[Causes of spread and return of scabies in health care institutes; literature analysis of 44 epidemics].

OBJECTIVE

To determine the risk factors that contribute to the transmission and return of scabies in health care institutions.

DESIGN

Literature analysis.

SETTING

Public Health Care Service Midden-Kennemerland. Heemskerk, the Netherlands.

METHODS

Search of Medline over the years 1976-1996 yielded 34 reports of 44 outbreaks. The contents were qualitatively examined on factors possibly contributing to the transmission and return of scabies in health care institutions.

RESULTS

Six such factors that contribute to the transmission and return of scabies in health care institutions were found: (a) among residents in health care institutions a considerable number are, once infested, at risk of developing crusted scabies, (b) many people are exposed through close contact, (c) the generally long diagnostic delay, (d) insufficient survey of the epidemiological problem, (e) treatment failures and (f) incomplete post-intervention monitoring.