Epidemic scabies in four Caribbean islands, 1981-1988

ABSTRACT

Scabies infestation has been reported to the PAHO/WHO Caribbean Epidemiology Centre (CAREC) from Trinidad and Tobago (T&T), Grenada, Dominica, the Turks and Caicos islands (T&CI) and, more recently, St. Lucia. Epidemic scabies was being reported from T&CI in 1981 (1200/100000 population), but there were no reports from T&T until 1982 (8/100000). The first phase of the bimodal epidemic in Grenada ocurred between 1982 and 1984 (9132/100000) and the explosive second phase from 1985 to 1987 (474-699/100000). In T&T there was a low incidence of scabies until 1985 (0-59/1000000 and in Dominica the rate fluctuated (67-14/100000) during the same period. From 1986 to 1988, scabies infestation reached epidemic proportions in T&T (410-709/100000) and fluctuated in Dominica (108-117/100000). In Tobago alone, scabies was not reported until March 1986, and by December the incidence rate was 105/100000; by 1988 it had increased to 1124/100000 population. Although no secondary infections have been reported from Grenada, Dominica, T&CI or St. Lucia, T&T has reported increased streptococcal skin infections and epidemic post streptococcal skin infections and epidemic post-streptococcal acute glomerulonephritis (PSAGN). The observed trend of increasing scabies infestation, increasing streptococcal isolates from skin lesions, and increasing PSAGN in T&T is noteworthy. (AU)