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Scabies outbreak among Utrecht students: ‘The itch kept me awake for nights’

Body: 

Skin bumps, red streaks, extreme itching: the itch mite is plaguing the student homes of Utrecht. Scabies is becoming a common diagnosis in the doctor's practice. "By spending a long time in each other’s homes, cuddling, or sleeping in each others’ beds, we help scabies to spread faster".

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Anna* studies Interdisciplinary Social Science at Utrecht University. Last year, she spent the night with a guy who had suffered from scabies a while before. He was treated for it and his symptoms disappeared — so, thus far, nothing out of the ordinary. However, earlier this year, Anna herself started getting small bumps. At first, she thought she might be allergic to something, but when her skin started to show streaks as well, the penny finally dropped: "I've got to see my GP, I have scabies." That's why she prefers not to share her story under her real name here.

The number of people seeing a doctor because of scabies has been strongly increasing since the autumn of 2021, according to the Netherlands Institute for Health Services Research (Nivel in the Dutch acronym). The number of scabies cases has been slowly increasing these past few years. While in 2014, a hundred people were affected by scabies per 100,000 inhabitants, in 2019 this number raised to 210 cases and in 2020, to 260 cases.

GPs in Utrecht cannot help but notice the increase in their practice. Sanneke Molthof, general practitioner and board member of umbrella organisation Utrecht City GPs, has been noticing "many more problems related to scabies" in the city, especially among students. Another doctor, Sanne Hillebrand of the Daltonlaan GP practice, agrees there’s been "an increase compared to two or three years ago."

Nocturnal digger
Scabies is caused by the itch mite, also known as Sarcoptes cabiei var hominis. The female mite uses its prickly legs to dig passages in the epidermis. Our fingers, wrists and the inside of our elbows are their favourite places to lay eggs. After a week, the eggs hatch into larvae that live on the skin. These larvae are so small that they can hardly be spotted with the naked eye.

If you have more than 15 minutes of immediate skin contact with someone with scabies, the mite can "jump across". It can also be transferred through clothes, towels, and bed linen.

Although it’s a relatively harmless skin condition, scabies can be pretty annoying. No wonder itch mites have "itch" in their name: they plague their new residents with extreme itching, red spots and small bumps. The skin can also show streaks where the mite digs its passages. Itch mites get especially active at night, in a warm bed. 

"The itch kept me up for several nights," says Anna, who was itchy on her hands, feet and armpits. "One night, during exam week, I was lying awake crying, thinking: "And I absolutely have to take an exam tomorrow."

She tried to suppress the itch with home remedies, like antihistamines. She also wore gloves at night to keep herself from scratching her skin. To no avail. "It only made things worse because the gloves made my hands warmer. After five days I called my GP again because I just couldn’t stand the itch anymore."

Lubricate, lubricate, lubricate
Scabies can be treated with an ointment like permethrin or with ivermectin pills. The ointment is available behind the counter, but the pills require a prescription. Strict hygiene measures are also part of the treatment: one has to wash all clothes, bed linen and towels at 60 degrees or keep them in sealed bin bags for three days. Roommates should do the same to prevent (re)contamination.

With Anna, the scabies bumps just kept coming back. And since the itch only got worse and worse, she was prescribed pills in addition to the ointment. Three months, eight ointments and five pill strips later, the scabies was completely gone. "I was lubricating, taking pills, lubricating, taking pills... Everything I touched had to be washed at 60 degrees every time. I followed the treatment by the book, but scabies just kept coming back".

"I must have washed my bedlinen a million times. Your bed has to be clean every time you go to sleep. During the day you wash your bed linen and the next morning you wash it again. At some point, I put everything from my closet in plastic bags and left it there for a week. My GP had no idea why it didn’t go away either."

Together on the couch
According to Utrecht-based GP Sanne Hillebrand, scabies can spread for quite a while without being noticed because their incubation period can take up to ten weeks. "During those ten weeks, you are contagious. By the time you realise you have scabies, you may have already infected other people, who will in their turn infect others."

The GP suspects that the pandemic might have played a role in the scabies outbreak. "All the restaurants and nightclubs were closed, causing students to throw more house parties. By spending a lot of time in each others’ homes, cuddling and sleeping in each others’ beds, students enabled the mites to spread much faster". 

Anne knows some fellow students who also became infected with scabies. "In some groups of friends, almost everyone has had it. Some friends of mine had to be treated because their housemates were infected."

Great panic
In Anna’s student home, which she shares with nine other people, luckily nobody else got infected. Perhaps one other housemate, but scabies is lingering around in his group of friends as well. She says some of her housemates reacted "in great panic". Anna: "it was their worst nightmare that we had scabies in our home, but most housemates were calm."

Back when Anna has scabies, her love life came to a halt. "You don’t spend the night with someone," she says. Movie nights with friends were a hassle as well. "We had to be very cautious. After all, I didn't want to pass it on to anyone else."

Mini bump
Anna is not ashamed of having had scabies. "It wasn’t my fault," she shrugs. Even so, she acknowledges that many people are disgusted by the idea, especially non-students. "I did get remarks like 'scabies, isn’t that something from the Middle Ages?' Or 'You students are just gross'"

Luckily, among students, most people were understanding, especially because many student homes had to deal with the same problem. "Many people in my immediate vicinity had it too and they were just as frustrated as I was. I called friends for advice, about the treatment for example. The fact that they understood helped me too."

Although Anna is now free of scabies, she thinks about it every now and then. "Every little bump I see on my skin or every little itch I think: 'No, not again!' I still have a little bit of an itch in the places where I had it. I don’t know if that’s just in my head or if it really is itching. But I try not to overthink it."

*DUB's editors know Anna's real name.

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