What is it?
Scabies is a skin infection that is caused by a microscopic bug called a mite.  The mite lives on the surface and burrows down into the skin.  Scabies causes a skin rash that itches intensely, especially at night.  The rash can be found between the fingers, around the wrists, elbows, underarms, nipples, abdomen, waist, buttocks, penis, and feet.  In infants, the head, neck, palms, and soles may be involved.  The rash typically starts as red bumps and white thread-like lines. Since the rash is so itchy, it often gets covered with scratch marks and bruises.

How is it Spread?
Scabies are spread by skin-to-skin contact between people. The mites can also be shed onto clothes, towels, pillows, bedding, and furniture.  They can spread by sharing these items.

When is it Contagious?
Scabies are contagious as long as the mites are alive.  It is commonly contagious during the weeks before the symptoms start.  After exposure to scabies, it can take 4-6 weeks to develop symptoms.  for people who have been previously exposed to scabies, symptoms can start within 1-4 days.  When the mites are off the body (e.g., on clothes, etc.) they do not survive for more than 3-4 days.

How is it Diagnosed and Treated?
Scabies are diagnosed by the typical symptoms.  Sometimes, a skin scraping may be examined under the microscope.  Scabies are treated by applying a special insecticide body lotion (e.g., Permethrin, Lindane/Kwell, Eurax).  The body lotion is then rinsed off after a certain amount of time depending upon the medication.  Treatment is usually repeated after 7-10 days to kill any newly hatched mites.  Consult your health care provider for the appropriate treatment since the medication can be dangerous for infants and women who are pregnant or nursing.

After treatment, itching commonly persists for weeks.  This does not necessarily mean that repeat treatment is necessary.  Anti-itching lotions (e.g., calamine) or antihistamine medications might help relieve the itching.

Should the Child Stay Home?
A child with scabies should be sent home from the program and may return the day after treatment is completed.

How Can We Limit the Spread?

• Scabies often spreads to other children and adults in child care and the family.  Consult your health consultant or local health department - they may recommend treatment for all child care and family members.  Follow the same measures in child care and at home at the same time.
• Launder clothes, towels, and bedding in a machine with detergent and hot water.  Dry in a hot dryer or press with a hot iron.  for non-washable items (e.g., pillows), dry clean or seal in a plastic bag for 4-7 days.
• Vacuum carpets and upholstered furniture.
• Separate personal clothes (e.g., jackets) and bedding in individual cubbies for each child.

Information provided on this page is not intended to provide medical advice or take the place of medical treatment.  The recommendations do not indicate a course of treatment or medical care.

These are guidelines to develop policies and procedures for preventing, recognizing and managing communicable disease in child care.  If the children in your care have been exposed to this disease, you may copy this exposure notice and hand out to your day care parents.

This Exposure Notice has been copied from "Keeping Kids Healthy, Preventing and Managing Communicable Disease in Child Care", a project of the The Center for Health Training funded by the California Department of Education, Child Development Division.