Scabies, an easily treatable disease, causes a lot of suffering. From quarrels in families because family members refuse a second treatment (because they are not bothered anyway), studying children who are shown the door or only allowed to sit motionless on a plastic-covered couch, to broken relationships, missed exams and ‘mangy delusions’. .
A patient got it from his sons who live away from home. Despite many treatments, the scab kept coming back. His sons were no longer welcome at home. However, the source turned out to be the still unknown friend of his daughter living at home. Through him, the scabies mite entered the family every time.
Another student, who also infected her parents, was no longer able to live in her student city. She stopped her studies because of scabies and lives with her parents again. A family of Syrian origin had been struggling with the mite infestation for more than a year, despite all instructions in which a GGD nurse had visited the family with six children at home.
It turned out that everyone except the youngest child had been treated, because the tubes and the money had run out. Another couple contracted scabies after buying a nice second-hand bench on Marktplaats.
Easily treatable condition
How is it possible that a relatively easy to treat condition has gotten so out of hand in recent years? We believe that diagnosis, treatment advice and public information are inadequate. That is why we advocate the following.
We believe that the collaboration between the GGD, general practitioners and dermatologists should improve. We are also in favor of more education, so that doctors can better diagnose scabies. Unambiguous and clear treatment advice is required, and public information is also important in this respect. In this way, wild ideas about treatments will be limited, and hopefully the epidemic will also be brought under control.
Public information needs to be improved. There are many leaflets on the internet, but certainly the old ones give incorrect information. There is a lot of pointing at each other. Because of the known overload, the GP prefers that the GGD infection control picks up scabies. The GGD only does settings, and is also overloaded. Dermatologists only see one patient within a family and have no insight into the family situation.
If someone has intense nocturnal itching for the first time, think immediately of scabies. Have the diagnosis confirmed by your doctor. Many general practitioners can use a highly magnifying loupe, a dermatoscope, to discover the mite in the corridors on the wrists. You see her as a V-shaped dot in front of the hallway.
Scrapings can also be taken for microscopic examination or sent for examination to a microbiological laboratory, where the DNA of the scabies mite can be demonstrated. If the doctor is unsuccessful, a referral to a dermatologist is necessary. At the Deventer Hospital we offer emergency places for scabies for the general practitioner. The GP can then treat the family with a certain diagnosis. It is important to only treat as soon as it can be said with certainty that there is an infection.
Everyone should be treated equally
In addition, it is a problem that the variability of the treatment between different general practitioners and dermatologists is large. The cornerstone of the treatment is that everyone is treated at the same time. If this does not happen, the so-called ping-pong effect will arise. Housemates without symptoms should also be treated.
A treatment consists of cream or pills. The effectiveness of the two drugs appears to be almost equal. The pills (Ivermectin) require a prescription and are more expensive. They have recently been reimbursed by health insurance. For students, who rarely pay their own risk, this makes no difference, it’s still a lot of money. The pills only kill the mites and therefore the treatment must be repeated after a week to kill the hatched eggs.
Out of desperation, people smear every day
When using the cream, both the mites and the eggs are killed. The whole body, for adults with the exception of the face and hairy head, must be rubbed in and this must be repeated after a week. This requires at least three tubes of 30 grams.
Research shows that many areas are skipped during lubrication, while it is crucial that every spot is treated. Then leave the cream on for 12 hours instead of the much recommended 8 hours before you take a shower. Out of desperation, people sometimes smear every day. However, this also causes itching!
In short, this problem needs to be addressed better. The number of infections is currently getting out of hand and we as a society are lagging behind.
Duveke was eventually rid of the scabies mite with the help of Ronald. Now let’s make sure all the other desperate victims get rid of it too!
