Scabies can be fought with one or two pills, and the protective effect will last for years, according to scientists.
At present, the standard remedy is a skin cream with an insecticide that does not provide long-term protection. In poor countries, pills can be distributed throughout the village, freeing entire communities from the parasite.
Although scabies are not fatal, they cause profound misery; Many people even find the idea disgusting. Two years ago, it was included in the list of neglected tropical diseases of the World Health Organization.
The scratching of the rash can cause impetigo, a bacterial skin infection with watery wounds.
Scabies are most common in poor countries, but can be found everywhere. It was diagnosed in American high school wrestling teams. In January, two firefighters in New York City, one of which had to close due to decontamination, reported cases of infestation among firefighters.
In the study published in the New England Journal of Medicine, Australian and Fijian researchers tested three treatment schemes in three groups of isolated island villages in Fiji.
One-third received the standard treatment prescribed in Fiji: people with scabies and their family members were given a permethrin-containing skin lotion. (Permethrin is an insecticide used in insect repellent garments and in some mosquito nets.)
In the second group, everyone in the village received the lotion.
In the third group all in the village who agreed to participate got an ivermectin pill; People with confirmed scabies received a second pill one week later.
Ivermectin, discovered in 1975 in Streptomyces avermitilis bacteria, is a powerful drug that kills many species of parasitic worms. Because Ivermectin lingers in the blood, it also kills insects that bite humans, including mosquitoes, lice and mites.
Nevertheless, the drug is safe enough to be administered to almost anyone except the youngest infants and pregnant women. It is also used in pets, for example, to kill heartworms. The inventors shared the Nobel Prize for Physiology or Medicine 2015.
After two years of follow-up in Fiji, less than 4 percent of the inhabitants of the villages that received ivermectin still had scabies. By contrast, the prevalence rate in the villages in need of care was 15 percent. In the villages where the inhabitants received topical permethrin, it was 13.5 percent.
In the ivermectin group secondary infections such as impetigo were 90% less common after two years than at the beginning of the experiment – far less common than in the other two villages.
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Effective because, according to the authors, the mass distribution of ivermectin must still be tested in larger, less isolated populations to see if the overall protective effect persists.
In 1971, a worldwide survey among dermatologists from the Journal of the American Medical Association revealed that scabies are increasing for unknown reasons around the world.
In the years following the Second World War, it was not uncommon to treat scabies with a DDT-containing lotion, especially in military hospitals. The use of topical DDT was later linked to some cancers by the World Health Organization.