Increase in scabies cases in Germany

Skin disease: Scabies widely used in Germany

02/22/2014

The figure of speech: „I get´the scabies!“ almost everyone knows this country. For many people, the simply phrased phrase is unfortunately unpleasant reality. The skin disease caused by mites is increasingly diagnosed. The itchy disease, however, has nothing to do with poor hygiene, as is often assumed.

Scabbers affects the homeless and the well-off
Many people in Germany consider the scabies an extinct disease. But that is not the case, among other things shows that lately doctors prescribe more and more drugs for skin disease. Also, the Berlin doctor Jenny De la Torre finds almost daily small blisters and pustules on the skin of a patient or hears complaints of severe itching. In her practice scabies, medically called scabies, is everyday. „In addition to lice and the train, it is the most common problem for my patients“, so the doctor who treats only the homeless. Since these often sleep in community facilities, they are considered particularly endangered. The assumption that the itchy illness affects only poor people with poor hygiene is wrong. Gutsituierte are affected. „The scabies have always existed and in all social classes. She can also get a "sun-kissed beauty" sunburned, "says the Hanoverian dermatologist Wolfgang Lensing.

Current warning from Leverkusen
In Germany, there are always reports of scabies. For example, in January, when four adolescents got sick in Lemgo, North Rhine-Westphalia. Or in the Uckermark, where in 2013 several diseases of children, adolescents and adults became known. And up to date is a warning from Leverkusen. There, foxes infected with mange were found. In animals, scabies is colloquially called mange. The city warns that this disease can affect other animals as well as humans. One does not know whether the scabies occur more frequently today than before, since there are no reliable numbers, said Prof. Hermann Feldmeier from the Institute of Microbiology and Hygiene at the Charité Berlin and co-author of a scabies counselor of the Robert Koch Institute (RKI). The infectious disease caused by itchy mites is not notifiable in Germany. However, according to the Infection Protection Act for affected patients, a ban on staying and working in community facilities is already valid on suspicion.

Increase in prescriptions of scabies drug detectable
If one considers the prescription numbers for the scabby drug Infectoscab in the case of statutory health insurance, one can conclude that scabies in the meantime occur more frequently. In 2007, the cream was prescribed 56,000 times, in 2012 already 79,000 times. This results from data of the scientific institute of the AOK (WIdO). The WidO annually publishes the Drug Prescription Report. His colleague Carsten Telschow reports: „In recent years, an increase in regulations appears to be evident. Infectoscab ranked 1,340 among the most widely prescribed drugs in 2012, and ranked 1,898 in 2007.“ The cream is therefore not the only, but the most commonly prescribed scabies drug. Some sufferers would also be treated with custom-made recipes that were missing in the statistics.

Hard to recognize disease
According to the World Health Organization (WHO), 300 million people worldwide are considered to have scabies. According to the RKI guidebook, skin disease in Central Europe is a sporadic disease in children, mothers, people with weak immune systems or sexually active adults. Lensing explained that doctors, even in dermatology clinics, often find it hard to spot scabies. The symptoms are often confused with eczema. To prove that it is not just another itchy skin rash, but the problem of scabies, one has to scan the body millimeter by millimeter for the barely visible parasites, scrape them off and identify them microscopically. „This is alien to life in a normal consultation“, so lensing.

Dry skin is a risk
Above all, mites would be transmitted through close skin contact. However, this would take a few minutes. Although rare, indirect transmission through clothing, bed linen or towels is also possible. Beds in shared accommodation, or hotels with fast user switching could also spread scabies. As Lensing said, even dry skin is a risk: „The mites must find a way to drill into the upper layer of horny cells. This is much easier with dry skin.“ When the arachnids make their way to the epidermis, the female mites lay their eggs or faeces. This triggers the intense itching that gave the disease its name, which is said to have plagued Napoleon.

Cause lack of hygiene is a prejudice
To see the cause of scabies in poor hygiene is, according to experts, a prejudice. As the RKI guidebook says, the supposed link between bad body hygiene and scabies probably does not correspond to reality. The opposite could be the case: „The biggest problem is people who have a so-called well-kept scabies“, so lensing. These patients often flattened the symptoms with creams so that they are barely recognizable as scabies. At the other extreme, the scabies crustosa, the patients were infected by thousands of mites - usually there would be hardly more than ten animals anywhere on the skin.

Scratching can lead to further infections
The dermatologist explained that the scabies is not directly dangerous, but could have problematic consequences: „When scratching you can enter bacteria into the skin, which can lead to further infections.“ The disease can be well controlled with medication. In order to create a mite-free environment, you do not have to disinfect the whole apartment. Often it is already enough to remove the bedding, wash at 60 degrees and to cool the room for a few days. „The mite needs warmth and food, if you take that away, it does not like it.“ In addition to medication, Jenny De la Torre gives her patients fresh clothes and the opportunity to take a shower. „So we have the disease usually in a few days under control“, said the homeless doctor. (Ad)