This is part 1 of a series on the scabies which, while not epidemic, is easier to catch than you think in hotel rooms, on cruise ships, at crowded airports and other areas where all you need is just one infested person.
Weary about worrying about bedbugs when you travel? Fine, then let’s talk about scabies. Never heard of them? We didn’t either until a pair of travel writer friends returned from a long trip bearing the telltale signs of pink pustules on their chest, back, buttocks and beyond.
Sure, bedbugs are scary. The miniscule insects hide during the day, usually in bedding, and emerge at night to suck the blood of anyone within crawling distance, leave behind telltale bite marks, and then retreat into hiding again. Humans don’t “catch” bedbugs, they have to sleep near them. Still, yuk.
But scabies mites are far worse. The microscopic human itch mite (Sarcoptes scabiei var. hominis) burrows into the upper layers of skin to lay eggs there and start a family. They are harder to find than bedbugs, are more difficult to diagnose, can stay for months, and are often resistant to treatment. And an infestation that can explode to hundreds, even thousands of mites, can begin with a single pregnant egg-laying female and can leave a victim with a widespread ugly, raised and maddeningly itchy rash.
Scabies most often are passed from human to human in close contact. But while the mites in their various forms cannot live long without a human host, they can lurk for up to 72 hours waiting for the next unsuspecting victim to happen along. That can means in airplane seats, rental cars, hotel rooms and cruise ship cabins when a traveler lingers long enough for the mites to find him. Isn’t travel grand?
Unfortunately, scabies occur worldwide and infestations are common. And while there is anecdotal evidence that scabies is becoming of greater concern to travelers, there are no statistics yet to back that up. What’s more our friends didn’t have them before they left on their extended vacation and cruise. “Scabies is common but not at epidemic levels,” says New Jersey board certified dermatologist Coyle S. Connolly, M.D.
Most worrisome is how easily the mites can be transmitted. According to the Centers for Disease Control and Prevention, “Scabies can be passed easily by an infested person to his or her household members and sexual partners.” Even without the telltale itchy rash, which can take months to show up, a mite host can be hazardous to be near. “An infested person can spread scabies even if he or she has no symptoms,” says the CDC.
Since the usual scabies infestation involves only a handful of viable mites, prolonged contact between humans ordinarily is the only way scabies is transmitted. Contact from a handshake or short contact with an airline pillow would not be enough to spread scabies, says Dr. Connolly.
But “crusted” (also called Norwegian) scabies is anything but ordinary. This severe form isn’t any more virulent than common scabies on a per-insect basis, but someone with crusted scabies can harbor thousands of mites—or as many as two million, according to the CDC. That makes shed mites much more numerous, which makes even fleeting contact hazardous.
“Because they are infested with such large numbers of mites, persons with crusted scabies are very contagious to other persons,” says the CDC. “In addition to spreading scabies through brief skin-to-skin contact, persons with crusted scabies can transmit scabies indirectly by shedding mites that contaminate items such as their clothing, bedding and furniture.”
(Come back for part 2 to learn just how scabies is diagnosed, treated, and mitigated)