Norwegian Scabies in DC

Last fall a call came into the Drug Information Center at Washington Hospital Center regarding a case of scabies on one of the patient care units in the hospital. The patient failed to mention upon admit that he was in fact infested with scabies. When the nurse did the admit, she noticed lots of red bumps over the man's entire body. She called the doctor and he ordered premethrin cream. Five days after the cream was administered, the scabies were still thriving. The doctor called the DI center in search of an alternative treatment and asked for an infectious disease consult. Low and behold the man had Norwegian Scabies. The same bug causes normal scabies and Norwegian Scabies, however with Norwegian Scabies there are an enormous amount of the little buggers. So - now the question was, how the hell do we get rid of these? Meanwhile, other patients on the unit developed scabie infections, even though the patient was in isolation. The entire unit was infected within a week - including the nurses and doctors. Even the clinical pharmacist working that floor contracted them. The original patient was also an AIDS patient - which was the reason premethrin cream did not work. This patient had to be given ivermectin by mouth to get rid of the scabies. The employees and non-immunocompromised patients were given premethrin 5% lotion. Two months after the orginial patient was discharged, WHC was still treating patients for the scabies outbreak.

So, now you can see that scabies are apparently a pretty common thing at WHC. I was quite surprised on Tuesday when the DI center received a question regarding scabies. One of the ICUs had a patient with scabies that was treated with premethrin 5% lotion. The nurse that called the DI center wanted to know if the patient should be in isolation...he'd be in the unit since Friday. So - guess what! The pharmacy was sending tubs of premethrin cream to the unit for patients that had been exposed to him. THANK GOD I LIVE IN THE BASEMENT NEAR THE MORGUE! Scabies aren't fond of dead bodies - it's hard for them to feed on the dead. Thank God for little favors, right? So...are you itching yet???? :)