Scabies is a skin disease caused by infestation with the mite Sarcoptes scabiei var. hominis. Closely related species of mite cause mange in animals. Although not fatal, scabies causes considerable morbidity (illness) through direct effects and occasional and mortality as a result of secondary bacterial infections.
Although it occurs worldwide, scabies is a truly neglected disease, largely absent from the global health agenda, and its huge burden of disease is largely underappreciated. Children in developing countries are most susceptible, with an average prevalence of 5–10%. The highest incidence is in tropical climates, with rates of up to 25% overall and up to 50% in some communities in the South Pacific and northern Australia. Poverty and overcrowding are the main risk factors, and outbreaks in institutions and refugee camps are common. Scabies causes intense itch, severely affecting sleep and quality of life. Crusted scabies, a severe infestation with thousands of mites, is associated with extremely high risk of contagion and causes considerable morbidity due to secondary bacterial infections.
Management of scabies is centred on identification and treatment of cases and household contacts, but there is little data to support this as an effective strategy for reducing scabies prevalence. Diagnosis can be difficult and is reliant on clinical identification in most tropical areas. Topical treatments are effective, but the most effective of these, permethrin, is relatively expensive and unavailable in many high-prevalence areas.
The International Alliance for the Control of Scabies (IACS) is a recently formed group from across the globe to advance the agenda of scabies control. The alliance is committed to the control of human scabies infestation, and to promoting the health and well-being of all those living in affected communities. Initial membership includes a diverse range of professionals including clinicians from high-prevalence areas, public health physicians, policy makers, and researchers studying the biology of the parasite, and continues to grow with identification and recruitment of further collaborators.