Why we need to pay more attention to scabies in New Zealand children

Dr Simon Thornley, a senior lecturer in the School of Population Health led a study, published in the Journal of Paediatrics and Child Health in 2018, that found that Auckland children diagnosed with scabies were more likely to develop acute rheumatic fever, which can cause long-term heart damage and death.

Both diseases are linked to poverty and overcrowding, and disproportionately affect Māori and Pacific children.

Scabies, a skin disease caused by a tiny parasitic mite, is also linked to impetigo, kidney disease and bacterial skin infection. Researchers have speculated that rheumatic fever is a complication of scabies.

Dr Thornley says prescribing data and small clinical studies suggest scabies is common in New Zealand and the diagnosis is frequently missed. And when people are diagnosed, they are unlikely to receive the optimal treatment.

“Most patients in New Zealand are unable to access the most effective treatment for scabies, Ivermectin, because of a lack of government funding,” he says.

“Farmers and vets can use it with impunity, but the treatment is reserved for only severe cases in humans.”

Dr Thornley and fellow researcher, Dr Gerhard Sundborn, organised a symposium on the topic in September as part of a drive to put scabies on the public health and research radar.

Little progress has been made with rheumatic fever prevention campaigns using traditional methods of early treatment of bacterial throat infection, they say. Focusing on diagnosis and treatment of scabies offers a promising new approach to tackling rheumatic fever.

“We have produced evidence showing a strong link between scabies and rheumatic fever and believe that the issue of scabies badly needs addressing in New Zealand, but the Ministry of Health and district health boards show little enthusiasm for tackling the problem,” Dr Thornley says.

“This is in contrast to Australia, where there are NGOs tackling the disease and crusted scabies is notifiable. Considering that the Western Pacific is the highest scabies prevalence area in the world, we believe that the issue needs attention and focus.”