Increase in the number of scabies in Germany



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Skin disease: scabies widespread in Germany

The phrase "I get the scabies!" Is known to almost everyone in this country. For many people, the phrase simply said is unfortunately an unpleasant reality. The skin disease caused by mites is diagnosed with increasing frequency. The itchy disease, however, has nothing to do with poor hygiene, as is often suspected.

Scabies afflicts the homeless and the well-off Many people in this country consider scabies to be an eradicated disease. However, the fact that this is not the case shows, among other things, that doctors have been prescribing drugs for the skin disease more and more recently. The Berlin doctor Jenny De la Torre also finds small blisters and pustules on a patient's skin almost every day or hears complaints about severe itching. In her practice, scabies, medically called scabies, is everyday life. “In addition to lice and the train, it is the most common problem for my patients,” says the doctor, who only treats the homeless. Since they often sleep in community facilities, they are considered to be particularly at risk. The assumption that the itchy disease only affects poor people with poor hygiene is wrong. Well-off people are also affected. “The scabies were always and in all social classes. She can also get a tanned ‘beautiful’, ”said Hanoverian dermatologist Wolfgang Lensing.

Current warning from Leverkusen In Germany there are always reports of outbreaks of scabies. For example, in January, when four young people fell ill in Lemgo in North Rhine-Westphalia. Or in the Uckermark, where several diseases of children, adolescents and adults became known in 2013. And a warning from Leverkusen is very topical. Foxes infested with mange were found there. In animals, scabies is colloquially called mange, and the city warns that this disease can also affect other animals and humans. One does not know whether the scabies occur more frequently today than before, because there are no reliable figures, said Prof. Hermann Feldmeier from the Institute for Microbiology and Hygiene at the Charité Berlin and co-author of a scabies guide at the Robert Koch Institute (RKI). The contagious disease caused by itch mites is not reportable in Germany. However, according to the Infection Protection Act, infected patients are prohibited from staying and working in community facilities even if they are suspected.

Increase in prescriptions for scabies medication noticeable If one looks at the prescription numbers for the scabies remedy Infectoscab among those with statutory health insurance, one can come to the conclusion that scabies is now occurring more frequently. The cream was prescribed 56,000 times in 2007 and 79,000 in 2012. This emerges from data from the AOK Scientific Institute (WIdO). The WidO publishes the Drug Prescription Report annually. Carsten Telschow reports: “Apparently there has been an increase in regulations over the past few years. Infectoscab ranked 1,340th among the most prescribed medicines in 2012, and ranked 1,898th in 2007. “The cream is therefore not the only, but the most frequently prescribed scabies medication. Some of those affected would also be treated with individually prepared recipes that were missing in the statistics.

Difficult to recognize disease According to the World Health Organization (WHO), 300 million people worldwide are considered to have scabies. According to the RKI guide, skin disease occurs in Central Europe as a sporadic disease in children, mothers, people with a weak immune system or sexually active adults. Lensing explained that it is often difficult for doctors, even in skin clinics, to spot scabies. The symptoms would often be confused with eczema. To prove that the problem is not another itchy rash, but scabies, one has to search the body millimeter for millimeter for the barely visible parasites, scrape them off and identify them microscopically. "In a normal office hour, this is unfamiliar," said Lensing.

Dry skin is a risk Above all, mites would be transmitted through close skin contact. However, this should take a few minutes. Even though it is rare, indirect transmission through clothing, bed linen or towels is also possible. Beds in shared accommodation or hotels with quick user changes could also spread scabies. As Lensing said, dry skin is also a risk: “The mites have to find a way to dig into the upper layer of the horny cells. This is much easier with dry skin. ”When the arachnids have made their way into the epidermis, the female mites lay their eggs or feces. This then triggers the intense itching, which gave the name to the disease that is said to have already plagued Napoleon.

Cause of poor hygiene is a prejudice According to experts, seeing the cause of scabies in poor hygiene is a prejudice. As it says in the RKI guide, the presumed connection between poor personal hygiene and scabies probably does not correspond to reality. The opposite could be the case: "The biggest problem is people who have so-called well-groomed scabies," said Lensing. These patients often leveled the symptoms with creams to such an extent that they were hardly recognizable as scabies. At the other extreme, the scabies crustosa, the patient is infected by thousands of mites - usually there are hardly more than ten animals anywhere on the skin.

Scratching can lead to further infections The dermatologist explained that the scabies are not directly dangerous, but they can have problematic consequences: "When scratching, you can enter bacteria into the skin, which can lead to further infections." Fight medication. In order to create a mite-free environment, you don't have to disinfect the entire apartment. It is often enough to just remove the bedding, wash at 60 degrees and cool the room for a few days. "The mite needs warmth and food, if you withdraw it, it doesn't like it." In addition to medication, Jenny De la Torre gives her patients fresh clothes and the opportunity to take a shower. "We usually have the disease under control in a few days," says the homeless doctor. (ad)

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