Scabies is very much alive

Optimism over the epidemic’s development is not entirely justified, says Wageningen Student GP.
Een 3D-gerenderd, medisch accuraat beeld van een schurftmijt op menselijk huid. A 3D rendered, medically accurate representation of a mange mite on human skin. Photo Shutterstock

At the start of this academic year, Resource columnist Sjoukje Osinga wrote about her three student sons with scabies. This infectious disease is on the rise throughout the country, amongst students in particular. What’s the situation in Wageningen?

Scabies means severe itching. The itching is caused by the mange mites that burrow beneath the skin to lay their eggs. After a few days, the eggs hatch and new mites crawl out, burrowing their way to their body parts to lay their eggs. The mites jump from one person to the next through skin contact or fabrics.

Not under control

In student housing, where youngsters live in close proximity to one another and use shared living spaces, the mites are rampant. Suzanne Dinther, a general practitioner at the Student Medical Centre in Wageningen, says: ‘In April, we thought the epidemic had abated, but that, unfortunately, does not appear to be entirely true.’

At the height of the epidemic, some ten students a day would report symptoms of scabies to the Student Medical Center. Now, this number is four to six. Van Dinther: ‘We do not yet have it under control.’

At the start of this year, the regional Public Health Services (GGD) distributed information flyers focusing on student through social media. The GGD Gelderland Midden infectious disease team says that ‘students have no trouble finding their way to diagnosis and treatment’. Treatment, including washing and ventilation instructions and contact tracing, remains necessary.

Heavy artillery

The mites must be treated with heavy artillery. A new outbreak may occur if so much as one single mite remains. Due to the persistence of the infection, the treatment policy for scabies has recently been amended, Van Dinther states. ‘Previously, we would treat the patient twice and offer a single preventive treatment for all the housemates. Now, we treat everyone twice. Additionally, we now prescribe pills rather than cream because we know that this leads to a higher rate of compliance. Treatment with cream is more difficult to administer.’ The effects of this new treatment protocol are not yet visible in the data.

Applying cream smeren

The scabies pills are only available through a doctor’s prescription. Every patient suspected of having scabies is prescribed a regimen of pills. Their housemates must then contact their own physician for preventive drugs.

Scabies cream can be obtained from a pharmacy. Van Dinther: ‘We have no idea how many students are applying cream, so we also lack information on the effect of such a treatment. We sometimes receive calls from students who have used the pharmacy’s cream but are still experiencing symptoms.’

It has become an obsession for some students; they dare not set foot outside

The treatment with oral medication has been covered by basic health insurance since November 2022. Van Dinther: ‘This has lowered the bar for treating the entire household. I do believe that students use preventive treatment for their entire house because they are terrified the infection won’t be stopped.’

Low threshold

The vaccination centre on the campus will take over from the Student Medical Centre in treating scabies as of September. This is thought to lower the threshold for students who have questions. Van Dinther: ‘You may see it as a walk-in consultation hour, where the students are examined for lumps and spots by a nurse. We hope this will be even more effective in treating scabies. It has become an obsession for some students; they dare not set foot outside, want only to stay where they are and feel really dirty.’

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