Scabies

During our visit to the GP yesterday, Mother told the doctor about how she cooks and gives food to the Old Lady on a daily basis now, and how the OL has this very super itchy condition etc. Mother asked the doctor if there is any risk in dealing with OL and whether the red spots on Mother's body now are likely to have anything to do with OL's condition. Basically, I think Mother is concerned about the occasional bouts of itch which she feels whenever she goes near OL but she does not want to tell us about her own suspicions/fear about this (because we will 'scold' her about the OL mah).

The doctor cautioned that whilst itchy conditions in old people can sometimes be just truly dry skin or allergy eg eczema, we must really be extra careful because some old folks do carry on their bodies a parasite and the associated itchy condition called scabies is highly contagious. She added that this is especially common amongst old folks who neglect their hygiene, or who are institutionalised. In response to my questions, she explained the treatment which will be required for such a condition. Very troublesome.

See the following information which I subsequently extracted from the National Skin Centre's website:

SCABIES

What is scabies?

Scabies is a very itchy skin problem, that commonly affects the hands, wrists and fingers. It can affect the elbows, armpits, nipples and buttocks. In males, the genitals are often affected. The itch is worse at night.

How do you get scabies?

This condition is caused by the scabies mite, which is a small parasite that burrows into the skin of infected patients. It is usually transmitted by close person-to-person contact, and by sharing the same bed or clothings, especially among children and people with poor hygiene. The whole family can be affected as scabies is quite infectious.

How is scabies treated?

The mite can be killed rapidly by the use of an effective medication eg. Benzyl benzoate emulsion or malathion or permethrin. Attention should be paid to the specific instruction on how the medication should be applied.

Why does it itch even after treatment?

You may still itch for some days to weeks,after correct treatment. This is because of the development of a hypersensitive reaction of your body to the dead mite. Your doctor would prescribe anti-histamine tablets and steroid creams to stop the itch. DO NOT APPLY the anti-scabies medication repeatedly, and excessively unless advised by your doctor, as you can develop a more severe dermatitis.

What are the medication to treat Scabies?

These include benzyl benzoate emulsion (for 3 days), malathion (Derbac) (1 day), crotamiton (Eurax) lotion or cream (5 days). For infants and young children, it is preferable to use crotamiton, or permethrin.

How should the medication agent be applied ?

First Evening:
Immediately after a shower, apply the lotion to the whole body from neck downwards, even to the unaffected areas. Do not forget the soles, armpits, genitals and other body folds. Do not apply on the face. Do not wash away the lotion until the next evening. Re-apply the lotion on the hands each time you wash them.

Second and Third Evenings:
Repeat the above treatment in the same manner. To eradicate any mites in the family, all warm clothings should be washed in hot water and then sunned. Bed linen, pillow case, pillows, mattresses should be dusted and sunned.

Is it necessary to treat family members?

Any family member with itch, or those with close body contact, or share the same bed or linen with the patient, whether affected or not, should have the same treatment at the same time. Your doctor would usually supply sufficient medicine for all of them.

Some other literature on UK medical websites also records that medical practitioners nowadays believe that bodily contact is not necessary for transmission of scabies; even standing close or nearby is sufficient for the parasitic mite to 'jump' to a new host! Yuks!

The thought of such a horrendous condition being transmitted to any of us is unbearable, so I called TYP to tell her about it and ask her to try to find out from the NZer exactly what medical condition OL is having.

To summarise, the result of this 'assignment' is this:

NZer will not say exactly what condition it is, although he claims that all the tests which the doctors had sent OL to did not show up anything contagious. But his comments are that even though the tests have showed up nothing contagious, if the OL continues to refuse to shower etc, then it won't be surprising even if contagious conditions do develop over time.

But surely, there must be a diagnosis? Damn that NZer! He is just not telling. >:(

Anyway, I hope TYP can try to find real information from the other possible source of information. R has commented that in the worst case scenario, we may just write in to AH for the information, but this must be KIV for the time being lah.

Until then, we will just have to keep our fingers crossed and hope that Mother's chix poxies clear up and nothing else lingers on after the estimated one-month recovery period. The doctor had cautioned that any red spots or dry skin or itch which continues after the chix poxies have cleared up should be investigated properly; scabies can manifest as red spots or innocent-looking dry skin.

Incidentally, Mother said the 4th-D-In-Law who lives next door, stopped by the evening before and mentioned to Mother that she (4DIL) had just gone to see the doctor because of some bouts of itching on her neck!...... scary, man!

After several rounds of discussion and a lot of hard thinking, Mother is considering ordering tingkat for the OL. Father supports this and has, surprisingly, offered to chip in 50% of the tingkat cost.