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Scabies: Proof of Custodial Neglect and Mismanagement

Published on May 23rd, 2018

Human scabies results when an adult female human itch mite burrows into the top layer of your skin, otherwise known as the epidermis. There the mite can hang out, poop, and lay eggs. The eggs can then produce new mites, leading to more and more mites in your skin. Each mite can live a couple months in your skin. That is the Circle of Mites.

Image result for scabies mites picture

When the infestation is ignored, thousands of mites may be reproduced.  Norwegian or crusted scabies tends to occur when your immune system is weak, allowing the mites to reproduce more. With so many mites, the skin forms crusts that are thick, gray, and crumbly.

The mites are so small that you can’t see them. A simple view from a microscope will allow caregivers to figure out if a resident has scabies.  Tthey can be passed unknowingly from person-to-person via skin-to-skin contact. Transmission only occurs via human-to-human contact.  The contact has to be prolonged and intimate.   This should not happen in a nursing home since caregivers are required 1) to wear sterile gloves before caring for a resident, and 2) wash their hands before caring for a resident.

The mite can survive on objects such as a blanket, other bedding, clothes, and furniture for about 3 to 4 days, so you could catch scabies from such items. Therefore, make sure you thoroughly wash (using the hottest temperature possible) or seal in a bag for at least a week any object that may be affected.

Symptoms can take anywhere from a few days to 4 to 6 weeks to appear. The itching tends to be worse at night and can keep you awake. The classic appearance of the rash is a line of little bumps, as described by the American Academy of Dermatology. The rash can become scaly and look a bit like eczema.

Image result for norwegian scabies crusted

Scratching can convert the rashes into sores. Sores can lead to infection. Infections can potentially lead to death, especially if you are in a weakened condition.  An elderly person’s immune system is weaker and won’t attack the mite as vigorously. If not treated, the mites will multiply indefinitely. A patient can have thousands of mites in his or her body. They form crust on the skin. The crust sheds, carrying mites and eggs with it. The outbreak spreads.  Tomorrow, we will discuss a recent nursing home case involving scabies.

 

Joe Pioletti
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