This study was conducted to understand the status of scabies infection and its epidemic characteristics in the Korean hospitals. 43 hospitals (86.0%) received the reports of scabies infection with suspicious or definite diagnosis to infection control department, implicating continuous increases 14.6% (7/48), 20.8% (10/48), 35.7% (17/48), 44.1% (21/48), and 56.7% (27/48) in 2010 to 2013 and 35.7% (17/48) in 2014 up to April. 92.0% of the hospitals had the rules and guideline of scabies infection control, which seemed to be prepared by the recent certifications of medical institutions and establishment of rules in infection control departments. However, less than half of the hospitals 44.0% (22/50) prepared the screening system related to scabies during the admission processes of the patients, 56.7% of the patients had the typical symptoms related to scabies when they admitted with 47.0% of pruritus, requiring the system to prevent from the scabies epidemic beforehand

1. http://www.iaeme.com/IJMET/index.asp 29 editor@iaeme.com
International Journal of Mechanical Engineering and Technology (IJMET)
Volume 10, Issue 07, July 2019, pp. 29-33. Article ID: IJMET_10_07_004
Available online at http://www.iaeme.com/ijmet/issues.asp?JType=IJMET&VType=10&IType=7
ISSN Print: 0976-6340 and ISSN Online: 0976-6359
© IAEME Publication
A STUDY ON THE PATIENTS WITH SCABIES
IN KOREA
Min -Hyang Park
Department of Nursing Science Chungbuk Health & Science University, Cheongju, Repulblic
of Korea
ABSTRACT
This study was conducted to understand the status of scabies infection and its
epidemic characteristics in the Korean hospitals. 43 hospitals (86.0%) received the
reports of scabies infection with suspicious or definite diagnosis to infection control
department, implicating continuous increases 14.6% (7/48), 20.8% (10/48), 35.7%
(17/48), 44.1% (21/48), and 56.7% (27/48) in 2010 to 2013 and 35.7% (17/48) in 2014
up to April.
92.0% of the hospitals had the rules and guideline of scabies infection control,
which seemed to be prepared by the recent certifications of medical institutions and
establishment of rules in infection control departments. However, less than half of the
hospitals 44.0% (22/50) prepared the screening system related to scabies during the
admission processes of the patients, 56.7% of the patients had the typical symptoms
related to scabies when they admitted with 47.0% of pruritus, requiring the system to
prevent from the scabies epidemic beforehand.
Keywords: scabies, infection, epidemic characteristics.
Cite this Article Min -Hyang Park, a study on the patients with scabies in Korea,
International Journal of Mechanical Engineering and Technology, 10(7), 2019, pp. 29-
33.
http://www.iaeme.com/IJMET/issues.asp?JType=IJMET&VType=10&IType=7
1. INTRODUCTION
Scabies, a parasitic dermatological disease by Sarcoptes scabiei Var. hominis, has the
symptoms of rash and severe pruritus at night and it is transmitted by the skin contact.
Norwegian scabies has been known as its severe symptoms and strong contagiousness with
atypical scales and eschars [1] and reported as the main cause of scabies infection [2] and to be
delayed further up to its diagnosis compared to the typical scabies [3]. Infection rates of scabies
in Korea were approximately 2% in 1960s, reached to the peak approximately in 1980s, and
then decreased to less than 1% since 1990s, in case of outpatients in dermatology of general
hospitals [4]. However, case reports and multicentric retrospective research results had been
continuously reported after starting report of epidemiology study on scabies occurred in elderly
nursing facilities in 2006 [5-11].

2. Min -Hyang Park
http://www.iaeme.com/IJMET/index.asp 30 editor@iaeme.com
In addition, the number of reimbursed patients by the diagnostic code of scabies (B86) was
increased from 36,688 in 2007 to 52,560 in 2011 upon the analysis results of health insurance
payment data for the past 5 years from 2007 to 2011. The biggest age group increased in terms
of number of treated patients per 100,000 population was over 80 years old with 31.6% annual
growth rate followed by 70s with 20.2% and 60s with 19.6%, showing the increase higher in
the elderly groups [12].
The number of scabies patients in overseas showed the increasing trend, too. In France, the
number of treated patients due to scabies had been increased from 1999 to 2010, reporting 328
patients per 100,000 population for its prevalence [13]. In Taiwan, it was reported that 399
patients were hospitalized from long-term care facilities into a general hospital with 890 beds
among 706 patients who were diagnosed from January 2006 to December 2008, and the average
age of them was over 80 years old [14]. In Japan, upon the epidemiology study result of scabies
in 1,795 psychiatry hospitals and long-term care facilities in January, 2005, 741 (41.3%)
institutions were responded to report that 334 (44.9%) institutions experienced the patients with
scabies, 159 (47.7%) experienced the epidemic of scabies, and 51 (15.3%) institutions had
Norwegian scabies during the epidemic of scabies [15].
