1. Introduction
Scabies is not a Notifiable Disease. In the event of cases or outbreaks at the University, there will not be a formalised multi-agency response with external health agencies in the way that there is for notifiable diseases such as Meningitis and Measles.
The University’s response to cases and outbreaks is limited as the organisation will not formally receive notification of cases and outbreaks. There are currently no formal reporting requirements relating to scabies.
This plan has been created to clearly outline how the University aims to support students and staff affected by scabies and also describe the limitations of the response to ensure there is a shared understanding across the organisation of what can and cannot be done.
Scabies can be an unpleasant and upsetting condition to experience. Although a formal response is not required, the University aims to support students and staff affected by scabies and is committed to sharing relevant information and advice created by the UK Health Security Agency (UKHSA) and Bath and North East Somerset (BaNES) Public Health Team to ensure that the community is sighted on how to access treatment, reduce the risk of re-infection and minimise transmission to others.
What is Scabies?
Scabies is an infestation of the skin caused by the parasitic mite called Sarcoptes scabiei. The mites burrow under the top layer of skin and lay eggs. The body’s immune system reacts to the mite’s droppings and saliva resulting in an immune reaction, which produces an intense itching. Scabies is contagious, meaning it spreads from person to person through close contact.
Common signs and symptoms of Scabies
- Intense itching, especially at night, which may affect most of the body or be limited to certain areas (see below)
- A rash or skin irritation that looks like red raised bumps, blisters, pimples, or brown nodules
- Mite burrows on the skin with a zigzag or "S" pattern
Common areas of infestation include:
- between the fingers
- wrists
- bends of elbows and knees
- armpits
- breasts
- waist and abdomen
- buttocks
- penis and scrotum
The above describes ‘classical’ scabies. ‘Crusted’ scabies is the same infection but with many more mites, causing scaling of the skin. People with crusted scabies do not often show the usual signs and symptoms of scabies and may be misdiagnosed with psoriasis (scaly rash) or eczema (red, itchy skin). Crusted scabies is much more contagious than regular scabies because there are more mites that can easily pass with direct skin-to-skin contact.
The definition of an outbreak is two or more cases of scabies in the same setting within an 8 week period. A scabies outbreak can be declared over if no new cases are identified within 12 weeks of symptom onset date of the last known case. However, given that outbreaks are not formally monitored, it is not possible to declare with certainty when they are over.
2. Aim and Objectives
The aim of this plan is to describe how the organisation can support students and staff in relation to scabies, both proactively and in response to being made aware of case(s) or outbreak(s).
The objectives of the University in relation to scabies are:
- To raise awareness of scabies and its treatment and reduce the associated stigma through regular information sharing as guided by external partners
- To encourage students and staff to protect their own health and wellbeing and that of others through taking prompt action to seek treatment for scabies, contain outbreaks and reduce spread
- To protect staff by ensuring that those who handle items which may contain mites, such as used bedding or towels, are provided with the appropriate PPE (disposable gloves and apron).
3. Scope
This is a University-wide response plan with relevance across the entire organisation. The plan focuses on scabies cases and outbreaks within the student community, as communal living arrangements such as student residences enable scabies to spread easily. In 2024 there was a national increase in scabies cases and outbreaks within student communities. Although focussed on students, this plan should also be referred to in the event of a known case / outbreak within the staff community.
4. Notifications
The University will not be formally notified of a scabies case / outbreak within the student or staff community by any external health agency. There is no obligation for students and / or staff members to inform the organisation if they are diagnosed with scabies. The organisation may become aware of a case / outbreak within the student community through the student affected, their friends, housemates or a parent / guardian. If the case relates to a member of staff, they may choose to inform their line manager or colleagues but are not required to do so. Although it would be helpful to know of case(s) / outbreak(s), the University cannot stipulate that the organisation is provided with confidential medical information as scabies is not a notifiable disease.
