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Scabies outbreak controlled by mass drug dosing

Mass drug dosing controlled scabies: study
Photo: Mass drug dosing controlled scabies: study
A 'super-simple' drug treatment of a whole community virtually eliminated scabies, according to new study.

Scabies was virtually eliminated in a community by dosing everyone with the drug ivermectin, say Australian researchers involved in a world-first study.

The findings have implications for controlling the debilitating skin disease around the globe, including in Aboriginal and Torres Strait Islander communities where it's endemic.

The study, published in the New England Journal of Medicine, was conducted by the Murdoch Childrens Research Institute and the Kirby Institute at UNSW Australia in Fiji, where one quarter of the population is infected.

Murdoch senior researcher Associate Professor Andrew Steer says while the recommended treatment of permethrin cream effectively treats individuals, many often become reinfected in the community.
Three isolated communities were given different interventions - standard cream treatment for affected individuals and their families, mass administration of the cream, and mass administration of ivermectin.

After one year the prevalence of scabies declined by 94 per cent in the ivermectin group and their skin sores were reduced by 67 per cent.

The disease declined by 64 per cent in the mass cream group and 49 per cent in the standard-care group.

"The tablet was a super-, super-simple intervention," Prof Steer told AAP.

"Everybody got a tablet and if you had scabies you had a second tablet seven days later and we did nothing else before coming back a year later.

"I think that is the wow factor for us. It's not a long treatment course and doesn't require people going back into the communities repeatedly."

Scabies, caused by a microscopic mite that burrows under the skin, is estimated to affect more than 100 million people globally, including 69 per cent of Australian indigenous infants in their first year.

"The terrible itching leads to severe secondary infections that can cause potentially deadly diseases including rheumatic fever, rheumatic heart disease and chronic renal failure - conditions that occur in Aboriginal people at the highest rates in the world," Prof Steer said.

The 2015 Nobel Prize for Medicine was awarded to the scientists who discovered ivermectin, now used in mass drug administration programs to control river blindness and lymphatic filariasis.

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