Scabies is an uncommon infectious disease in the hospitals. If its effective infection control
activities are not performed timely, it may implicate the additional costs on the secondary
infections in the patients or hospital employees and infection control, and secondary damages
such as psychological damage and working limitation in the employees. Kim et al [16] reported
that all the patients and hospital employees who had visited the intensive care unit in
neurosurgery department of a general hospital for the past three months had been treated with
dermatology cares as one nursing assistant was identified as the scabies patient who was
working at the intensive care unit, resulting in 11.9% of secondary infection rate and 44.0% of
tertiary infection rate. In addition, upon a literature review related to scabies from 1983 to 2003,
it was reported that 16 hospitals had experienced 19 times of hospital infections with scabies.
Among the hospitals experienced the hospital infections, 9 hospitals had 18 infected patients
on average, the incidence in 5 hospitals was 12.9%, the number of infected hospital employees
was 39 on average in 16 hospitals, and average incidence in 9 hospitals was 34.6% [2]. There
was a case that infection control was performed including timely treatments and isolations for
the causative patients and preventive treatments for the exposed people once the epidemic of
scabies was occurred in a tertiary hospital in Canada. As a result, no more infection was
occurred beside five employees and two patients who had the symptoms, and the treatments for
those exposed were completed [17]. Scabies infection seems to be increased in the hospitals
which may be related to the transfers from long-term care facilities, however, the recent
practices of scabies infection in the hospitals were not identified in detail and few studies had
been performed on the infection control activities at the epidemic of scabies in the domestic
hospitals. This study aims to understand the incidence of scabies and characteristics of its
epidemic in the domestic hospitals and to utilize them as the basic data.
2. THEORETICAL BACKGROUND
2.1. Symptoms of scabies infection and epidemiological characteristics
Scabies is a dermatological disease occurred by Sarcoptes scabiei Var. hominis. Female
Sarcoptes scabiei can be observed with naked eyes, laying the eggs upon making burrow on the
skin surface, and they have four pairs of legs moving 5 mm per day. Scabies transmission is
occurred by body and skin contacts commonly in the congested areas and its epidemic is
frequently occurred in nursing homes, nursing care hospitals, and jails. Once the person is
infected by scabies, they are found in between fingers, flexus of wrist, near the man’s penis,

3. A study on the patients with scabies in Korea
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sole, top of the foot, buttocks, axillary areas, and so on after latent period of 2-6 weeks [18]. In
a multicenter research on the practices of scabies patients, occurrence areas were reported to be
51.1%, 47.0%, 38.0%, 36.8%, and 34.8% at hands, near genital organs, armpits, between
fingers, and sole, respectively [19].
Scabies infection is diagnosed normally based on the distribution of rash and existences of
burrows.
If possible, the diagnosis of scabies should be performed by identifications of Sarcoptes
scabiei, their eggs, or stools. It can be performed with microscopic exam upon eliminating
Sarcoptes scabiei at the end of burros, or capturing them, their eggs, or stools using the needle
tip carefully [18].
With respect to the case reports of scabies, upon the analysis of epidemiological
characteristics in 1,539 outpatients with scabies in the domestic general hospitals, the patients
aged between 70 – 79 years old were the most prevalent with 14.7%; the estimate times of
infection were November and September with 11.6% and 11.2%, respectively, showing
distribution of patients more in fall and winter; and the shares of durations up to the diagnosis
were 40.5%, 59.7%, 73.6%, and 82.0% for 1, 2, 3, and 4 months, and 3.6% took over one year.
9.0% patients were in the immobile status and 13.6% patients were in the assisted mobile status.
With respect to the estimated places of primary infection, patients’ own homes were the most
prevalent with 66.7%, while nursing hospitals, general hospitals, and nursing homes were 8.7%,
7.7%, and 6.7%, respectively. For the estimated infection routes, 25.8% were reported to be
infected by other patients, healthcare assistants, or healthcare professionals in the hospitals or
nursing homes [9].
