From the Guidelines
Patients with scabies should remain in isolation until they have completed treatment and taken measures to decontaminate their environment, which can be achieved by washing and drying bedding and clothing on hot cycles or removing them from body contact for at least 72 hours, as recommended by the 2015 guidelines 1. When managing scabies, it's crucial to consider not just the treatment of the individual but also the decontamination of their environment to prevent reinfection and spread to others.
- Key considerations include:
- Decontaminating bedding and clothing through machine washing and drying using hot cycles or dry cleaning
- Removing items that cannot be washed from body contact for at least 72 hours
- Advising patients to keep their fingernails closely trimmed to reduce the risk of skin injury from scratching The isolation period should be guided by the need to ensure that the patient's environment is free from scabies mites, which can survive off a human host for up to 72 hours, as implied by the decontamination recommendations 1.
- Treatment options, such as topical permethrin 5% cream or oral ivermectin, are effective in killing the mites but do not immediately eliminate the risk of transmission if the environment is not properly decontaminated. Given the information from the 2015 guidelines 1, the focus should be on ensuring the patient's environment is properly decontaminated, which typically requires at least 72 hours, to prevent the spread of scabies and to protect against reinfection.
From the Research
Isolation Period for Scabies Patients
The isolation period for patients with scabies is not explicitly stated in the provided studies. However, some studies provide guidance on when patients can resume normal activities:
- According to 2, patients and close contacts should avoid sexual contact until completion of treatment and should strictly observe personal hygiene rules when living in crowded spaces.
- 3 recommends that affected patients should be isolated, and all contact persons should be treated.
- The infectivity of female mites when removed from patients does not exceed 48 hours at room temperature (21°C) and relative humidity of 40-80% 3.
Key Considerations
Some key considerations for determining the isolation period include:
- The type of scabies (common or crusted)
- The treatment used (topical or oral)
- The patient's immune status
- The risk of transmission to others
Treatment and Isolation
The provided studies focus on the treatment of scabies, including:
- Topical permethrin 5% cream 2, 3, 4
- Oral ivermectin 2, 5, 6, 4
- Benzyl benzoate 25% lotion 2
- Malathion 0.5% aqueous lotion 2
- Sulphur 6-33% cream, ointment or lotion 2
These treatments have varying cure rates and onset of action, but the studies do not provide a clear recommendation for the duration of isolation.