5. Response to case(s)/outbreak(s)
When an individual suspects they may have scabies, there are a number of steps they need to follow in order to treat the condition and minimise onward transmission. These include:
- Diagnosis - by GP or pharmacist
- Treatment – this is usually a topical cream (normally applied on two occasions, 7 days apart) but may be oral tablets
- Maintenance of good hygiene practices
- Identification of close contacts with advice given to be treated for scabies at the same time as the case (even if asymptomatic)
- Hot washing (50’c minimum) of laundry including bedding, towels and clothing. If items can be laundered but not on a hot wash, they should be tumble dried on a hot cycle for at least ten minutes after they have been washed at a lower temperature. Items which cannot be laundered may be placed in a sealed plastic bag for at least 3 - 4 days (minimum 72 hours) to kill any mites present
- Avoidance of skin-to-skin contact with others until 24 hours after the first dose of treatment has been completed
- Exclusion or isolation of cases or contacts is not normally required.
It is important to note that symptoms (such as itch or rash) may continue for up to 6 weeks after treatment completion. This does not mean that the treatment has failed.
Student case(s)/outbreak(s)
Students can be signposted to this scabies information and advice page.
Students and staff are encouraged to report suspected or diagnosed scabies case(s) and / or outbreak(s) in University accommodation to the Residential Life Team by emailing reslifesupport@bath.ac.uk.
The Residential Life Team will support the affected student(s) through
- Arranging the cleaning and disinfecting their bedroom
- Signposting students to the scabies information and advice page which contains important information on diagnosis, treatment and minimising onward transmission
- Arranging the laundering of the case’s used bed linen and provision of clean
- Warning and informing of staff working in the areas affected and a reminder to wear the required PPE (disposable aprons and gloves)
The bedroom of the case must be deep cleaned. If the case lives in a large hall of residence, they will need to look pragmatically at who is a ‘close contact’ and which communal areas they have spent time in in order to advise of treatment and cleaning requirements. In a smaller shared / house or flat, all house / flat mates should be treated as close contacts and be advised to seek treatment (even if asymptomatic) and wash their bedding, clothes etc. as per the instructions above. In this type of environment, all communal areas should be deep cleaned including the thorough vacuuming of all soft surfaces including sofas and chairs, curtains, carpets and rugs.
If the University is made aware of a student case and the student lives in private accommodation, they should be signposted to the scabies information and advice page.
Staff case(s)/outbreak(s)
Affected staff may inform their line manager or colleague that they have (suspected or confirmed) scabies but are not obliged to do so. On being made aware of a staff case / outbreak, the affected individual(s) should also be signposted to the scabies information and advice page.
Exclusion / isolation from work is not normally required and staff can continue to work following a scabies diagnosis but should avoid skin-to-skin contact until 24 hours after their first round of treatment. If they are in a role where hands-on or close contact is required (e.g. in the nursery, the Sports Training Village (STV), or researching physical health with a direct physical contact requirement), staff must wear appropriate PPE (gloves and apron) until 24 hours after completing treatment. If staff require time off work due to scabies, they should report their sickness through their standard procedures, flagging that it is scabies related if they are comfortable sharing this information.
Staff working in roles which involve the handling of items which may potentially contain mites, such as used bedding or towels, are expected to wear the appropriate PPE (disposable gloves and apron) whilst handling these items.
Escalation
In the event of a significant outbreak within the university community affecting a high number of students and / or staff, a Silver Incident Response Team may be convened as per the Incident Response Framework and advice and support will be requested from UKHSA and BaNES Public Health Team as required.
6. Appendices
Appendix 1: Pharmacies with extended opening hours
The following pharmacies are likely to have extended opening hours if a prescription is required out of hours.
https://bsw.icb.nhs.uk/wp-content/uploads/sites/6/2022/07/Participating-Pharmacies-April-22.pdf
The opening hours of other local pharmacies can be checked here:
Pharmacies near Bath - NHS (www.nhs.uk)
Appendix 2: Silver Incident Response Team Membership Guidance
The following membership should be considered:
- Director of Education and Student Services (Chair)
- Director of Student Support and Safeguarding (Deputy Chair)
- Chief Operating Officer
- Head of Organisational Resilience and Business Continuity
- Senior Case Manager, Student Support
- Executive Director (External Relations)
- Deputy Director of Safety and Wellbeing Services
- Deputy Director of Human Resources
- Head of Security Services
- Director of Campus Services
- GP Partner, University Medical Centre
- Chief Executive, The SU
If suggested members are unable to attend, they may send a nominated deputy who must be briefed and able to represent their department.