Updated Public Health advice in relation to scabies for children and young people

The Health protection in children and young people settings, including education - GOV.UK (www.gov.uk) guidance is to be updated shortly. Wording in the scabies section is to be changed to advise there should be no enforced exclusion from school for scabies. This change has been driven by a desire to ensure any exclusion advice for missed education is proportionate and balanced against the risk of infection, taking into account any equity issues.

Original wording:

Exclude affected children from nursery or primary school settings until after the first treatment has been completed.

Older children can attend school settings with advice to avoid close skin contact with others until after the first treatment has been completed.

Contact your UKHSA HPT if there are 2 or more cases of scabies within your setting.

Encourage the affected individual to complete all recommended doses of treatment. It is important that the full treatment course is completed. This may involve several treatments spread out over time.

In line with clinical recommendations, all household contacts and any other very close contacts should also receive treatment at the same time as the case, and should also complete their full course of recommended treatment. Contacts do not need to be excluded from the setting.

Updated wording:

Affected individuals can attend the setting with advice to avoid close physical contact with others until 24 hours after the first dose of chosen treatment.

Young children not able to adhere to this advice due to their age (e.g. those under 5 years old) or additional needs, should be excluded from the setting until 24 hours after the first dose of chosen treatment. The risks/benefits of this should be reviewed on a case by case basis and take into account the holistic needs of the individual and the impact on their wellbeing, as well as the risk of transmission of scabies to the wider school population. 

Encourage the affected individual to complete all recommended doses of treatment. It is important that the full treatment course is completed.  This may involve several treatments spread out over time.

In line with clinical recommendations all household contacts and any other very close contacts should also receive treatment in a manner that is coordinated with the case and should also complete their full course of recommended treatment. 

If the case is treated before the contacts, the case should then be re-treated at the same time as ongoing contacts to prevent reinfection.

Contacts do not need to be excluded from the setting.

Contact your UKHSA HPT if there are 2 or more cases of scabies within your setting.

Other guidance pieces will also be updated to reflect this change, this includes UKHSA guidance on the management of scabies cases and outbreaks in long-term care facilities and other closed settings - GOV.UK (www.gov.uk) and the NHS website Scabies - NHS (www.nhs.uk)