Several patients at a Lakewood, New Jersey nursing home have received treatment in the wake of a suspected scabies outbreak earlier this month, NJ.com reports. Officials at the Fountain View Care Center notified the Ocean County Department of Health on February 7, 2019 that a number of its resident may have come down with the mite infestation, which is marked by relentless, intense itching and a pimple-like skin rash.

Jennifer Crawford, supervisor for the county health department’s communicable disease unit, confirmed that the suspected outbreak was confined to residents at Fountain View Care Center.

Tests Negative For Scabies

Four patients and three staff members at the facility tested negative for scabies after receiving treatment, but since the infestation is difficult to diagnose, those negative results don’t necessarily mean that they didn’t have scabies at one time. Nicole Kirgan, a spokeswoman for the state health department, says three additional tests are still pending results.

State health officials say the Fountain View Care Center has been properly decontaminated. Representatives of the facility have been in regular contact with officials at the county department of health. “The last update was yesterday and we’re comfortable everything is being properly addressed,” Crawford told NJ.com.

What Is Scabies?

Scabies is not an infection. It’s not spread by a bacteria or virus. Instead, scabies is an infestation, in which tiny mites known as Sarcoptes scabiei colonize the outer layers of human skin, burrowing down and laying their eggs. This causes intense itching and a rash.

Scabies Symptoms

Scabies infestations are slow to show themselves, according to WebMD. When a person is first infested with mites, the skin symptoms may not appear until four to six weeks later:

• intense itching, particularly at night
• pimple-like rash
• scales or blisters
• sores caused by scratching

Scabies mites are able to live anywhere on the human body, but they prefer to make their homes between the fingers, at the folds of the wrist, elbow and knee, around the waistline and navel and on the breasts or genitals. In young children, infestations are commonly seen on the head, neck, face, palms and soles of the feet.

Diagnosing An Infestation

Scabies is difficult to diagnose because it can easily be mistaken for other skin conditions, including mosquito bites and acne, because the rash looks similar to these other conditions. Scabies is differentiated by the relentless itching it causes, which is most severe in children and the elderly.

The infestation can also be distinguished by the appearance of linear burrows under the skin, raised tracks where female mites have tunneled below the skin and laid their eggs. After tunneling a burrow, each female mite lays between 10 and 25 eggs inside the tunnel.

Most people with a scabies infestation only carry around 10 to 15 mites at a given time. Since each mite is less than half a millimeter long, spotting the critters on the skin is very difficult. To the naked eye, scabies mites appear as tiny black specks on the skin, but lab tests using a microscope can identify mites and eggs from a skin scraping upon closer inspection.

How Is Scabies Spread?

Scabies outbreaks are most common in nursing homes, day care centers, prisons and long-term care facilities, because the rash can only be spread under crowded conditions where people are in close contact with one another. The mites spread through prolonged, skin-to-skin contact (more than a hug or handshake), since the mites need enough time to crawl from one person to the other.

The infestation is common among both staff members and residents in nursing homes because caregivers often assist patients with daily living tasks, including bathing and dressing. The US Centers for Disease Control & Prevention recommends that all new patients and staff members in long-term care facilities be screened for scabies prior to admission.

Scabies mites are unable to jump or fly, and they crawl very slowly. In some cases, shared personal items, such as bedding, clothes, or towels, can also transmit scabies mites.