Scabies

[Parisha Shrestha]

Hi everyone,

We’ve been dealing with recurring scabies cases for the past year, particularly within one section of our facility. Despite implementing comprehensive measures—including strict linen and laundry procedures, thorough deep cleaning, and even removing nearby trees—we continue to see new cases. Several residents in that area frequently develop rashes. After a month without any issues, the problem has resurfaced again.

We’re seeking advice on any additional strategies or best practices that might help us better control or fully eliminate this ongoing outbreak. Any insights from others who have managed similar situations would be greatly appreciated.

Thank you

[Carrie Spinks]

Hi Parisha,

Sounds very challenging

Due to the long incubation period (2-6weeks) the mite can present as rid, when in in fact it is not.

I notice you are in NSW/Sydney and hence provided some great resource links to base facility management: https://www.seslhd.health.nsw.gov.au/sites/default/files/documents/SESLHDPR%20363%20-%20Scabies%20-%20Management%20of_0.pdf
https://www.health.nsw.gov.au/environment/pests/parasites/Pages/scabies.aspx

First question to ask: what type of scabies has the home got? Is there pathological confirmation? Determining the type of scabies will dictate treatment.

Are there any staff with symptoms (as well as residents) – this is important to identify, isolate and treat.

Tip: Scabies is person to person contact and hence removal of trees may not alter transmission. Scabies can only live up to 2-3 days without a human host.

In my experience it’s often timing and organisation that is essential in the management of scabies – aligning everything up: 24hrs case isolation after treatment, topical treatment for residents, frequent visitors and staff (addition of oral for cases if crusted), cleaning/disinfection and laundering or bagging non-washable items 72hrs.

Consider breaking management down to actions on day 1, day 2, day 7 and day 8.

Happy to email tips directly to you – content is a bit long to post online.

This is a great topic for a 2026 Aged Care COP webinar – thanks for the tip.

Regards Carrie

[Yvonne Andrews]

Hi Parisha,

This can be very difficult to get rid of.
Some things to consider. Are they scabies or bed bugs? There is a difference.

If you are treating residents with Lyclear are you:
Putting it on at night head to toe, leaving it overnight,
treating everyone at the same time, residents, staff and visitors.
washing it off in the morning and putting on fresh sheets and clothing
removing all clothes and bedding that from that room that has been used in the last 72 hours,
vacuuming floors, beds, chairs
Bagging anything that cannot be cleaned for 72 hours
but most importantly are you doing a second treatment 7 days later. Sometimes there are eggs that hatch and have missed the treatment.
If taking the tablets, then we found the best treatment was 2-3 lots 7 days apart.

Hope this helps

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