7 out of 10 children in remote Indigenous communities have had scabies at least once before their first birthday... most Australians are fortunate enough not to know what scabies is.
Scabies is a highly contagious skin disease caused by mites that burrow under the skin, reproduce, then burrow again. The mites cause itching, infections and skin sores, which left untreated can lead to chronic diseases and premature death. Eliminating scabies significantly reduces the flow on effects for down-stream conditions such as rheumatic heart disease and kidney failure.
Crusted scabies is a neglected and misunderstood disease
Crusted scabies is a far more severe form of simple scabies. It is a highly infectious and devastating condition that occurs when an individual’s immune system is not able to control scabies mite replication. Hyper-infection develops, often with up to a million or more scabies mites (compared with 5-10 in simple scabies). It is not uncommon in remote indigenous communities where many individuals are at risk of lifelong recurrences.
Patients with crusted scabies are “core transmitters” of simple scabies in communities. They have a lower life expectancy, often develop complications from secondary bacterial infections and family members often suffer recurrent scabies, skin sores and complications, including the inability to sleep.
Patients and families are often stigmatised, children may be given sedatives to sleep, are excluded from school, and employment and personal relationships are significantly affected by the disease. The disease is disfiguring and it has a significant impact on the psychosocial health and quality of life of family members.
Patients suffer their illness and shame in silence with little ongoing care. As it is highly infectious, managing it is the first step towards eliminating scabies as a public health issue in Australia. The Healthy Skin program is the first in the world to trial a chronic disease case management approach to prevent recurrences. Preliminary results have been promising.