Investigation of a scabies outbreak in a kindergarten in Constance, Germany
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In industrialized countries, scabies occurs sporadically or in the form of protracted epidemics, typically in nursing homes for elderly people. Outbreaks of scabies in a kindergarten are very rare. The main goal of our study was to investigate an outbreak of scabies in a kindergarten and to identify risk factors for the infestation with the ectoparasitosis. We investigated an outbreak of scabies in a kindergarten in the City of Constance, southern Germany, with a particular pedagogical concept. Risk factors indicating a transmission of Sarcoptes mites through body contact or via fomites were assessed using questionnaires and by following the daily routine in the kindergarten. A total of 16 cases were identified. The attack rate was significantly higher in nursery teachers (risk ratio 42.1) compared to children (risk ratio 10.5). In all cases, scabies had developed rather recently, with minimal clinical manifestations. In nursery teachers, the probability of scabies was 4.4 times higher in those teachers who hugged children regularly. Children who preferably played with their own soft toys had a lower probability of developing scabies [risk ratio 0.14, 95 % confidence interval (CI) 0.05–0.42; p = 0.04]. It seems conceivable that the particular pedagogical concept of the kindergarten favored the spread of Sarcoptes mites. We were unable to show whether transmission had preferably occurred through body contact or via fomites.
KeywordsRisk Ratio Index Case Scabies Body Contact Mass Treatment
We express our gratitude to the city heath department and the employees of the public kindergarten in Constance, Germany. The data of this study are part of the medical thesis by B.W. L.A. received a postdoctoral scholarship from the German–Brazilian PROBRAL program jointly supported by the German Academic Exchange Service (DAAD, Germany) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brazil).
Conflict of interest
The authors declare that they have no conflict of interest.
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