A systematic review of scabies transmission models and data to evaluate the cost-effectiveness of scabies interventions.

BACKGROUND: Scabies is a common dermatological condition, affecting more than 130 million people at any time. To evaluate and/or predict the effectiveness and cost-effectiveness of scabies interventions, disease transmission modelling can be used. OBJECTIVE: To review published scabies models and data to inform the design of a comprehensive scabies transmission modelling framework to evaluate the cost-effectiveness of scabies interventions. METHODS: Systematic literature search in PubMed, Medline, Embase, CINAHL, and the Cochrane Library identified scabies studies published since the year 2000. Selected papers included modelling studies and studies on the life cycle of scabies mites, patient quality of life and resource use. Reference lists of reviews were used to identify any papers missed through the search strategy. Strengths and limitations of identified scabies models were evaluated and used to design a modelling framework. Potential model inputs were identified and discussed. FINDINGS: Four scabies models were published: a Markov decision tree, two compartmental models, and an agent-based, network-dependent Monte Carlo model. None of the models specifically addressed crusted scabies, which is associated with high morbidity, mortality, and increased transmission. There is a lack of reliable, comprehensive information about scabies biology and the impact this disease has on patients and society. DISCUSSION: Clinicians and health economists working in the field of scabies are encouraged to use the current review to inform disease transmission modelling and economic evaluations on interventions against scabies.

Quantifying behavioral changes in territorial animals caused by sudden population declines.

Although territorial animals are able to maintain exclusive use of certain regions of space, movement data from neighboring individuals often suggest overlapping home ranges. To explain and unify these two aspects of animal space use, we use recently developed mechanistic models of collective animal movement. We apply our approach to a natural experiment on an urban red fox (Vulpes vulpes) population that underwent a rapid decline in population density due to a sarcoptic mange epizooty. By extracting details of movement and interaction strategies from location data, we show how foxes alter their behavior, taking advantage of sudden population-level changes by acquiring areas vacated due to neighbor mortality, while ensuring territory boundaries remain contiguous. The rate of territory border movement increased eightfold as the population declined and the foxes' response time to neighboring scent reduced by a third. By demonstrating how observed, fluctuating territorial patterns emerge from movements and interactions of individual animals, our results give the first data-validated, mechanistic explanation of the elastic disc hypothesis, proposed nearly 80 years ago.

The use of radio-collars for monitoring wildlife diseases: a case study from Iberian ibex affected by Sarcoptes scabiei in Sierra Nevada, Spain.

BACKGROUND: Wildlife radio tracking has gained popularity during the recent past. Ecologists and conservationists use radio-collars for different purposes: animal movement monitoring, home range, productivity, population estimation, behaviour, habitat use, survival, and predator-prey interaction, among others. The aim of our present study is to highlight the application of radio-collars for wildlife diseases monitoring. The spread of wildlife diseases and the efficacy of management actions for controlling them propose serious challenges for ecologists and conservationists, since it is difficult to re-capture (or simply observe) the same animal in pre-determined temporal interval, but such difficulty is overcome by the use of gps-gsm radio collars. METHODS: In the present study we report, for the first time to our knowledge, the use of radio-collars in the monitoring of Iberian ibex affected by Sarcoptes scabiei in Sierra Nevada mountain range, Spain. Twenty-five moderate or slightly mangy animals were radio-collared between 2006 and 2013. RESULTS: The radio-collars allowed us to confirm the presence of resistance to S. scabiei within Iberian ibex population. Twenty (80%) of the collared animals recovered totally from mange, while the disease progressed in the other five Iberian ibex (20% of the collared animals) and the animals died. The average estimated recovery time of the resistant animals was 245 ± 277 days, and the estimated average survival time of the non-resistant Iberian ibex was 121 ± 71 days. Non-resistant animals survived at least 100 days, while all of them died with less than 200 days. Sixty per cent of the resistant animals were recovered with less than 200 days. CONCLUSIONS: We report, for the first time, the successful use of radio collars for wildlife diseases monitoring using Iberian ibex/S. scabiei as a model. By using radio collars we documented that most of the Sarcoptes-infected Iberian ibex are resistant to this disease, and we estimated the average time for Iberian ibex recovering from mange infection and the average survival time of the non-resistant ones. We expect wider use of radio-collars for wild animals diseases monitoring, affected/not-affected animals interaction, and treatment efficacy, among others.

