8 Simi Valley Hospital Employees Get Scabies

Eight employees at Simi Valley Hospital contracted scabies from a 62-year-old patient treated at the hospital earlier this month, officials said Friday.

The male patient, whose identity was withheld, experienced kidney failure and was taken to the hospital’s emergency room March 2. The patient had an intense form of scabies, known as Norwegian scabies, and subsequently spread a milder form to some hospital personnel.

Scabies is caused by mites, microscopic insects that tunnel or burrow under the skin. The mites, their droppings and the dead skin they leave behind can cause the skin to crust or cake in the form of a rash.

Technically an infestation rather than an infection, crusted scabies -- also known as Norwegian scabies -- is transmitted by flesh-to-flesh contact, such as between two people sleeping in the same bed or holding hands.

The infested hospital workers were thought to have been in contact with the patient, who remains in intensive care for his other illnesses. Each worker was treated immediately and most have returned to work, according to Alicia Gonzales, a hospital spokeswoman.

Gonzales said it was unknown when the employees noticed their rashes, but that medical staff confirmed none of them experienced crusted scabies.

“There is no outbreak, that’s for sure,” she said, adding that only people in physical contact with those infested would be susceptible to the mites.

Norwegian scabies doesn’t refer to a different kind of scabies mite but to the level of infestation. Ordinary scabies may result in five to 10 mites over an entire body, while crusted scabies could result in hundreds or thousands of mites under the skin.

Those infested for the first time with the mites, known as Sarcoptes scabiei, typically don’t show symptoms -- mostly an itching on the skin-- until two to six weeks after their initial exposure.

“It itches like crazy,” said Dr. Robert M. Levin, Ventura County’s public health officer. This is the first confirmed case of crusted scabies in Ventura County in 2005; the last case occurred 10 months ago.

Los Angeles County has had five cases of crusted scabies reported this year, four of them detected during a hospital admission, and 17 cases in 2004, said Dr. David Dassey, deputy director of the county’s Department of Health Services acute communicable disease control program.

Anyone can contract crusted scabies, Dassey said, though it is more prevalent in people over 65 and those with weakened immune systems, such as patients with chronic renal failure, diabetics and people who have Alzheimer’s disease or have had a stroke, who may be bedridden and unable to communicate about their skin irritation.

Treatment involves a prescription lotion that is applied to the body from the neck down after a thorough bath or shower.

There is also an oral medication approved for this purpose, but it is not commonly available.