This outbreak represents the largest rise in diphtheria cases seen in western Europe in the past 70 years, underscoring the public health challenges associated with migrant populations [[2]].
Scabies Treatment Options
While permethrin cream has been a standard treatment for scabies, increasing resistance is a concern. Alternative treatment options include:
- Ivermectin (oral medication)
- Benzyl benzoate (topical cream)
- Malathion lotion
- Sulfur ointment
A healthcare professional can determine the most appropriate treatment based on individual circumstances and potential drug resistance.
Scabies Cases: A Summary
| Region | Increase in Cases (2020-2023) | Key Factors |
|---|---|---|