A pathological study of sepsis associated with sarcoptic mange in raccoon dogs (Nyctereutes procyonoides) in Japan.

The pathological findings in Japanese raccoon dogs with sarcoptic mange infection associated with death from sepsis are described. Microscopical lesions of the skin were consistent with those described previously in wildlife populations with Sarcoptes infection, but secondary lesions were also present in the lungs, heart, kidneys, liver, spleen and brain of these animals. This infection was therefore very similar to "crusted scabies" or "Norwegian scabies" in man and was characterized by severe pathology and high mortality, with deaths frequently occurring due to sepsis.

Outbreak of sarcoptic mange in alpacas (Vicugna pacos) and control with repeated subcutaneous ivermectin injections.

An outbreak of sarcoptic mange was investigated in an alpaca herd. Clinical disease occurred 2 months after the introduction of four alpacas with dry seborrhoeic skin lesions, the cause of which was not investigated. Initially a group of females was affected, despite repeated topical treatment with ivermectin at a dose of 0.5mg/kg bodyweight. One female died and post-mortem examination indicated sarcoptic mange as the cause of death. Infection with Sarcoptes scabiei was also demonstrated on microscopic examination of skin scrapes taken from clinically affected cohorts. Later in the outbreak, a separate group of male alpacas was also affected. Treatment using subcutaneous ivermectin injections at a dose of 0.2mg/kg, administered at 14-day intervals, was evaluated. During this course of treatment, another female died. A successful response in the other alpacas was eventually reached following 12 treatments of the female group and 8 treatments of the male group.

Fatal Sarcoptes scabiei infection of blue sheep (Pseudois nayaur) in Pakistan.

Sarcoptes scabiei was detected for the first time in skin scrapings, hair pluckings, and histologic sections from a blue sheep (Pseudois nayaur) from the Shimshali Pamir in the Karakorum range of the western Himalaya in Pakistan (36 degrees 28'N, 75 degrees 36'E). Local reports suggest many hundred animals have been affected by a severe skin disease over a 10-yr period, but the shy nature of this species and the extreme climate that they inhabit meant only a single affected animal was available for detailed evaluation. The severe skin lesions were confined to the forelegs and brisket, and many Sarcoptes scabiei mites were present in all the samples examined. Histologic preparations of the skin showed hyperkeratotic and parakeratotic hyperkeratosis of the epidermis with a severe exudative dermatosis with many polymorphonuclear neutrophils and gram-positive cocci, yet no eosinophils. These findings might suggest the lack of an appropriate immune response to the parasite or other coping strategies because there has been no abatement of the clinical signs in affected animals over several years. Treatment options are limited due to the behavior of the species and its habitat. The blue sheep is a primary source of prey for the endangered snow leopard (Panthera uncia) and continued depletion could have serious consequences for the survival of the latter.

The rise and fall of psoroptic scabies in bighorn sheep in the San Andres Mountains, New Mexico.

Between 1978 and 1997, a combination of psoroptic scabies (Psoroptes spp.), mountain lion (Puma concolor) predation, and periodic drought reduced a population of native desert bighorn sheep (Ovis canadensis) in the San Andres Mountains (SAM), New Mexico, from >200 individuals to a single ewe. In 1999, this ewe was captured, ensured to be Psoroptes-free, and released back into the SAM. Eleven radio-collared rams were translocated from the Red Rock Wildlife Area (RRWA) in New Mexico into the SAM range and monitored through 2002 to determine whether Psoroptes spp. mites were still in the environment. None of these sentinel rams acquired scabies during this period, and no additional native sheep were found to be present in the range. In 2002, 51 desert bighorn sheep were translocated into the SAM from the Kofa National Wildlife Refuge in Arizona (n = 20) and the RRWA in New Mexico (n = 31). Twenty-one bighorn sheep have died in the SAM since that time, but Psoroptes spp. mites have not been detected on any of these animals, nor have they been found on mule deer (Odocoileus hemionus) sampled since 2000. We conclude that psoroptic scabies is no longer present in the San Andres bighorn sheep population and that psoroptic scabies poses a minimal to nonexistent threat to the persistence of this population at this time.

