Treatment for scabies proving tricky as cases rise among student populations

An illustration of the parasitic scabies mite which causes an itchy rash.
An illustration of the parasitic scabies mite which causes an itchy rash. Photo credit: Getty Images

By Samantha Gee for RNZ

Scabies cases are spreading among student populations, but access to treatment is proving difficult, with topical creams in short supply around the country.

Otago University Students' Association welfare and equity representative Kaia Kahurangi-Jamieson said cases of the skin condition caused by a parasitic mite spiked last August and seemed to be on the rise again.

"Anecdotally, there seems to be quite a prominence of scabies in the student community and that's coupled with a lack of availability of scabies cream and I've also heard it's quite difficult to get Ivermectin at the moment so it's really just in full force down here."

Ivermectin - which gained notoriety during the Covid-19 pandemic - required a prescription and the subsidised treatment was only available if people could prove a topical treatment had not worked.

Kahurangi-Jamieson said that seemed to be a result of issues with people trying to treat Covid-19 with the antiparasitic drug.

"One of the difficulties with that is it involves students having repeat appointments with the doctor... once they have hold of the cream and done multiple treatments that haven't worked, they have to go back and get another appointment and that's a big financial barrier for a lot of students."

But that was if they could find the topical treatments in the first place.

"I've heard of someone asking around to see if anyone had any spare scabies cream at their flat as they had been to a number of chemists and couldn't find it anywhere which is quite concerning."

Kahurangi-Jamieson said a lot of students were living in flats with four or more others, and trying to get everyone to do their laundry at once in a bid to halt the infection, especially given the lack of topical treatments, was challenging.

"It is a very treatable condition and luckily for us, it's not one that's hugely threatening in any way other than just being really, really inconvenient and contagious and those issues of contagion are particularly highlighted in student populations due to the close proximity of flatting.

"It's difficult to be doing your academic and social best when you are itchy all the time, I imagine."

As scabies is not a notifiable disease exact case numbers are unknown.

Canterbury Infection Management Service clinical director Dr Sarah Metcalf said there had been an increase in presentations and referrals for scabies management to GPs and private dermatologists over the last six months to a year, but there was no indication it was an epidemic.

Cases were being seen across Canterbury, the West Coast and other centres, with a high prevalence in student populations.

Metcalf said the spread of scabies was often exacerbated by crowded living conditions and it could be hard to diagnose, as many who had it did not know they were infected.

Oral ivermectin was only available on special authority if the patient met particular criteria and its use was endorsed by a microbiologist, dermatologist or infectious diseases specialist. In which case it would be subsidised.

In Christchurch, GP Dr Angus Chambers said he typically saw one or two cases a month, maybe less, but he had seen several in the last week.

"We run both a GP and urgent care business so people drop into us if they can't get into their GPs and we're quite close to the university and it seems as if the outbreak is involving the student population as well."

People with the infection suffer from an itchy rash - and all close contacts of an infected person need to be treated, Dr Chambers said.

"The usual treatment is a type of insecticide cream, but one of the problems is that that's become in extremely short supply at the moment so it's quite hard to get hold of it."

A Google search confirmed the subsidised topical permethrin treatment is sold out on most New Zealand pharmacy websites.

"It can drive people a bit around the bend the itch of scabies, it's a very, itchy rash and then of course, you can get secondary infections, sometimes bacteria start growing and that can bring with it some dangers."

Pharmac said stock of 5 percent permethrin lotion was critically low and additional stock was being airfreighted into the country within the next one to two weeks.