Health officials in the U.K. have issued a warning about an emerging health crisis as the country faces a sudden surge in scabies cases amid an acute shortage of treatments.

Scabies is a highly contagious skin condition caused by infestation of human itch mites. These mites burrow into the upper layer of the skin, where they live and lay their eggs. The condition typically spreads through direct skin contact.

According to reports, scabies outbreak is particularly pronounced in the north of England, where infection rates have doubled compared to the seasonal average.

Two treatment options for scabies in the country – permethrin and malathion – are in short supply due to supply chain problems, war in Ukraine and a rise in the cost of raw materials. The shortage of treatment drugs can lead to a public health crisis, officials warned.

"The shortage of scabies treatments is something that urgently needs more attention. The public health calculation is not particularly complex – scabies spread easily and if people aren't treated, then they will continue to spread. Unfortunately, the consequences of treatment shortages are proving easy to ignore. There is very limited tracking of scabies cases and people are often embarrassed to talk about it," Mabs Chowdhury, the president of the British Association of Dermatologists, told The Guardian.

Officials are concerned as scabies has spread across communal living facilities, including care homes.

"This makes treatment much more difficult. If even one person isn't treated completely, everyone can be reinfected," Chowdhury added.

Signs of scabies

The symptoms of scabies may take 4-8 weeks to develop. However, the infested person can transmit the condition even during this time. In some cases, the signs may appear within four days.

The most common sign is intense itching, particularly at night. Many people develop a rash or scaly patches on the skin that look like eczema. The rashes can turn into sores. Burrows may appear on the skin surface, especially between the fingers, skin folds on the wrist, elbow, knee and on the penis, breast or shoulder blades.

People with a severe form of scabies – Norwegian scabies or crusted scabies – can develop thick crusts of skin surface that contain large numbers of scabies mites and eggs.

Prevention

Scabies spreads through prolonged skin-to-skin contact with an infested person. However, crusted scabies can even spread through brief skin-to-skin contact or by exposure to contaminated objects such as bedding, clothing or furniture. Avoiding skin contact and sharing contaminated things can prevent it.

The infested person and those potentially exposed should seek treatment simultaneously to prevent potential reexposure and reinfestation. Items such as bedding and clothing used by infested people up to three days before treatment should be either dry-cleaned or washed with hot water. Items that cannot be dry-cleaned or laundered can be disinfested by storing them in a sealed plastic bag for a week. Scabies mites do not survive more than two to three days away from human skin.

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