Diseases and mortality in free-ranging brown bear (Ursus arctos), gray wolf (Canis lupus), and wolverine (Gulo gulo) in Sweden.

Ninety-eight brown bears (Ursus arctos), 20 gray wolves (Canis lupus), and 27 wolverines (Gulo gulo), all free-ranging, were submitted to the National Veterinary Institute, Uppsala, Sweden, during 1987-2001 for investigation of diseases and causes of mortality. The most common cause of natural death in brown bears was infanticide. Infanticide also was observed in wolverines but not in wolves. Traumatic injuries, originating from road or railway accidents, were the most common cause of death in wolves and occurred occasionally in brown bears. Most wolverines were submitted as forensic cases in which illegal hunting/poaching was suspected. Sarcoptic mange was observed in several wolves but not in brown bears or wolverines. Sarcoptic mange most likely was acquired from infected red foxes (Vulpes vulpes) that were killed by wolves. Other parasites and infectious diseases were only found sporadically.

Morbidity and mortality of red foxes (Vulpes vulpes) and gray foxes (Urocyon cinereoargenteus) admitted to the Wildlife Center of Virginia, 1993-2001.

The medical records of 48 red foxes (Vulpes vulpes) and 35 gray foxes (Urocyon cinereoargenteus) examined at the Wildlife Center of Virginia (Waynesboro, Virginia, USA) from 1993 to 2001 were reviewed. The most common diagnosis in red foxes was orphaned (33%), followed by trauma (27%), undetermined diagnosis (23%), and sarcoptic mange (17%). Trauma (46%) was the most frequent cause of morbidity and mortality in gray foxes followed by orphaned (23%), undetermined (20%), toxoplasmosis (6%), presumptive canine distemper (3%), and rabies (3%). One gray fox had concurrent toxoplasmosis and presumptive canine distemper (3%). Similar diseases were detected in previous studies at a diagnostic laboratory; however in this study, trauma and orphaned animals were more common than infectious diseases. The lack of diagnostic information on some cases limited the usefulness of this study, and more emphasis should be placed on performing postmortem examinations of wildlife presented to wildlife rehabilitation centers.

Outcome of an interventional program for scabies in an Indigenous community.

OBJECTIVE: To implement an intervention program for reducing the prevalence of scabies in a large Northern Territory Aboriginal community. DESIGN: Prospective, longitudinal screening, intervention and follow-up study. PARTICIPANTS AND SETTING: All children aged 5 years and under in one of the largest Aboriginal communities in the Northern Territory, total population, approximately 2,200 (95% Indigenous). MAIN OUTCOME MEASURES: A decrease in prevalence of scabies, infected scabies and non-scabies pyoderma over seven months. RESULTS: The number of children aged 5 years and under screened intially and at the three follow-up screenings ranged from 201 to 242 (more than 98% of those eligible on each occasion). The prevalences of scabies, infected scabies and non-scabies pyoderma before intervention were 35%, 12% and 11%, respectively. At 6 weeks postintervention these had decreased to 3%, 1% and 4%, respectively; low prevalences were maintained at four and seven months. CONCLUSIONS: This intervention, which was based on community motivation, involvement and control, successfully reduced the prevalence of scabies. Continuing community health education and regular screening will be crucial in controlling scabies. The methods and results of this study may be helpful in developing a coordinated program for all remote Aboriginal communities in the area.

Lindane poisonings.

One percent lindane, widely used to treat scabies and pediculosis, presents toxicologic problems when used excessively. A 16-year-old mentally retarded boy accidentally ingested approximately 392 g of 1% lindane shampoo and recovered. A 2-month-old, 4.5-kg, male infant was found dead in his crib after excessive application of a 1% lindane lotion. In the former patient, initial serum levels of lindane were 206 parts per billion (ppb) declining to 1.0 ppb after 25 days. In the latter, lindane was identified in the brain at a concentration of 110 ppb. Brain levels of lindane were three times greater than the levels found in the blood. Although the relationship of this pesticide exposure to the fatal outcome in the second case was conjectural, it was illustrative of the problem of interpreting CNS events that occur shortly after excessive exposure to this insecticide.