Scabies cases are increasing worldwide, and Türkiye is no exception. A month ago, professionals at Ümraniye Hospital revealed that approximately 30 to 40 cases were reported every day. At the 31st National Dermatology Congress, the Turkish Dermatology Association stated that scabies cases in Türkiye increased by 30% compared to last year. The association also added that scabies have become an epidemic in the last 5-6 years.
Scabies is a dermatological disease caused by the human itch mite infecting the skin. Scabies mite gets into the upper layer of the skin and starts living and laying eggs there. Its symptoms might include severe itching and skin rash. Scabies mites can survive for one to two months on a person, but if they are not inhabiting a body, they will only be able to survive for one to two days. If the person never had scabies before, the symptoms might take 4-8 weeks to develop, whereas if the person had the disease before, the symptoms will most likely be visible in 1-4 days. It is also important to note that a person can spread scabies even when they haven’t started displaying the symptoms yet, which makes scabies epidemics hard to control.
Common scabies symptoms may include severe itching and itchy acne-like rashes. Scratching the rashes is not recommended since it can cause skin sores, and these sores can be infected by bacteria. The itching or rash can be limited to a certain region or spread to the entire body. The common regions they can be found in include elbows, armpits, wrists, the area between the fingers, buttocks, waist, and belt line.
Scabies are spread through prolonged skin-to-skin contact with an infected person. The contact needs to be prolonged, so a quick handshake or a hug will usually not spread the disease. Some doctors even say that the contact needs to last at least 20 to 30 minutes for scabies to spread. Scabies can also spread indirectly if the infected and the uninfected person share an article of clothing, towel, or bedding. Scabies are mostly found in crowded places because they require skin-to-skin contact to spread. Therefore, scabies outbreaks are mostly seen in places like nursing homes, childcare centers, or prisons.
The most common product used to treat scabies is called “Scabicides” which patients can’t get without a prescription. Its application varies based on the patient; for example, adults apply it to all parts of their body whereas for young children, the cream should only be applied to the head and the neck. There is also a pill option to treat scabies called “Ivermectin” which patients who don’t have the means to wash off the scabicide cream use, but these pills are not covered by insurance in Türkiye.
Why did it become an epidemic?
In 2022, Denizli Doctors’ Room president Fazıl Necdet Artıç stated that it’s a requirement for doctors to examine 70 patients per day, and when this number is divided by the patient examination times, it equals approximately 5.5 minutes per patient. Of course, this duration is not enough for doctors to examine patients in detail, which results in scabies spreading uncontrollably since the disease is more likely to go unnoticed if it hasn’t visibly spread to most of the body. Even if it is visible, doctors still have to examine the mites with a dermatoscope in order to be sure of their diagnosis and not prescribe the wrong medicine.
Another major reason for the epidemic is the earthquakes that happened in February. The first result of the earthquakes, which presumably played a role in the spread of scabies, was the crowded hospitals. These spaces provided a perfect opportunity for scabies to spread because they were very crowded and the doctors were too busy tending to the patients severely hurt by the earthquakes. Similarly, thousands of people lost their houses and were forced to live with relatives or in tents in crowded areas, having a hard time looking after their hygiene. So, if anyone from the household got scabies, it would most probably spread to everyone else they were living with. In addition, people had limited access to water. The problem is that the cream medicine covered by insurance to treat scabies needs to be washed after 14-17 hours, so it is hard for these people to properly use the medicine without suffering from any side effects, such as more severe itching. As a result, doctors are demanding that pills be covered by insurance and distributed to the areas affected by the earthquakes.
If the government doesn’t take action about the spread, doesn’t allow doctors more examination time, or doesn’t include the Ivermectin pill in health insurance, it can be easily predicted that the scabies cases will get out of control very soon if they haven’t already.
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