A contagious skin condition has reached five Dartmouth-Hitchcock Medical Center patients and employees.
On Aug. 14, a patient visited the hospital’s Hematology/Oncology unit and was later diagnosed with the skin condition known as crusted or Norwegian scabies, a form of the disease that occurs in those with compromised immune systems. Scabies outbreaks are more common if a person with crusted scabies does not seek immediate treatment.
Scabies is caused by the human itch mite, a parasite transmitted by close and prolonged skin-to-skin contact. The mites that transmit scabies can survive for approximately a month in the body, but only a few days outside a human host. Symptoms include a red, itchy rash.
After the first scabies patient was diagnosed, DHMC took preventive measures to reduce the chances of it spreading. Anyone who enters a patient’s room must wear gloves and a hospital gown, DHMC spokesperson Rick Adams said. The first patient was also put into isolation.
To prevent further spread of scabies, DHMC’s infection control and prevention team identified those who it believed were at risk of exposure, including the doctors and nurses in charge of caring for the patient as well as any housekeepers, dietary staff and transportation staff who may have encountered the patient.
This resulted in a group of around 300 people, all of whom were brought in for precautionary treatment.
About 800 people attended a screening clinic over the weekeend, which was set up for anyone who thought they had potentially been exposed to the infestation. The hospital conducted skin-scraping tests to determine whether a person had the disease.
Out of the clinic’s visitors and the group that DHMC identified, four additional people were diagnosed with scabies. Adams says the hospital believes these people may have been exposed while near the in-patient Hematology/Oncology unit where the original patient was being treated.
Once a person is diagnosed with scabies, treatment must begin as soon as possible. Scabies can be treated through both oral medication and a topical cream.
Itching the rash is discouraged because this may lead to skin sores which heighten the risk of a bacterial infection, such as staph.
Symptoms sometime appear six to eight weeks after initial contraction. Adams noted that the disease is easily treatable, though the situation is more serious for patients who are immunocompromised, disabled or elderly.
Over the weekend, the hospital also set up a hotline with the New Hampshire Department of Health and Human Services for scabies-related questions.
Adams said this is a rare occurrence in the in-patient setting, and said the hospital’s priority is to keep patients and employees, as well as their families, healthy.
DHMC has implemented similar treatment and prevention plans in the past, including during a 2006 outbreak of whooping cough, or pertussis. Thirty-four staff members were diagnosed at the hospital, which conducted screenings and implemented preventative measures.
In October 2013, there was a scabies outbreak at Exeter Hospital, about 100 miles away from DHMC. Thirty-three employees were diagnosed with the condition after being exposed to an infested patient, and around 300 more were treated as a safeguard, WMUR reported at the time.
DHMC spokesperson Mike Barwell said that as a result of the recent scabies outbreak, the hospital is now “more aware of the condition and more vigilant.”
