Increase in scabies cases in Germany – you should know that

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It itches and scratches, small red nodules and blisters form – these can be signs of scabies (technical term scabies). The contagious skin disease is transmitted from skin to skin via the scabies mites.

Scabies cases in Germany have been increasing noticeably for several years. The Robert Koch Institute reports, citing billing data from resident doctors

over 380,000 patients with scabies for 2018 and
nine times as many as in 2009.

The increase in adolescents and young adults is particularly evident. Here there is an increase of more than a factor of eleven.

Dermatologist: More and more cases of scabies that have to be treated in the clinic

“We have been observing an increase in cases for several years,” says Prof. Dr. Peter von den Driesch, Medical Director of the Center for Dermatology, Phlebology and Allergology at the Stuttgart Clinic. “In fact, also of cases that no longer respond to the usual outpatient measures. Then the whole family comes to us as an inpatient in the clinic and is treated here for four days.”

The expert sees one reason above all “Ping-Pong Effect” , in which those affected repeatedly infect each other. Von den Driesch names the main transmission sites

the family,
Collective accommodation and
Retirement or nursing homes.

“Generally where people live together in a small space,” says von den Driesch. A language or communication problem may also play a role in that the independent treatment with cream or ointment does not work. Basically, however, scabies occurs in all families and all social classes. “We already had a family of doctors in our ward,” says the dermatologist.

Also Prof. Dr. Viktor Meineke from the Derma Center in Munich assumes that the number of cases will increase. In addition to the billing data from the health insurance companies, there would also be an increase in prescribed scabies medicines. He sees the fact that a disease is often not recognized until late as a major problem with the spread. “It is only after weeks of infection that severely itchy rashes appear and the infection is only then discovered. As a result, the patient can infect other people for longer.”

Scabies – this is how the skin disease is transmitted

The mites are transmitted via intensive skin-to-skin contact, which, according to the RKI, must last about five to ten minutes. The transmission can take place, for example, through cuddling, sleeping together in a bed, personal hygiene and caressing of small children or the personal hygiene of sick people. Scabies is not a sexually transmitted disease in the narrower sense, but it can also be transmitted (through skin contact) during sex. “Where people have sex, the scabies mite can spread optimally,” says Meineke. “There is too much heat, which makes the sluggish animals mobile, and skin contact for several minutes, which gives their movements more chances for host switching.”

Danger: In the case of the highly contagious form of scabies with a strong crust formation, the so-called scabies crustosa (bark itch, formerly also scabies norvegica), the number of mites is enormously high, so that even brief skin contact can lead to infection. However, it is significantly rarer.

Scabies – these are the symptoms

The first signs of illness often only appear after four to six weeks. In concrete terms, this is a reaction of the immune system to the eggs and excretions of the mites.

These are the symptoms:

Burning of the skin and itching, which is particularly pronounced at night, fine initially whitish, later reddish lines on the skin (mite ducts) and small black dots (mites), pin-sized blisters, reddened nodules or pustules when scratched, also purulent skin areas

The main infested with mites are:

Spaces between fingers and toes Wrists Ankles Armpits Elbows Nipples Genitals In infants and young children, this also includes the head and face

“The mite has favorite places,” says dermatologist von den Driesch from the Stuttgart Clinic. “When I see lesions between my fingers and around my navel, that’s always an alarm signal.”

“If scabies is suspected, a doctor should always be consulted”

Both experts appeal: “If scabies is suspected, a doctor should always be consulted.” Ointments are usually prescribed for treatment, “which really have to be applied to every centimeter of the skin,” emphasizes von den Driesch. He also recommends putting the bed linen in “quarantine for four days”, for example in a sealable plastic bag, and then washing it. And of course: “Avoid skin contact.”