In a British epidemiology study on scabies epidemic in 7 residential care homes where its
epidemic was experienced, they reported 94.9% of the residences with dementia, females with
74.4%, incontinence patients with 79.5%, and incomplete mobile residences with 61.5%. Over
80% of them had the symptoms of itching and redness and they were diagnosed within one
week from the symptom occurrence, but it took over 5 months in some cases [19].
2.2. STATUS OF SCABIES EPIDEMIC IN THE MEDICAL
INSTITUTIONS AND FACILITIES
In 2008 in a university hospital, one patient admitted due to dyspnea as a main symptom was
transferred from general ward into intensive care unit to be diagnosed with systemic infection
by Norwegian scabies on Day 6 and reported to Infection Control Department. Preventive
treatments were administered to the employees and 78 patients who contacted the patient and
no secondary infection was reported upon follow up for the following two months [20]. No
multicenter study report was found on the scabies epidemic in the Korean hospitals.
In case of overseas, five healthcare professionals and two patients were reported to be
infected with scabies according to a report on the scabies epidemic in Canada that was occurred
unknowingly until the third admission of the patient who had got renal transplantation in a
tertiary hospital in 2020 [17]. In Japan, according to the epidemiology study of scabies in 1,795
psychiatry hospitals and long-term care facilities in 2005, 334 (44.9%) institutions had the
infection in 2004, 159 (47.7%) experienced the epidemic of scabies, and 51 (15.3%) institutions
answered to have Norwegian scabies. In the cases of scabies epidemic, Norwegian scabies were
64.0% and ordinary scabies were 46.6% [21].
2.3. INFECTION CONTROL OF SCABIES AND TREATMENT
In 2010, CDC in the USA announced the guidelines for preventing and controlling scabies
outbreaks and their contents on general scabies are as follows. People who are exposed to

4. Min -Hyang Park
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scabies should be recorded on their general characteristics and their symptoms should be
monitored up to two months. Direct skin contact should be avoided with the scabies patients.
In case of contacting the patients, gloves should be worn, and hands should be washed
afterwards. Direct skin contact should be avoided with the patients on the treatment of scabies
within 8 hours. Family members of the employees who are exposed to scabies and treated
should be included as the treatment subjects. The employees who are exposed to scabies can
return the clinical site after treatment, however, those with symptoms should wear disposable
gloves when they perform nursing cares to the patients for some more days after the treatment
until they are confirmed without infection. Additional guidelines on Norwegian scabies are as
follows. High potential of epidemic of Norwegian scabies should be remembered.
Epidemiologic data should be used for the confirmed cases with Norwegian scabies on building,
room, floor, employees, admission date, initial symptoms related to scabies, visitors, and so on.
Caution to contact should be performed (gown, disposable gloves, shoe covers, and so on). The
patients with Norwegian scabies should be isolated (Cohort isolation can be considered).
Visitors should be controlled.
In case of scabies epidemic in the domestic medical institutions, they reported to pay
attention to the separate collection of linens that patients used and to disinfect the goods used,
bed, and surfaces of medical devices [16][20].
Vorou[2] et al. reported from reviews of 16 case reports with scabies from 1983 to 2003
that three cases out of them should have washed linens and patients’ clothing using high
temperature water and dryer, and four of them should have cleaned carpets and furniture by
vacuum cleaning [22].
3. CONCLUSION
This study was conducted to understand the status of scabies infection and its epidemic
characteristics in the Korean hospitals. 43 hospitals (86.0%) received the reports of scabies
infection with suspicious or definite diagnosis to infection control department, implicating
continuous increases 14.6% (7/48), 20.8% (10/48), 35.7% (17/48), 44.1% (21/48), and 56.7%
(27/48) in 2010 to 2013 and 35.7% (17/48) in 2014 up to April. 92.0% of the hospitals had the
rules and guideline of scabies infection control, which seemed to be prepared by the recent
certifications of medical institutions and establishment of rules in infection control departments.
However, less than half of the hospitals 44.0% (22/50) prepared the screening system related to
scabies during the admission processes of the patients, 56.7% of the patients had the typical
symptoms related to scabies when they admitted with 47.0% of pruritus, requiring the system
to prevent from the scabies epidemic beforehand.
In terms of season to occur scabies, Park et al. [9] reported higher distributions in fall and
winter with 11.6% in November and 11.2% in September, while the detection season of scabies
epidemic in this study did not show the seasonality since 20.0% occurred in January and April,
and 16.7% in August. This may be difficult to compare the cases directly because the
occurrences of scabies were not be considered as the time to detect the causative infected
patients, however, it can be used as one of the references, which require further studies on the
epidemiologic changes of scabies compared to the past.
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